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228 09/2017 Part IX APPLIANCES PDF

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09/2017 Part IX APPLIANCES (APPROVED LIST OF APPLIANCES - NOTES) Part IX - Appliances (Approved list of Appliances - Notes) APPROVED LIST OF APPLIANCES See Part II, Clause 8A (page7) The price listed in respect of an appliance specified in the following list is the basic price (see Part II, Clause 8) on which payment will be calculated pursuant to Part I, Clause 5B in respect of the dispensing of appliances. NOTES 1. Definition - The appliances that may be supplied against orders on Forms FP10 are listed below and must conform with the specifications shown. See Part 1, Clause 2 (page3). These specifications include published official standards ie BP, BPC or relevant British, European or International Standards or the Drug Tariff Technical Specification. It should be emphasized that any appliance must conform with the entry in this part of the Tariff as well as the official standard or technical specification quoted therein. Other dressings and appliances which may be necessary will normally be provided through the Hospital Services. 2. Sealed Packets - These are those which are "tamper-evident" - sealed with an easily detachable device that prevents removal of the contents without the seal being broken. Additionally in the case of sterile products: once a sealed package has been opened it should not be possible to re-seal it easily. Where an appliance, other than a bandage, required by the Tariff to be supplied in a sealed packet is ordered of a quantity or weight not listed in the Tariff, the quantity ordered should be made up as nearly as possible with the smallest numbers of sealed packets available for the purpose. Where the quantity ordered is less than the smallest quantity/weight, supply the smallest pack. The quantity of material in each packet supplied should be recorded on the prescription form. 3. Quality - Any medical device placed on the market in the UK has to be CE marked by the manufacturer in accordance with the safety, quality and performance requirements laid down in the EC Medical Devices Directive 93/42/EC and the Medical Devices Regulations 2002 (as amended) which transposes the Directive in to UK law. Manufacturers are required to obtain certification from a third party conformity assessment organisation known as a notified body for all but the lowest risk devices. Notified bodies have been designated as competent to undertake this function by the regulatory authority in the registering member state. In the UK this is the Medicines and Healthcare products Regulatory Agency (MHRA). There are a number of conformity assessment routes that the manufacturers can adopt to demonstrate conformity with the requirements of the Directive but the majority use a quality system approach. More details of the CE marking process can be obtained from the MHRA, 151 Buckingham Palace Road, Victoria, London. SW1W 9SZ or from their website http:// www.mhra.gov.uk/Howweregulate/Devices/index.htm. 4. Weights - All weights specified in the Tariff in respect of appliances are exclusive of wrappings and packing material. 5. Invoice price - This is the price chargeable for the appliance to the contractor by the manufacturer, wholesaler or supplier. 6. Technical Specifications - Numbered Technical Specifications for the items in Part IXA/B/C were published separately in 1981 in loose leaf volume and a revised list was published in 1983. The Specifications will not be reprinted annually but individual specifications will be introduced, amended and reprinted, or withdrawn, as necessary. A list of Technical Specifications is given on page 229. CE marked Devices have shown that they meet the essential requirements of the Medical Devices Regulations 2002 and there is no further need for them to demonstrate compliance with other specifications, such as those referred to above. 7. Nurse Prescribing - See Part XVIIB for details of Nurse Prescribing. 228 09/2017 Part IX APPLIANCES (LIST OF TECHNICAL SPECIFICATIONS) Part IX - Appliances (List of Technical Specifications) LIST OF TECHNICAL SPECIFICATIONS These specifications are available from: NHS Business Services Authority, NHS Prescription Services Drug Tariff Team 3rd Floor Annex Bridge House 152 Pilgrim Street Newcastle upon Tyne NE1 6SN Spec Date of No. last revision Absorbent Cotton, Hospital Quality 1 1981 Bandages High Compression (Extensible) 52 5/1992 Contraceptive Devices Vaginal Contraceptive Caps (Pessaries) 8 1981 Dressings Povidone Iodine Fabric 43 1988 Sterile Dressing Pack 10 1981 Sterile Dressing Pack with NW Pads 35 1/1991 Elastic Hosiery Graduated Compression 40 1988 Suspender Belt 13 1981 Gauze Tissues Gauze and Cotton Tissue 14 1983 Latex Foam Adhesive 19 1981 Pessaries 20 1981 Protectives EMA Film Gloves, Disposable 21 1981 Stockinette Elasticated Surgical Tubular, Foam Padded 25 1983 Swabs Non-Woven Fabric 28 3/1993 Non-Woven Fabric, Filmated 29 1981 Trusses Spring 31a 1981 Elastic Band 31b 1981 229 09/2017 Part IXA APPLIANCES Part IXA - Appliances Part IXA-Appliances Appliance Size or Weight Basic Price p ABSORBENT COTTONS each Absorbent Cotton BP 1988 25g 77 Where no quantity is stated on the prescription the 25g 100g 176 pack is to be supplied. 500g 592 Absorbent Cotton, Hospital Quality 100g 122 Specification 1 500g 386 To be supplied only where specifically ordered. ACNE TREATMENT Aknicare Cream 50ml 1200 Lotion 25ml 1300 Aknicare SR Skin Roller 5ml 1000 ADHESIVE DRESSING REMOVER STERILE - SILICONE BASED Appeel Sterile foam applicator 5 384 Appeel Sterile medical adhesive remover spray 100ml 1650 Appeel Sterile single use sachet 5ml 116K Appeel Sterile single use wipes 30 1554 ANAL IRRIGATION SYSTEM Products marked with the symbol o in this category must be dispensed with a supply of wipes and disposal bags. All products in this category receive a home delivery fee of 340p Aquaflush Actif Irrigation Cone System (CS Bullen Ltd (formerly Oakmed Ltd)) o Starter Set AFAS 7700 (Contains 1 water bag, 1 pump, 1 hook for water bag, 1 extension tube, 5 cones wrapped in glove/disposal bag, 1 strap, 1 washbag) o Monthly Set AFAM 9900 (Contains 1 water bag, 1 pump, 1 hook for water bag, 15 cones wrapped in glove/ disposal bag) Aquaflush Compact System (CS Bullen Ltd (formerly Oakmed Ltd)) o Starter Set AFCS 3395 (Contains 1 pump, 5 cones, 5 glove/disposal bags, 1 wash bag) o Monthly Set AFCM 5800 (Contains 1 pump, 15 cones, 15 glove/disposal bags) Aquaflush Lite System (CS Bullen Ltd) o Starter Set AFLS 7300 (Contains 1 water bag, 1 pump, 1 hook for water bag, 1 extension tube, 7 cones, 7 lubricant sachets, 1 washbag) o Monthly Set AFLM 9500 (Contains 1 water bag, 1 pump, 16 cones, 16 lubricant sachets) o Refill Pack AFLA 5800 (Contains 15 cones, 15 lubricant sachets) Aquaflush Quick System (CS Bullen Ltd (formerly Oakmed Ltd)) o Starter Set AFQS 7700 (Contains 1 water bag, 1 pump, 1 hook for water bag, 1 extension tube, 5 cones, 5 glove/disposal bags, 1 strap, 1 washbag) o Monthly Set AFQM 9900 (Contains 1 water bag, 1 pump, 15 cones, 15 glove/disposal bags) 230 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p ANAL IRRIGATION SYSTEM pack of 2 Aquaflush Extension Tubes AFExtn 612 per pair Aquaflush Straps AFStrap 509 IryPump S (B Braun Medical) each o IryPump S Set 29120E 49475 o IryCone+ 29220E 6070 IryPump Container 29240 4203 o Navina Classic System 69005 7462 (System includes 1 Navina Classic control unit, 1 water container, 1 tube set, 2 rectal catheters, 1 accessory set, 1 Navina case) Navina Classic Control Unit 69013 5710 o Navina Classic System - refill 69006 7462 (Contains 1 Navina Classic control unit, 1 water container, 1 tube set, 2 rectal catheters) o Navina Smart System 69009 29850 (System includes 1 control unit, 2 rectal catheters, 1 water container, 1 tube set, 1 accessory set, 1 Navina case) Navina Smart Control Unit 69014 29850 (Contains Navina Smart control unit, 1 charger, 1 power adaptor) o Navina Consumable Set 69003 12927 (Contains 15 rectal catheters, 1 water container) pack of 10 o Navina Rectal Catheter Set 68940 8144 (Contains 10 rectal catheters) each Navina Tube Set 69011 876 (Contains 1 catheter tube, 1 water container tube) o Peristeen System 29121 7628 (System includes 1 control unit, 2 rectal catheters, 1 water bag, 2 straps) o Small 29126 7628 (System includes 1 control unit, 2 rectal catheters, 1 water bag, 1 strap) o Peristeen Accessory Unit 29122 13295 (Contains 15 rectal catheters, 1 water bag) o Small 29127 13295 (Contains 15 rectal catheters, 1 water bag) pack of 10 o Peristeen Rectal Catheters 29123 8500 o Small 29128 8500 (Contains 10 rectal catheters) per pair Peristeen Straps 29124 545 pack of 2 Peristeen Tubes 29125 763 231 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p ANAL IRRIGATION SYSTEM each Qufora Irrigation System (MacGregor Healthcare Ltd) o IrriSedo Mini System 53601-015 5900 (15 irrigation set) (Contains 1 pump, 15 Hydrophilic coated cones, 15 waste bags) o IrriSedo Mini System 53601-030 11800 (30 irrigation set) (Contains 1 pump, 1 conebag, 30 Hydrophilic cones) o IrriSedo Bed System (5 Irrigation Set) - 12mm 53201-055 4990 (Contains 1 water bag with pump, 5 rectal catheters 12mm, 5 collection bags, 5 gel sachets) o IrriSedo Bed System (5 Irrigation Set) - 21mm 53001-055 4990 (Contains 1 water bag with pump, 5 rectal catheters 21mm, 5 collection bags, 5 gel sachets) o IrriSedo Bed System (5 Irrigation Set) - 30mm 53101-055 4990 (Contains 1 water bag with pump, 5 rectal catheters 30mm, 5 collection bags, 5 gel sachets) o IrriSedo Bed System (15 Irrigation Set) - 12mm 53201-015 14970 (Contains 1 water bag with pump, 15 rectal catheters 12mm, 15 collection bags, 15 gel sachets) o IrriSedo Bed System (15 Irrigation Set) - 21mm 53001-015 14970 (Contains 1 water bag with pump, 15 rectal catheters 21mm, 15 collection bags, 15 gel sachets) o IrriSedo Bed System (15 Irrigation Set) - 30 mm 53101-015 14970 (Contains 1 water bag with pump, 15 rectal catheters 30mm, 15 collection bags, 15 gel sachets) o Irrisedo Balloon System - Base Set (Regular) 58101-002 7000 (Contains 1 control unit with velcro strap, 1 water bag, 2 hydrophilic rectal balloon catheters (regular)) o IrriSedo Balloon System - Base Set (Small) 58102-002 7000 (Contains 1 control unit with velcro strap, 1 water bag, 2 hydrophilic rectal balloon catheters (small)) o IrriSedo Balloon System - Accessory Set (Regular) 58201-015 11500 (Contains 1 water bag, 15 hydrophilic rectal balloon catheters (regular)) o IrriSedo Balloon System - Accessory Set (Small) 58202-015 11500 (Contains 1 water bag, 15 hydrophilic rectal balloon catheters (small)) o IrriSedo Balloon System - Catheter Set (Regular) 58301-010 7900 (Contains 10 hydrophilic rectal balloon catheters (regular)) o IrriSedo Balloon System - Catheter Set (Small) 58302-010 7900 (Contains 10 hydrophilic rectal balloon catheters (small)) 232 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p ANAL IRRIGATION SYSTEM each IrriSedo Cone System o Starter Set QTS 7780 (Contains 1 pump, 1 water bag, 5 hydrophilic coated cones, 5 waste bags, 1 toilet bag) o 15 Irrigation Set QTM 10166 (Contains 1 pump, 1 water bag, 15 hydrophilic coated cones, 15 waste bags) o Accessory Set 52601-015 5900 (Contains 15 hydrophilic cones) pack of 15 Qufora IrriSedo Extension Tube 52715-015 4500 APPLICATORS - VAGINAL Type 1. (Estriol)(formerly Gynest) 160 NB 1 Where an Estriol Cream pack ordered by the prescriber does not include an applicator, and the contractor considers that one is required, an Estriol Vaginal Applicator should be supplied and the prescription form endorsed accordingly. 2 For details of prescription charges payable, See Part XVI, Sub paragraph 12.14.8 ARM SLINGS Web, Adjustable 206 AUTO INFLATION DEVICE (for the treatment of Glue Ear) Otovent 490 BACTERIAL DECOLONISATION PRODUCTS Prontoderm Foam 200ml bottle 363 Prontoderm Nasal Gel 30ml tube 514 Part IXA-Appliances 233 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p BANDAGES each 1. The term "bandage" used in a prescription form without qualification is to be interpreted to mean an Open-Wove Bandage, Type 1 BP 5cm x 5m. All bandages supplied are to be of the lengths and widths specified in the Tariff. Where a bandage longer than those specified in the Tariff is ordered, the number of bandages which will, in total, provide the length nearest to that ordered should be supplied. Where a bandage in a width other than those specified is ordered, the next wider specified width should be supplied. 2. All bandages to be supplied completely wrapped as received from the manufacturer or wholesaler. Elastic Adhesive Bandages and Plaster of Paris Bandages to be supplied sealed in containers as received from the manufacturer or wholesaler. Except where otherwise stated all bandages possessing elasticity to be not less than 4.5m in length when fully stretched. Conforming Bandage (Synthetic) Hospiform 6cm x 4m (stretched) 14 8cm x 4m 17 10cm x 4m 19 12cm x 4m 24 Cotton Conforming Bandage BP 1988 Type A Easifix Crinx 5cm x 3.5m 69 7.5cm x 3.5m 84 10cm x 3.5m 104 15cm x 3.5m 142 Cotton Crêpe Bandage Hospicrepe 239 5cm 44 7.5cm 63 10cm 81 15cm 118 Cotton Crêpe Bandage BP 1988 7.5cm 314 10cm 403 Cotton, Polyamide and Elastane Bandage Hospilite 5cm 37 7.5cm 51 10cm 62 15cm 91 Neosport 5cm 54 7.5cm 73 10cm 91 15cm 112 Setocrepe 10cm 121 Soffcrepe 5cm 70 7.5cm 99 10cm 125 15cm 182 Cotton Stretch Bandage BP 1988 Hospicrepe 233 5cm 52 7.5cm 72 10cm 96 15cm 136 PremierBand 5cm 45 7.5cm 63 10cm 79 15cm 118 Crêpe Bandage BP 1988 5cm 100 7.5cm 141 10cm 184 15cm 266 Part IXA-Appliances 234 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p BANDAGES each Elastic Adhesive Bandage BP 1993 5cm 370 (Syn: Zinc Oxide Elastic Adhesive Bandage) 7.5cm 535 Where no size is stated by the prescriber 7.5cm size should 10cm 711 be supplied. Elastomer and Viscose Bandage, Knitted BS compression type 2, for light support Clinilite 5cm 44 7.5cm 61 10cm 80 15cm 116 K-Lite 5cm x 4.5m 56K 4.5m stretched 7cm x 4.5m 78K *10cm x 4.5m 102K 15cm x 4.5m 147K K-Lite Long 5.25m stretched *10cm x 5.25m 116 Knit-Firm 5cm 36 7cm 51 10cm 66 15 cm 96 BS compression type 3a, for light compression Cliniplus 10cm x 8.7m 180 Elset 6m stretched 10cm x 6m 263 15cm x 6m 282 8m stretched 10cm x 8m 337 Elset S 12m stretched 15cm x 12m 564 K-Plus 8.7m stretched *10cm x 8.7m 231K K-Plus Long 10.25m stretched *10cm x 10.25m 267K L3 8.6m Stretched 10cm x 8.6m 224K High Compression Bandage (Extensible) K-ThreeC *10cm x 3m unstretched 287K SurePress 10cm x 3m unstretched 365 Specification No. 52 P.E.C. High Compression Bandage Syns: Polyamide, Elastane, and Cotton Compression (High) Extensible Bandage; "PECCHE" Bandage Setopress 10cm x 3.5m unstretched 358 V.E.C. High Compression Bandage Syns: Viscose, Elastane, and Cotton Compression (High) Extensible Bandage; "VECCHE" Bandage Tensopress 7.5cm x 3m unstretched 273 10cm x 3m unstretched 351 * see also Multi Layer Compression Bandaging Part IXA-Appliances 235 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p BANDAGES each Multi-layer Compression Bandaging 3M Health Care Ltd Coban 2 - multi-layer compression bandage kit one size 824 Coban 2 Lite - multi-layer compression bandage kit one size 824 Coban Self-Adherent Bandage 10cm x 6m (stretched) 293 Activa Healthcare see L&R UK and Lohmann & Rauscher Aspen Medical Europe AndoFlex NL cohesive self-adherent bandage (latex free) 10cm x 4.5m (stretched) 192 10cm x 5.9m (stretched) 249 AndoFlex TLC - 2 layer compression bandage kit with one size 720 malodour control (latex free) AndoFlex TLC Lite - 2 layer compression bandage kit with one size 720 malodour control (latex free) AndoFlex TLC-XL - 2 layer compression bandage kit with one size 845 malodour control (latex free) AndoFlex UBZ - 2 layer compression bandage kit with zinc 7.5cm 525 (latex free) 10cm 635 BSN medical Ltd Jobst Compri2 - two-layer compression bandage kit 18-25cm 671 25-32cm 767 Jobst Compri2 lite - two-layer compression bandage kit 18-25cm 671 25-32cm 845 Jobst Comprifore - multi-layer compression bandage kit 18-25cm 687 Jobst Comprifore kits contain a combination of the following components: Jobst Comprifore #1 10cm x 3.5m (unstretched) 44 Jobst Comprifore #2 10cm x 4.5m (stretched) 95 Jobst Comprifore #3 10cm x 8.7m (stretched) 217 Jobst Comprifore #4 10cm x 2.5m (unstretched) 270 Jobst Comprifore Latex-free - multi layer compression 18-25cm 723 bandage kit Jobst Comprifore Latex-free kits contain a combination of the following components: Jobst Comprifore #1 Latex-free 10cm x 3.5m (unstretched) 43 Jobst Comprifore #2 Latex-free 10cm x 4.5m (stretched) 93 Jobst Comprifore #3 Latex-free 10cm x 8.7m (stretched) 226 Jobst Comprifore #4 Latex-free 10cm x 2.5m (unstretched) 282 Jobst Comprifore Lite - multi-layer compression bandage kit 18-25cm 449 Jobst Comprifore Lite kits contain a combination of the following components: Jobst Comprifore #1 10cm x 3.5m (unstretched) 44 Jobst Comprifore #2 10cm x 4.5m (stretched) 95 Jobst Comprifore #4 10cm x 2.5m (unstretched) 270 Jobst Comprifore Lite Latex-free - multi-layer compression 18-25cm 484 bandage kit Jobst Comprifore Lite Latex-free kits contain a combination of the following components: Jobst Comprifore #1 Latex-free 10cm x 3.5m (unstretched) 43 Jobst Comprifore #2 Latex-free 10cm x 4.5m (stretched) 93 Jobst Comprifore #4 Latex-free 10cm x 2.5m (unstretched) 282 Velband Absorbent Padding Bandage - listed on page241 10cm x 4.5m 73 236 09/2017 Part IXA APPLIANCES Appliance Size or Weight Basic Price p BANDAGES each ConvaTec Limited SurePress Absorbent Padding - listed on page241 10cm x 3m 57 H & R Healthcare Ltd Hero H-2 - multi-layer compression bandage kit 18-25cm 704 Hero H-2 Lite - multi-layer compression bandage kit 18-25cm 704 Hero H-2 XL - multi-layer compression bandage kit 25-32cm 805 Hero H-2 kits contain a combination of the following components: Hero H-2 layer 1 10cm x 3m 423 Hero H-2 layer 2 10cm x 5m 398 Hero H-2 Lite layer 2 10cm x 5m 398 Hero H-2 XL layer 1 10cm x 5m 483 Hero H-2 XL layer 2 10cm x 6m 453 L&R UK (formerly Activa Healthcare) Actico 2C - multi-layer compression bandage kit 18-25cm 808 25-32cm 910 Actico 2C kits contain a combination of the following components: Actico 2C Comfort layer 1 10cm x 3.5m 437 Actico 2C Compression layer 2 10cm x 6m 402 Cellona Undercast Padding - listed on page241 5cm x 2.75m 32 7.5cm x 2.75m 38 10cm x 2.75m 47 15cm x 2.75m 61 Lohmann & Rauscher (formerly Activa Healthcare) Rosidal Soft 10cm x 2.5m 527 12cm x 2.5m 645 15cm x 2.5m 813 Robinson Healthcare (Ultra Four Non-latex Bandages) Ultra Four - multi-layer compression bandage kit up to 18cm 641 18-25cm 567 Ultra Four RC - multi-layer compression bandage kit 18-25cm 414 Ultra Four kits contain a combination of the following components: Ultra Soft Wadding Bandage (layer #1) - listed on page241 10cm x 3.5m (unstretched) 39 Ultra Lite (layer #2) 10cm x 4.5m (stretched) 85 Ultra Plus (layer #3) 10cm x 8.7m (stretched) 189 Ultra Fast Cohesive Bandage (layer #4) 10cm x 6.3m (stretched) 259 Smith & Nephew Healthcare Ltd Profore - multi-layer compression bandage kit up to 18cm 1035K 18-25cm 964K 25-30cm 800K above 30cm 1199K Profore Lite - multi-layer compression bandage kit above 18cm 557K Profore kits contain a combination of the following components: Profore Wound Contact Layer 14cm x 20cm 32 Profore #1 - listed on page241 10cm x 3.5m (unstretched) 72K Profore #2 10cm x 4.5m (stretched) 137K Profore #3 10cm x 8.7m (stretched) 400K Profore #4 10cm x 2.5m (unstretched) 330K Profore + 10cm x 3m (unstretched) 374K 237

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Definition - The appliances that may be supplied against orders on Forms FP10 are listed below and must conform with the specifications shown. See Part 1, Clause 2 (page 3). These specifications include published official standards ie BP, BPC or relevant British, European or International Standards
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