Endorsing FP10 Prescriptions
(Last updated 02/07/2008)
Learning Objectives
On completion of this package you will:

Know who can dispense FP10 prescriptions

When necessary be able to endorse prescriptions to show what product has been
supplied

Be able to identify prescriptions that require endorsement because extra dispensing
fees will be paid (for dispensers in community pharmacies)

Be able to calculate how many professional/dispensing fees are due and how many
patient charges should be collected if the patient pays for their prescriptions
The package is divided into the following sections:

Who can dispense an FP10 prescription?

Endorsements That Clarify What Has Been Dispensed

Endorsements for Claiming Additional Fees

Endorsements to prevent the dispenser from being out of pocket

Endorsements to show the number of professional fees and patient charges
People who supply drugs or appliances on FP10 prescriptions have to hold a contract to
provide Pharmaceutical Services. The Drug Tariff published by the NHS Business
Services Authority Prescription Pricing Division sets out the rules for the reimbursement
and remuneration of contractors who provide these services. The rules sometimes do not
apply to all types of contractors. This package is applicable to both community
pharmacies and dispensing doctors and where the rules do not apply to dispensing
doctors this is clearly indicated. You will find it useful to look at the Drug Tariff as you
work your way through this package.
The Drug Tariff can be found electronically at
www.ppa.org.uk/ppa/edt_intro.htm
Who can dispense an FP10 Prescription?
When you receive a prescription from your GP, you probably take it to a pharmacy
(chemists) for dispensing. There are a few other places where an FP10 prescription can
be dispensed. From the following list select those places where you think they should
have a contract to dispense NHS prescriptions in addition to community pharmacies:

Doctors surgery / practice premises

Hospital pharmacy

Post office

Medical appliances and sundries supplier

Family planning clinic
Follow this link to check your answers.
You may want to discuss which groups of professionals you think should have a contract
to dispense FP10 prescriptions with your colleagues or lecturer. There are different points
of view about how restrictive the NHS needs to be in awarding contracts for supplying
pharmaceutical services. Developments in IT mean that delivery of dispensed medicines
from a remote location is a viable service, do you think the NHS should encourage this
route of supply? What are the advantages and disadvantages for patients?
Most prescriptions are dispensed through pharmacies. The pharmacy has to have a
contract with their local primary care trust to provide pharmaceutical services before
payment is made to the owner of the pharmacy for supplying drugs and appliances on
FP10 prescription.
Other places where NHS prescriptions can be dispensed
Doctors in rural areas may have a contract for providing pharmaceutical services and such
doctors are referred to as dispensing doctors.
The majority of GP practices do not dispense FP10s for their patients. Before a patient is
eligible to receive dispensed medicines from a dispensing doctor specific criteria have to
be met. For example the patient would have serious difficulty in obtaining any necessary
drugs or appliances from a pharmacy by reason of distance from the pharmacy.
Dispensing doctors can supply any drug to their patients providing the drug is not in
Schedule 1.
Patients may require immediate treatment with a drug or appliance at the doctor's
premises. In this situation the doctor cannot write an FP10 to receive payment for
supplying the drug or appliance. Some products that are not needed for immediate
treatment (for example vaccinations and some forms of contraception such as IUDs) also
have to be administered by a GP or nurse and these are included
in the list of items that a doctor can administer personally to a patient. FP10 prescriptions
are submitted to the Prescription Pricing Division by both dispensing and non-dispensing
GPs to claim payment for personally administered items. The full list of these
items can be found in the doctor’s Statement of Financial Entitlements
http://www.dh.gov.uk/PublicationsAndStatistics/Publications/
PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/
en?CONTENT_ID=4107508&chk=dc/lzz
There are several vaccines that doctors "personally administer" in high volumes such as
influenza vaccination (often the practice nurses are responsible for giving these to
patients). The GP practice claims payment for these specific High Volume Vaccines using
the form FP34D Appendix for Dispensing Doctors and FP34PD Appendix for Prescribing
only Doctors.
NHS hospitals do dispense prescriptions from their pharmacy departments but these are
prescriptions written by doctors employed by the hospital trust. Hospital prescriptions are
paid for from the hospital's budget. A NHS hospital can not dispense FP10 prescriptions
and send them to the Prescription Pricing Division for reimbursement at NHS expense
since they do not have a contract with their local primary care trust.
Post offices can not dispense NHS prescriptions. They would not be granted a contract to
provide pharmaceutical services unless their premises were also eligible for registration
with the Royal Pharmaceutical Society as a pharmacy.
The owner of a medical appliances and sundries outlet can apply for a contract to
dispense FP10 prescriptions. Such Appliance Contractors can only dispense FP10s for
appliances in Part IX of the Drug Tariff.
Family planning clinics do supply contraceptives to their patients but they do not use FP10
prescriptions for the supply. They are allowed to supply drugs that are paid for from the
clinic's budget in the same way as for drugs prescribed in an NHS hospital. The NHS has
changed in accordance with the National Plan and new ways of providing medical and
pharmaceutical services have been developed. For example walk-in-centres have been
established and some drugs can now be supplied to patients under protocols known as
patient group directions (PGD). FP10 prescriptions are only used to provide drugs and
appliances where the service provider has a contract with the primary care trust to provide
medical and/or pharmaceutical services.
Endorsing FP10 Prescriptions
The remaining sections of this package provide the opportunity to learn more about best
practice for dispensers when endorsing NHS prescriptions in accordance with the Drug
Tariff. We have provided examples of items that could be prescribed by GPs on FP10:you
need to decide how you would endorse the prescription. You will find the Drug Tariff and
the British National Formulary helpful in completing the exercises.
The remuneration paid to dispensers differs depending on the type of dispensing
contractor. If you would like to know how remuneration is calculated follow this link to our
section on Drug Tariff Guidance: Remuneration
Dispensers are sometimes advised that it is better to add too much information as an
endorsement than too little. This is because of a concern that the contractor will receive
less payment than they perhaps should receive because of missing information.
However, adding unnecessary information takes more time for the dispenser, as all
endorsements have to be read to determine whether the endorsement can be allowed.
This slows down the processing of prescriptions. Best practice is to add the correct
endorsements and exclude extraneous information. Pharmacy computer systems often
contain software to print endorsements on the FP10. Dispensers still need to read each
endorsement to ensure that they are making valid claims for payment. Claiming for an
item that has not actually been dispensed is fraud.
Endorsements That Clarify What Has Been Dispensed
Every dispensing contractor will be reimbursed the basic price of the drug or appliance
that has been dispensed. The basic price of the drug is defined in the Drug Tariff Part II
Clause 8. If the drug, appliance or chemical reagent is included in the Drug Tariff Parts
VIII or IX, the basic price is the price listed in the Drug Tariff. If a drug is not listed in Part
VIII of the Tariff, the basic price is the list price, for supplying to contractors, published by
the manufacturer, wholesaler or supplier. Follow this link for more information on Parts
VIII and IX.
When a drug that is not in Part VIII is available in different pack sizes, the basic price will
be based on the pack size to be used for a prescription for the quantity ordered. For
products in Part VIII or IX the pack sizes to be used in calculating the basic price are
listed.
Sometimes it is clear from the prescription exactly what product and which pack size
should be used to determine the basic price. However the dispenser may need to
endorse the prescription to show more information about the product or the pack size.
For generic products listed in Part VIII of the Drug Tariff no endorsement is required
except for the few items that are listed with more than one pack size.
For generic products not listed in Part VIII of the Drug Tariff, endorsements to show the
source of supply of the product and the pack size are required. However if there is only
one source of supply and one pack, no endorsement is necessary.
For proprietary products endorsement of the pack size is only required if there is more
than 1 pack size available. If there is more than 1 pack size available and no
endorsement is present reimbursement will either be on the basis of the common pack
size (Drug Tariff Part VII) or if no common pack size by using the next largest pack size to
the quantity ordered.
For items that are rarely prescribed, the supplier, pack size and basic price excluding VAT
need to be endorsed.
For products that are prescribed by a formula, the dispenser can either supply the product
by dispensing extemporaneously in the dispensary or by asking a specials manufacturer
to prepare the product for dispensing. If a specials manufacturer is used, the prescription
must be endorsed with the relevant details i.e. source of supply and the price.
Consider the following examples of products that can be prescribed on FP10. What
endorsement (if any) would you make on the prescription? Reading the Drug Tariff Part II
Clauses 9 and 10 will help you find the answers. You will also need to consult Part VIII of
the Drug Tariff.
Click on the titles to find the answers e.g. on Example 1
Example 1
Codeine Linctus 15mg/5ml sugar free 200 ml
Example 2
Tabs Dexamethasone
2mg x 60
Example 3
Docusate Caps 100mg x 30
1 qds if required
Example 4
Ginger Syrup mitte 200ml
Example 5
Methadone HCl 15mg
Glucose Liq 0.5ml
Mixt Mag Hydrox ad 10ml
Mitte 200ml
Example 6
Suppos metronidazole
500mg 25
Example 7
Nimodipine Tabs 30mg
mane X 28
Example 8
Tab Keflex 250mg
Sig 1 qds
Example 9
Atenolol Tabs 50 mg
mane X 30
Example 10
Tabs Trinordiol 3 x OP
As directed
Example 11
Oilatum Emollient 300ml
Example 12
Easifix Crinx bandage 5cm x 2
Example 13
Bordered Granuflex
10 x 10cm 2 OP
Endorsements That Clarify What Has Been Dispensed
Example 1
When a product is prescribed by generic name you should check whether it is listed in
Part VIII of the Drug Tariff. Codeine linctus 15mg/5ml sugar free is listed in Part VIII as
Category A. The only endorsement that might be required would be the pack size. There
is however only 1 pack size listed in Part VIII and therefore no endorsement is necessary.
The prescription will be priced using the Part VIII price. If a pack size different from the
Part VIII pack was endorsed, it would be ignored. If a pharmacist endorsed the FP10 with
the name of a proprietary brand of codeine linctus, this would not be accepted since the
product is in Part VIII.
Products listed in Category A are readily available from a number of
manufacturers/suppliers.
Example 2
Dexamethasone tablets 2mg are listed in Part VIII as Category A. The only endorsement
required for products in Part VIII is the pack size if more than one pack size is listed.
Dexamethasone tablets 2mg are listed as pack sizes of 50, 100 and 500. Depending on
which pack the dispenser used, he or she would endorse accordingly. If the pack size
were not endorsed, the prescription would be priced using the 500 pack size because this
is listed as the common pack.
Example 3
Docusate capsules 100mg are included in Part VIII Category C. This means that they are
priced based on a particular brand or particular manufacturer, in this case the Dioctyl price
will be used. There are 2 pack sizes listed in Part VIII and therefore the endorsement is
the pack size used for dispensing. If there were no endorsement, the prescription would
be priced using the next largest size to the quantity ordered on the prescription.
Example 4
Ginger Syrup is included in Part VIII Category E. This is an item that is normally
extemporaneously prepared. No endorsement is required because the prescription will be
processed using the Part VIII price and pack size stated. An additional fee will be paid if it
is dispensed in a pharmacy and the prescriber orders an extemporaneously prepared
liquid preparation to be supplied in more than one container (see Drug Tariff Part IIIA 2C)
Example 5
This is a preparation that has to be extemporaneously prepared and therefore an
additional fee will be paid if it is dispensed in a pharmacy. The Dispenser needs to
endorse the prescription extemporaneously dispensed before they will receive the
additional fee. Each of the ingredients in the formula is listed in Part VIII as Category A
with only one pack size. No endorsement is needed for the pack or quantity supplied.
Example 6
Metronidazole suppositories 500mg are not listed in Part VIII and therefore Part 11 Clause
9 requires the endorsement of the brand name or the name of the manufacturer or
wholesaler from whom the supply was purchased. There are several suppliers of
metronidazole suppositories and either a proprietary or a generic product could be
supplied. A pack size would only need to be endorsed if there was more than 1 pack size
available.
Example 7
Nimodipine tablets 30mg are not listed in Part VIII and therefore Part II Clause 9 requires
the endorsement of either the brand name or the name of the manufacturer or wholesaler
from whom the supply was purchased. In this example Nimodipine is only available as
one brand (proprietary product) and if you don’t endorse the brand name or supplier, the
prescription will be processed because the Prescription Pricing Division will know that
Nimotop will have been dispensed. You do not need to endorse the pack size because
Nimotop 30mg tablets are only available in 1 pack size.
Example 8
Keflex tablets 250mg are a proprietary product that is priced according to the
manufacturer’s list price. Did you notice that the prescriber had completed the number of
days’ treatment box? Before dispensing you would calculate that 28 tablets are required.
Many dispensers would endorse the actual quantity given as well as the pack size when
the number of days’ treatment box has been used. If there were no endorsement it would
be calculated that 28 tablets were required and the common pack size would be used to
price the prescription because Keflex tablets 250mg are included in the list of drugs with a
commonly used pack size in Part VII.
Example 9
Atenolol 50mg tablets are included in Part VIII Category M. Only one pack size of 28
tablets is listed. No endorsement has to be made but the dispenser may wish to add one
because Atenolol tablets are supplied in a calendar pack (see Drug Tariff Part II Clause
10C). The prescriber has ordered 30 tablets. The dispenser could supply 28 tablets
because this is the quantity in the calendar pack. However the dispenser could also
decide that the prescriber's intention is for the patient to receive the exact quantity ordered
and therefore supply 30 tablets. If the dispenser supplies the exact quantity, the quantity
must be endorsed e.g. 30/28 or 30 ex 28. If there is no endorsement of the quantity, it will
be assumed that the number of packs or sub-packs nearest to the quantity ordered has
been supplied. Products listed in Category M are readily available from a number of
manufacturers/suppliers. The Department of Health determines the price they will pay for
a product in Category M.
Example 10
Trinordiol tablets are a proprietary product and therefore the prescription must be
endorsed with the pack size. They are available as a calendar pack containing 3 strips of
21 tablets. The difficulty for the dispenser is what did the prescriber mean by 3 x OP. The
abbreviation OP is usually understood to mean original pack. Did the prescriber intend 3
strips i.e. 63 tablets or 3 packs i.e. 189 tablets. 63 tablets provide 3 months treatment and
189 tablets provide 9 months treatment. If the prescription is not endorsed to show how
many tablets have been supplied, it will be referred back to the dispenser to clarify the
quantity. The abbreviation OP is best avoided since it causes confusion.
Example 11
Oilatum Emollient bath additive is a proprietary product and therefore the prescription
must be endorsed with the pack size. The GP has prescribed 300ml but the product is
actually available in 250ml and 500ml packs. The arrangements for supplying special
containers apply to this product (see Drug Tariff Part II Clause 10B) because it is not
appropriate to repack the product. The dispenser should supply the quantity in the special
container (or containers) nearest to that ordered and endorse the FP10 with the number
and size of those containers. In this case the endorsement should be 1 x 250ml.
Example 12
Easifix Crinx bandage is an appliance in Part IX of the Drug Tariff. No endorsement is
required because the prescription provides sufficient information for the product to be
priced.
Example 13
Bordered Granuflex is an appliance in Part IX of the Drug Tariff. If no endorsement is
present, the prescription will be priced on the assumption that 2 individual dressings have
been supplied not 2 boxes of 10 dressings. The dispenser cannot endorse the
prescription to show that 2 boxes were dispensed because the prescriber has not clearly
specified that his or her intention was to prescribe 20 dressings.
Endorsements for Claiming Additional Fees
This section only applies to dispensing through pharmacies and not to dispensing doctors.
Prescriptions for particular types of products attract additional fees because they involve
more work for the dispenser than the average prescription. Some of these additional fees
are paid automatically by the Prescription Pricing Division but for others the dispenser
needs to endorse the prescription appropriately to claim the fee.
Consider the following examples of products that attract additional fees when prescribed
on FP10. What endorsement (if any) would you make on the prescription? Reading the
Drug Tariff Part IIIA will help you find the answers. If you use the most recent edition of
the Drug Tariff, you can also check how much the additional fees are worth.
You would also need to endorse the supplier and pack size when necessary but for the
purpose of this exercise just comment on the additional fee endorsement
Example 14
Tab Ritalin 10mg x 30 (thirty)
Take 2 twice daily
Example 15
Sodium Benzoate Soln 250mg/5ml as directed
Example 16
Single (left side) femoral spring truss
Example 17
Amitriptyline Oral Solution 10mg/5ml sugar free x
300ml – please dilute Sig 10ml tds
Example 18
Tabs buprenorphine 200 micrograms x 28 (twenty
eight) Sig 1 sl tds
Endorsements for Claiming Additional Fees
Example 14
Ritalin (methylphenidate) is a Schedule 2 controlled
drug.
Example 15
If the dispenser prepared this Sodium Benzoate Solution in the dispensary, the
prescription should be endorsed “ED”, indicating extemporaneously dispensed .
Example 16
It is likely that the dispenser will need to measure the patient to determine the appropriate
size of truss to supply. The FP10 should then be endorsed "MF", indicating measured
and fitted.
NB training is required to measure and fit trusses correctly.
Example 17
Amitriptyline is not available as an oral solution in a strength of 10mg/5ml and therefore
this would have to be prepared by diluting one of the higher strength oral solutions that are
available. The prescription should be endorsed ED”, indicating extemporaneously
dispensed.
This prescription is probably for an elderly person.
Example 18
Buprenorphine is a Schedule 3 controlled drug.
Other circumstances when an additional fee could be claimed include:
 Dispensing of elastic hosiery that requires measuring the patient
 Where a preparation that requires the addition of a vehicle/diluent by the
pharmacist results in a liquid of stability of less than 14 days, and for
pharmaceutical reasons necessitates supply in more than one container
 Semi-solids or solids prepared by dilution or admixture of a proprietary product
See the Drug Tariff for how to claim additional fees when the situations described above
apply.
There are also some prescriptions that attract additional fees for dispensing where no
endorsement is necessary. The fee will be added automatically by the Prescription
Pricing Division.
Examples of these include:
 Where the prescriber orders an extemporaneously dispensed liquid preparation to
be supplied in more than one container
 Prescriptions where the net ingredient cost (basic price) of the item exceeds £100.
Endorsements to prevent the dispenser from being out of
pocket
There are 3 types of endorsement that could be made to ensure that the dispenser has
been reimbursed appropriately for the cost of the products on the FP10.
These are:
 Broken bulk
 No cheaper stock obtainable
 Discount not given
Clicking on the topics above will take you to an explanation.
Broken bulk
When a dispenser supplies a product for which there is little demand and needs to obtain
a larger pack size than will cover the quantity on the FP10, the dispenser may be able to
claim for the reimbursement of the cost of the complete pack. In this situation the
prescription is endorsed "broken bulk". The dispenser should use the pack size that will
leave the minimum balance after supplying the drug.
Broken bulk claims should not be made where there is an established demand for the
product. The Prescription Pricing Division monitor how often broken bulk claims are made
by a contractor and will ignore claims that are inappropriate.
The only Drug Tariff Part IX products for which broken bulk claims can be made are for
stoma and incontinence appliances.
Claims are not allowed for drugs packed in special containers apart from calendar packs.
Claims will also not be accepted for a manufacturer's shipping outer e.g. 27 x 200ml
Maxijul Liquid.
Discount not given
For specials, other than those containing Controlled Drugs in schedules 1, 2 and 3 of the
Misuse of Drugs Regulations 2001, where discount has not been obtained from specials
manufacturers, contractors need to endorse 'DNG' for 'discount not given' to avoid
discount being removed. If discount was obtained by the contractor no endorsement
should be made.
Endorsements to show the number of professional fees and
patient charges
Dispensing contractors are usually paid one professional fee (dispensing fee) per item on
the FP10. The number of professional fees is entered in the box at the bottom left hand
corner of each prescription form. Patients who pay the prescription charge usually pay
one charge per item on the prescription form. There are, however circumstances when
the number of professional fees and/or prescription charges are more or less than you
might expect.
For the following prescriptions decide how many professional fees would be due and how
many prescription charges should be paid. Reading the Drug Tariff Part XVI will help you
find the answers.
Follow this link to check your answers.
Tab Prempak-C 0.625
3 x 40
Take 1 as directed
Tabs Dianette 3 x 21
Tabs Dianette 3 x 21
Maxijul Liquid ACBS
Assorted flavours x 24
Tabs Bezalip 200mg x 60
Tabs Bezalip Mono x 30
Tabs Phenindione 10mg 60
Tabs Phenindione 50mg 60
1 pair Below knee stockings Class III
The number of professional fees and prescription
charges due are as follows:
Prempak-C 0.625 - two fees and two charges. This is a combination pack containing two
different tablets.
Dianette tablets - without the symbol there would be one professional fee and one
charge; with the symbol there is still one professional fee but there is no charge to the
patient. The symbol shows that Dianette is being prescribed as an oral contraceptive and
oral contraception is dispensed free of charge.
Maxijul Liquid - one prescription charge and up to 4 professional fees. The dispenser
receives a fee for each flavour dispensed. The number of flavours dispensed
should be endorsed on the form.
Bezalip Tablets 200mg and Bezalip Mono - two fees and two charges. Bezalip Mono is a
different formulation of bezafibrate than Bezalip tablets.
Phenindione tablets 10mg and 50mg - two fees and one charge. These are different
strengths of the same formulation of a drug.
1 pair below knee stockings - one fee and two charges. More than one piece of elastic
hosiery has been supplied.