To PC or not to PC???

[pharmunsure]

Hi there,

I've been having a discussion with a pharmacy friend about what we can and cannot legally change on a prescription and endorse either PC or PNC. I've always been pretty strict with changes and requested new script for amendments ie quantity/strength/form however my friend she just PC or sometimes PNC an ammendment ie giving caps instead of tablets, giving different strengths etc as long as the patient is OK with the change.... What are the limits to PC and PNC? A chappy at the NPA told me anything can be PC'ed except the actual drug, is that so?

[johnep]

PNC routine with requests for Amoxicillin Tabs, Penicillin and Erythromycin 500mg.
johnep

[Sinister]

good question. let's say the rx is for escitalopram 20mg which was out of stock recently and i just give 2x10mg. can i in theory just write the 'pc' and put the rx through?
or rx says normacol granules, patient is expecting sachets (was always on sachets)? can i just endorse as sachets 'pc' and forget it?

[Pharmanaut]

good question. let's say the rx is for escitalopram 20mg which was out of stock recently and i just give 2x10mg. can i in theory just write the 'pc' and put the rx through?
or rx says normacol granules, patient is expecting sachets (was always on sachets)? can i just endorse as sachets 'pc' and forget it?

Watch out for this.
The CIP used by the PPA/PPD now ignores any endorsments unless you put an asterisk before and after the drug name, which then makes the system snag to a manual operator.
At least the last I heard from the PSNC that was the case.

Also remember doubling up might help the patient, but you do not get paid for what you have issued unless countersigned by the prescriber.

[bobbin]

good question. let's say the rx is for escitalopram 20mg which was out of stock recently and i just give 2x10mg. can i in theory just write the 'pc' and put the rx through?

No, if the script is for 20mg tablets you will be paid for the 20mg tablets unless the script has been returned to the prescriber for amendment. The PC endorsement will not be accepted.

[bobbin]

giving caps instead of tablets, giving different strengths

The PC endorsement cannot be used to change what has been prescribed. The PPA pays pharmacies based on what has been prescribed, not what has been endorsed. Endorsements are only required when additional information is needed for pricing eg. pack size used for dispensing - if more than one size is available. Most items do not require an endorsement.

The PC (prescriber contacted) and PNC (prescriber not contacted) endorsements are only needed when.........

1. The quantity or strength of the prescribed product has not been stated.

......and........

2. It is not convenient for the prescription to be returned to the prescriber for the quantity/strength to be added.

In theory, the PNC endorsement is only used when it has not been possible to contact the prescriber.

Here is some information from the PPA.................

Strength not stated by the prescriber and:-

* the prescription item has more than one strength
* the strength is not stated by the prescriber
* the pharmacist endorses that the larger strength has been dispensed.

In these cases the prescription must also be endorsed by the pharmacist either p.c. or p.n.c. (and initialed and dated) without either of these endorsements, the NHS Prescription Services is unable to accept the larger strength as added by the pharmacist and is required to return the form.

Action needed by pharmacists: ensure that p.c or p.n.c is endorsed (and initialled and dated).

Number or quantity not stated by the prescriber

* the number or quantity is not stated by the prescriber
* where the prescriber is contacted, the number/quantity should be added by the pharmacist, with p.c. (and initialed and dated)
* where the prescriber cannot be contacted, the pharmacist may supply sufficient to complete up to 5 days treatment (with the exceptions as outlined in the BNF). The number/quantity should be added by the pharmacist, with p.n.c. (and initialed and dated)
* without either of theses endorsements, the NHS Prescription Services is unable to accept the number/quantity added by the pharmacist and is required to return the form.

Action needed by pharmacists: ensure that p.c. or p.n.c. is endorsed (and initialled and dated).

Situations where the use of p.c. or p.n.c. is not an acceptable endorsement

The convention of using the p.c. or p.n.c. endorsement relates to systemically administered preparations (other than controlled drugs) where the strength, number or quantity is not stated by the prescriber. An endorsement of p.c. or p.n.c. cannot be accepted by the NHS Prescription Services when e.g.:

* A different presentation has been dispensed to that prescribed, for example tablets x prescribed which are available in two presentations non-modified release and modified release. The use of p.c. to supply the modified release cannot be accepted by the NHS Prescription Services and instead the prescriber's endorsement is needed
* A different drug/appliance/dressing has been dispensed to the one prescribed.

[johnep]

So when we get a script for a cream and the instructions say 'take one tablet twice a day'?
johnep

[bobbin]

So when we get a script for a cream and the instructions say 'take one tablet twice a day'?
johnep

There is no need to endorse anything. The PPA have no interest in the dosage instructions whatsoever because they are not necessary to calculate your payment. The only exception is when the dose is necessary to calculate the quantity eg. dental script that says '1 tds for seven days' and no quantity stated.

[Sinister]

bobbin, just wanted to say a big thank you. Your info is very useful.

[bobbin]

bobbin, just wanted to say a big thank you. Your info is very useful.

You're welcome!