Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002

Official Consolidated Version

This is an official version of consolidated legislation compiled and issued under the authority of the Legislation (Jersey) Law 2021.

 

26.500.22

 

Showing the law from 1 May 2023 to Current

 

 

Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002

Article

1                 Interpretation. 4

2                 Approval of suppliers. 4

3                 Terms and conditions of supply of pharmaceutical benefit. 5

4                 Schemes for securing proper pharmaceutical services. 5

5                 Prescribed form for the supply of pharmaceutical benefit. 5

6                 Period of supply of pharmaceutical benefit. 5

7                 Supply. 6

8                 Offences. 7

9                 Calculation of prescription costs payable by the Minister. 7

10              Citation. 7

APPROVAL OF SUPPLIERS OF PHARMACEUTICAL BENEFIT  8

PART 1  8

‎Form of application for approval as supplier of pharmaceutical benefit of person(s) lawfully conducting a retail pharmacy business. 8

PART 2  9

‎Form of application for approval as supplier of pharmaceutical benefit of person(s) other than person(s) lawfully conducting a retail pharmacy business. 9

PART 1  10

TERMS AND CONDITIONS TO BE OBSERVED BY AN APPROVED SUPPLIER   10

1                 Supplier to supply pharmaceutical benefit. 10

2                 Place and hours of business. 10

3                 Dispensing medicines. 11

4                 Names of pharmaceutical chemists. 11

5                 Charges. 11

6                 Advertising. 11

7                 Information to be provided. 11

8                 Payment. 12

9                 Withdrawal 12

PART 2  12

‎Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business. 12

PART 3  12

‎Form of notice to be displayed by an approved supplier other than a person lawfully conducting a retail pharmacy business. 12

PART 4  13

‎Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business at times when the person’s premises are closed. 13

Form of prescription   14

dispensing fees  16

TABLE 1: BASIC DISPENSING FEES  16

TABLE 2: ADDITIONAL DISPENSING FEES  16

Notes  17

Table of Legislation History. 20

Table of Renumbered Provisions. 21

Table of Endnote References. 21

 

 

Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002[1]

1        Interpretation

(1)     In this Order, unless the context otherwise requires –

“approved prescribing practitioner” means any medical practitioner, dentist, optician or other prescribing practitioner approved by the Minister under Article 26 of the Law;

“Drug Tariff” means the statement compiled and published by the Secretary of State for Health of the United Kingdom pursuant to Regulation 18(1) of the National Health Service (Pharmaceutical Services) Regulations 1992 of the United Kingdom, as that statement is for the time being in force;

“Health Card” means an Identity Card issued in accordance with the Health Insurance (Evidence) (Jersey) Order 2008;

“Law” means the Health Insurance (Jersey) Law 1967;

“prescription” has the same meaning as given to the expression “prescribed form” by Article 5.[2]

(2)     [3]

2        Approval of suppliers

(1)     An application by a person conducting a retail pharmacy business for approval under Article 26(2) of the Law as a supplier of pharmaceutical benefit must be substantially in the form set out in Part 1 of Schedule 1.

(2)     An application by any other person for that approval must be substantially in the form set out in Part 2 of Schedule 1.

3        Terms and conditions of supply of pharmaceutical benefit

For the purpose of Article 26(2) and (3) of the Law the terms and conditions a person in an application for approval as an approved supplier must undertake to supply pharmaceutical benefit on are those set out in Part 1 of Schedule 2.

4        Schemes for securing proper pharmaceutical services

(1)     The Minister may act in accordance with paragraph (2) if at any time he or she is satisfied that there is an insufficient number of places of business of approved suppliers open outside normal business hours.

(2)     The Minister may after consulting the Pharmaceutical Benefit Advisory Committee prepare a scheme designed to ensure that a sufficient number of places of business of approved suppliers are open at reasonable times outside normal business hours.

(3)     The scheme must –

(a)     specify the days and hours during which places of business of approved suppliers are to be open; and

(b)     provide for payments to be made to those suppliers in respect of periods during which their premises are open under the scheme.

5        Prescribed form for the supply of pharmaceutical benefit

(1)     For the purposes of Article 15(2) of the Law “prescribed form” means a form substantially in the form set out in Schedule 3 that –

(a)     contains the particulars required to complete the form;

(b)     is dated with the date on which it is to become effective;

(c)     is signed by the approved prescribing practitioner that gave the form; and

(d)     is printed and watermarked in such manner as may be designated by the Minister.[4]

(2)     A form is not in the prescribed form if it authorizes the supply of pharmaceutical benefit for more than one person.

6        Period of supply of pharmaceutical benefit[5]

(1)     An approved prescribing practitioner, other than a dentist, must not give a prescription for the supply of pharmaceutical benefit to a person for a period exceeding 90 days.

(2)     An approved prescribing practitioner who is a dentist must not give a prescription for the supply of pharmaceutical benefit to a person for a period exceeding 30 days.

(3)     An approved prescribing practitioner must not give more than one prescription for the same pharmaceutical benefit at any one time.

(4)     However, an approved prescribing practitioner may give up to 4 prescriptions in respect of the same pharmaceutical benefit at any one time if the prescriptions are for consecutive periods of supply.

(5)     An approved prescribing practitioner must not during a period of treatment give a further prescription to a person for the same pharmaceutical benefit unless the practitioner is satisfied that it is necessary or desirable to do so for the purpose of the treatment and –

(a)     the pharmaceutical benefit is intended for the continuation of the treatment after the expiry of the present period of treatment and the prescription is dated no earlier than 21 days before the end of that period;

(b)     the prescription is for an increase in dosage; or

(c)     the prescription is to replace pharmaceutical benefit previously supplied on prescription and destroyed or lost.

(6)     An approved supplier must not supply pharmaceutical benefit ordered on a prescription –

(a)     before the effective date of the prescription; or

(b)     which does not comply with the requirements of this Article.

7        Supply

(1)     This Article applies where in accordance with a prescription pharmaceutical benefit is supplied by an approved supplier in respect of an insured person or a dependant of an insured person.

(2)     The person to whom the pharmaceutical benefit is supplied must produce and show to the approved supplier the insured person’s Health Card.

(3)     Subject to paragraph (4) –

(a)     the person to whom the pharmaceutical benefit is supplied must surrender the prescription to the approved supplier; and

(b)     the approved supplier must mark on the prescription the health insurance number specified on the insured person’s Health Card.

(4)     The person taking delivery of pharmaceutical benefit is not required to surrender the prescription if, by electronic means, the approved prescribing practitioner who signed the prescription –

(a)     notifies the approved supplier of the particulars contained in the prescription and its effective date;

(b)     confirms that the prescription is signed by the practitioner; and

(c)     undertakes to surrender the prescription to the approved supplier within 72 hours of the notification,

and the approved supplier is satisfied that, by reason of an emergency, the practitioner has been unable to furnish the person taking delivery of the pharmaceutical benefit with the prescription so that it is available for surrender at the time of delivery.[6]

(5)     [7]

(6)     [8]

(7)     [9]

(8)     [10]

8        Offences

(1)     Except as provided by paragraph (2), a person who fails to comply with a provision of this Order shall be guilty of an offence and liable to a fine not exceeding level 2 on the standard scale.

(2)     A person who fails to surrender a prescription as required under Article 7(3)(a) is liable to a fine not exceeding level 1 on the standard scale.

9        Calculation of prescription costs payable by the Minister[11]

(1)     The amount to be paid by the Minister to an approved supplier for each item of pharmaceutical benefit supplied on a prescription in respect of an insured person or a dependant of an insured person is the sum of –

(a)     the basic price of the ingredients calculated in accordance with the Drug Tariff as at the date of supply;

(b)     the appropriate basic dispensing fee in Table 1 of Schedule 5; and

(c)     any additional dispensing fee or fees in Table 2 of Schedule 5.

(2)     However, if paragraph (3) applies, the amount to be paid under paragraph (1) is the amount that would be payable under that paragraph if each instalment had been supplied on a separate prescription.

(3)     This paragraph applies if the prescription –

(a)     was signed by an approved medical practitioner;

(b)     specifies that it is to be supplied in instalments at stipulated intervals or on given dates; and

(c)     at the time of supply is for a substance or product that is in Part 1, 2 or 3 of Schedule 2 to the Misuse of Drugs (Jersey) Law 1978.

10      Citation

This Order may be cited as the Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002.

 

Schedule 1

(Article 2)

APPROVAL OF SUPPLIERS OF PHARMACEUTICAL BENEFIT

PART 1

HEALTH INSURANCE (JERSEY) LAW 1967

‎Form of application for approval as supplier of pharmaceutical benefit of person(s) lawfully conducting a retail pharmacy business

 

PART 2

HEALTH INSURANCE (JERSEY) LAW 1967

‎Form of application for approval as supplier of pharmaceutical benefit of person(s) other than person(s) lawfully conducting a retail pharmacy business

 

 

Schedule 2[12]

(Article 3)

PART 1

TERMS AND CONDITIONS TO BE OBSERVED BY AN APPROVED SUPPLIER

1        Supplier to supply pharmaceutical benefit

(1)     The supplier must supply pharmaceutical benefit with reasonable promptness to a person who presents a prescription for them.

(2)     Sub-paragraph (1) does not require a supplier to supply a pharmaceutical benefit that the supplier does not ordinarily supply.

(3)     If under this paragraph a supplier is required to supply a medicine or drug the supplier must supply the medicine or drug in a suitable container being –

(a)     in relation to capsules, tablets, pills or any other medicine or drug in solid form (other than those prepacked in foil or paper-board or strip card containers by the manufacturer) – an airtight container of glass, aluminium or rigid plastic;

(b)     in relation to ointments, creams or pastes (other than those prepacked by the manufacturer) – a container of glass, aluminium or rigid plastic;

(c)     in relation to eye, ear or nasal drops (other than those prepacked by the manufacturer) – a container of glass either incorporating or having a separate dropper attachment;

(d)     in relation to liquid medicines (other than those prepacked by the manufacturer) – a container of glass or rigid plastic, including, in the case of an oral liquid medicine, a 5 ml. plastic measuring spoon (unless the patient already has one or the manufacturer’s pack includes one).

(4)     The supplier must not give, promise or offer a gift or a reward as an inducement to or in consideration of a person presenting a prescription to the supplier.

2        Place and hours of business

(1)     The supplier must supply pharmaceutical benefit at the place or places of business specified in the supplier’s application for approval under Article 26 of the Law.

(2)     The supplier must keep that place or those places open for the supply of pharmaceutical benefit –

(a)     during normal business hours; and

(b)     on the days and during the hours specified in any scheme made by the Minister under Article 4.

(3)     At each such place of business the supplier must display a notice to be provided by the Minister in the form set out in Part 2 or Part 3 of this Schedule.

(4)     If the supplier is a person lawfully conducting a retail pharmacy business the supplier must also display a notice to be provided by the Minister in the form set out in Part 4 of this Schedule when the supplier’s place of business is closed.

(5)     The notice must indicate –

(a)     the addresses of other people lawfully conducting a retail pharmacy business where medicines and drugs may be obtained; and

(b)     the times when they may be obtained at those premises.

(6)     Each notice must be displayed in a manner that makes it easily visible to members of the public.

3        Dispensing medicines

The supplier must ensure that the supply of medicines on prescriptions is performed by or under the supervision of a pharmacist.

4        Names of pharmaceutical chemists

Whenever required to do so by the Minister the supplier must furnish to the Minister the name of each pharmacist employed by the supplier in dispensing medicines on prescription.

5        Charges

Except for charges that are required or authorized to be made by this or any other Order made under the Law the supplier must supply a pharmaceutical benefit and any container free of charge.

6        Advertising

(1)     The supplier must not advertise either directly or by implication that the supplier is an approved supplier or that the supplier provides or is authorized to provide pharmaceutical benefit.

(2)     Despite sub-paragraph (1) the supplier may –

(a)     display a notice required by paragraph 2;

(b)     include in an advertisement a statement of the days and hours at which pharmaceutical benefit is supplied.

7        Information to be provided

(1)     This paragraph does not apply except where the Minister requires information to determine the amount payable under Article 10 to the supplier for pharmaceutical benefit supplied by the supplier.

(2)     The supplier must furnish to the Minister or to such person or body as the Minister directs information that the Minister requires concerning so much of the supplier’s business that relates to the supply of pharmaceutical benefit.

(3)     The supplier must permit a person authorized in writing to do so by the Minister to conduct surveys at each place of business at or from which the supplier supplies pharmaceutical benefit.

8        Payment

(1)     On dates specified by the Minister the supplier must furnish to the Minister or to such person or body as the Minister directs the prescriptions on which pharmaceutical benefit has been supplied by the supplier.

(2)     The prescriptions must be arranged in the manner the Minister directs and must be accompanied by a declaration.

(3)     The declaration must contain such particulars relating to the supply by the supplier of pharmaceutical benefit as the Minister specifies.

9        Withdrawal

If the supplier wishes to cease to be an approved supplier the supplier must give at least 3 months written notice to the Minister (or such shorter notice as the Minister may agree) that the supplier no longer wishes to supply pharmaceutical benefit.

 

PART 2

‎Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business

 

Health Insurance Scheme

(Name of approved supplier)

Approved under the Health Insurance (Jersey) Law 1967 to dispense medicines and supply drugs.

These premises are open at the following times –

 

PART 3

‎Form of notice to be displayed by an approved supplier other than a person lawfully conducting a retail pharmacy business

 

Health Insurance Scheme

(Name of approved supplier)

Approved under the Health Insurance (Jersey) Law 1967 to supply drugs (except poisons in Part 1 of the Poisons List set out in the Schedule to the Poisons List (Jersey) Order 1986).

These premises are open at the following times –

 

PART 4

‎Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business at times when the person’s premises are closed

 

Health Insurance Scheme

When these premises are closed, medicines and drugs may be obtained at the addresses and times shown below –

Schedule 3[13]

(Article 5)

Form of prescription

 

Schedule 4[14]

 

 

Schedule 5[15]

(Article 9(1)(b) and (c))

dispensing fees

TABLE 1: BASIC DISPENSING FEES

TABLE 2: ADDITIONAL DISPENSING FEES

Notes

(1)     Category 1 urgent additional dispensing fees are payable only if –

(a)     the prescription is endorsed –

(i)      “URGENT” by the approved prescribing practitioner, and

(ii)      by the approved supplier with the date and time of dispensing;

(b)     the prescription is supplied on a day other than a Sunday or a public holiday; and

(c)     the supply is made –

(i)      when the supplier’s premises are not open for supply, and

(ii)      on the same day the prescription is written, or the following day if supplied after midnight.

(2)     Category 2 urgent additional dispensing fees are payable only if –

(a)     the prescription is endorsed –

(i)      “URGENT” by the approved prescribing practitioner, or “DISPENSED URGENTLY” by the approved supplier, and

(ii)      by the approved supplier with the date and time of dispensing;

(b)     the prescription is signed by the patient (or the patient’s representative);

(c)     the prescription is supplied on a Sunday or a public holiday; and

(d)     the supply is made –

(i)      when the supplier’s premises are not open for supply, and

(ii)      on the same day the prescription is written, or the following day if supplied after midnight.

(3)     The urgent additional dispensing fees are not payable for prescriptions supplied by an approved supplier when the supplier’s premises are open for supply in accordance with a scheme prepared by the Minister under Article 4.

 

Schedule 6[16]

 

 

Endnotes

Table of Legislation History

Table of Renumbered Provisions

Table of Endnote References