NHS Flexible Resourcing

Dispensing doctors 

NHS Employers and the General Practitioners Committee (GPC) have agreed changes to the dispensing feescale, effective from 1 October 2009.

Image of GP with patientThe agreement includes a new mechanism to uplift the feescale annually, starting with 2009/10. 

It will reimburse dispensing practices for the increased volume of items whilst limiting the 'profit' element of the payment.

Since the introduction of the existing feescale, the number of items dispensed has increased by 5.7 million but the feescale has not changed, leading to an increase in costs.   

Changes to the 2009/10 feescale

The agreed changes are:

  • the dispensing envelope for 2009/10 should be £165.8 million - the agreed feescales for 2009/10 have been calculated to deliver this amount
  • the new feescale is 8.7 per cent lower than the existing one but, over the current financial year, it equates to a 4.9 per cent drop because it is being introduced mid-year ( from 1 October)
  • if the financial envelope is exceeded or underspent by one per cent, NHS Employers and the GPC will discuss the reasons why and, depending on the reasons, this may lead to an alteration in that year’s payments

The new feescale has been calculated and agreed by the Technical Steering Committee run by the NHS Information Centre (IC). See the IC's website for the Committee's full report,  Proposed Dispensing Feescales for GMS Contractors in England & Wales from 1 October 2009. 

Amendments to Statement of Financial Entitlements

In line with the above changes, an amendment to the Statement of Financial Entitlements (SFE) has been introduced.

These amended directions are the fifth in a series of changes to be made to the SFE published in April 2005. These amending directions make three changes to the dispensing provisions in the General Medical Services SFE.

The first introduces new dispensing feescales for general practitioners (GPs) to replace those in parts 2 and 3 of annex G of the SFE (see direction 4).

The other two cover the following vaccines that GPs cannot claim a personal administration fee for:

  • the HPV vaccine (HPV - Human papillomavirus types 16 and 18) (see direction 3(Aa)) which is added to the list of vaccines provided centrally as part of the Childhood Immunisation Programme
  • a new provision relating to the proposed 2009 swine flu vaccine (see direction 3(b))

New mechanism for agreeing future feescales

The new mechanism used to calculate the new 2009/10 feescale, will be used to calculate future ones, as follows:

  • the mechanism splits the feescale into a 'cost' and 'profit' element
  • the 'cost' element will be uplifted every year to allow for the annual increase in volume - the volume will be calculated by the NHS Information Centre using data on historic increases
  • the 'profit' element will be uplifted by the annual Doctors and Dentists Reward Body (DDRB) award
  • this mechanism is designed to align profits with the uplift for all GP practices through the DDRB process, whilst recognising the increase in dispensing volume and the associated costs  

 Next steps

The new feescales will automatically be introduced from 1 October 2009. 

As part of the changes, the Department of Health has agreed to carry out a 'cost of service inquiry' to get a full picture of the costs of providing dispensing services.





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