241 02/2018 Part IX APPLIANCES

532 Pages·2017·1.27 MB·English

02/2018 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 (page8)
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 242. 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.
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02/2018 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
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02/2018 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 116
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)
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02/2018 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 49876
o IryCone+ 29220E 6119
IryPump Container 29240 4237
o Navina Classic System 69005 7522K
(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 5756K
o Navina Classic System - refill 69006 7522K
(Contains 1 Navina Classic control unit, 1 water container, 1 tube set, 2 rectal
catheters)
o Navina Smart System 69009 30092K
(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 30092K
(Contains Navina Smart control unit, 1 charger, 1 power adaptor)
o Navina Consumable Set 69003 13032K
(Contains 15 rectal catheters, 1 water container)
pack of 10
o Navina Rectal Catheter Set 68940 8210K
(Contains 10 rectal catheters)
each
Navina Tube Set 69011 883K
(Contains 1 catheter tube, 1 water container tube)
o Peristeen System 29121 7690
(System includes 1 control unit, 2 rectal catheters, 1 water bag, 2 straps)
o Small 29126 7690
(System includes 1 control unit, 2 rectal catheters, 1 water bag, 1 strap)
o Peristeen Accessory Unit 29122 13402
(Contains 15 rectal catheters, 1 water bag)
o Small 29127 13402
(Contains 15 rectal catheters, 1 water bag)
pack of 10
o Peristeen Rectal Catheters 29123 8569
o Small 29128 8569
(Contains 10 rectal catheters)
per pair
Peristeen Straps 29124 549
pack of 2
Peristeen Tubes 29125 769
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02/2018 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))
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02/2018 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) 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 366
Prontoderm Nasal Gel 30ml tube 518
Octenisan md Nasal Gel 6ml tube 376
Part IXA-Appliances
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02/2018 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 85
10cm x 3.5m 105
15cm x 3.5m 143
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 71
7.5cm 100
10cm 126
15cm 184
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
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02/2018 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 56
4.5m stretched 7cm x 4.5m 78
*10cm x 4.5m 102
15cm x 4.5m 147
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 231
K-Plus Long
10.25m stretched *10cm x 10.25m 267
L3
8.6m Stretched 10cm x 8.6m 224
High Compression Bandage (Extensible)
K-ThreeC *10cm x 3m unstretched 287
SurePress 10cm x 3m unstretched 368
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
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02/2018 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 Medical UK Ltd 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 676
25-32cm 773
Jobst Compri2 lite - two-layer compression bandage kit 18-25cm 676
25-32cm 852
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 page254 10cm x 4.5m 74
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APPLIANCES
Appliance Size or Weight Basic Price p
BANDAGES each
ConvaTec Limited
SurePress Absorbent Padding - listed on page254 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 Medical UK Ltd (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
Lohmann & Rauscher (formerly Activa Healthcare)
Cellona Undercast Padding - listed on page254 5cm x 2.75m 32
7.5cm x 2.75m 38
10cm x 2.75m 47
15cm x 2.75m 61
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 page254 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 1035
18-25cm 964
25-30cm 800
above 30cm 1199
Profore Lite - multi-layer compression bandage kit above 18cm 557
Profore kits contain a combination of the following components:
Profore Wound Contact Layer 14cm x 20cm 32
Profore #1 - listed on page254 10cm x 3.5m (unstretched) 72
Profore #2 10cm x 4.5m (stretched) 137
Profore #3 10cm x 8.7m (stretched) 400
Profore #4 10cm x 2.5m (unstretched) 330
Profore + 10cm x 3m (unstretched) 374
250