The Universal Claim Framework (UCF) supports electronic claiming for pharmacy-led services.
The framework allows community pharmacy to manage and deliver pharmacy-led services from their Patient Medication Record (PMR) system.
Claims for reimbursement
Claims for re-imbursement are sent as part of the dispensing process and included in the payment and reporting for that dispensing month.
Some services require a form to be printed as part of the service description. Information is printed on the form on who needs to see what service was provided to the patient.
The pharmacy may also choose to print forms to support the dispensing and checking process in the pharmacy.
For some services supported by the UCF, the patient’s Community Health Index (CHI) number is needed to send the electronic claim.
This number may already be known through previous contact with the patient. However where the patient’s CHI number is not known, the lookup facility in PCR allows the CHI number to be obtained using the patient’s details.
What services can the UCF be used for?
Use of this facility has been approved for the following services:
- Unscheduled Care
- public health services including emergency hormonal contraception and smoking cessation
- healthy start vitamins
- health board local services
- gluten-free food service
- meningitis B prophylaxis
- urinary tract infection (NHS Pharmacy First Scotland)
- impetigo (NHS Pharmacy First Scotland)
- skin infections (NHS Pharmacy first Scotland)
- shingles (NHS Pharmacy first Scotland)
- Lateral Flow Device (LFD) pharmacy collection
The claim for the service should be submitted using the CPUS form if the patient’s CHI is not known and can't be looked up. It is not possible to submit the claim electronically without knowing the patient’s CHI.
Read the UCF Service Summary.
What, if any, additional changes does the UCF deliver?
The UCF also includes improvements and changes to NHS Pharmacy First Scotland minor ailment claims. NHS Pharmacy First Scotland minor ailment claims is now an electronic claims only service.
This means that it is important, as part of your housekeeping arrangements, to make sure all NHS Pharmacy First Scotland minor ailment claims are successfully sent electronically.
There will be no reimbursement from the paper form.
The UCF also includes functionality that allows NHS Pharmacy First Scotland minor ailment claims where a CHI is not known to be submitted for payment.
This will happen immediately using a dummy CHI number added automatically by the PMR system.
You will no longer need to add the code 99996 to any of the services, such as the gluten-free food service or smoking cessation service, as the relevant GP practice is printed automatically where required.
What if I have issues with my Patient Medical Record (PMR)?
You should contact your PMR supplier if you have issues.
What information and/or guidance will be provided?
PMR suppliers will be updating their user guides to provide guidance when supporting UCF services.
Will I need new hardware?
Existing hardware will support the introduction of the UCF.
Is there any additional information I need to add as part of UCF?
The GP practice code - not the GP prescriber code as is currently required on CPUS forms - will be required for the following:
- Unscheduled Care PGD
- UTI - GP registered
- impetigo - GP registered
- varenicline supply.
If you do not know the practice code then you must look it up using the GP practice list available at the Public Health Scotland website. You must then add it to the patient’s PMR record and the electronic claim message.
Once you have done this, the GP practice details will be recorded in your PMR system to support notification to the GP practice where required.
Has the Unscheduled Care PGD been updated to reflect UCF?
Yes the latest version of the NHS 24 Unscheduled Care PGD has been updated to reflect these changes and refers to the use of CP4/3 forms.
What forms should I send to Practitioner Services?
The printed output will indicate whether the form should be send to Practitioner Services as part of the monthly / bi-monthly submission.
What information should I put on my GP34 form?
There is no requirement to add UCF items to the GP34 item count. UCF forms submitted to Practitioners Services should be included in the GP34 form count.
How can I claim if the service is not listed as a UCF service?
A paper CPUS form should be used to submit a claim for item re-imbursement
How can I cancel a UCF claim after the 7 day period?
A claim amendment form should be completed and sent to P&CFS pharmacy payments to allow a correction to be made.
Covering administrative adjustments if you notice an error with an electronic claim and are unable to amend it.
Further information on what is required for each of the UCF has been collated and is available in this document.
GP contact details including prescriber codes
Public Health Scotland (formerly ISD) holds a range of data relating to general practices in Scotland, including their prescriber and practice codes to aid with submitting claims for UCF services.
Click on the 3rd bullet point for the list of GPs in post, and their practice contact details.