APPLICATION TO AMEND CORE HOURS NAME OF PRIMARY CARE

 RIDING ESTABLISHMENTS ACTS 19641970 APPLICATION FOR LICENCE TO
  APPLICATION FORM AND PERSONAL INFORMATION SHEET IF
EMA520992013 EMAPDCO SUMMARY REPORT ON AN APPLICATION FOR A

FRONT TO THE WORDPRESS APPLICATION THIS FILE
12 FILLING OUT DESCRIPTION OF THE APPLICATION
2013 EDUCATION AND OUTREACH GRANTS APPLICATION FORM

FORM OF RETURN TO BE SUBMITTED TO THE PRIMARY CARE TRUST,

APPLICATION TO AMEND CORE HOURS


Name of Primary Care Trust

     

Name of pharmacy contractor

     

Address of premises to which this return applies

     

Address for correspondence (if different)

     

Current and Proposed Core hours


Current



Proposed



Day

Open from

To

Lunchtime

Open from

To

Lunchtime

Monday

     

     

     

     

     

     

Tuesday

     

     

     

     

     

     

Wednesday

     

     

     

     

     

     

Thursday

     

     

     

     

     

     

Friday

     

     

     

     

     

     

Saturday

     

     

     

     

     

     

Sunday

     

     

     

     

     

     


Date this change is to take effect


Amendment for this week only (tick)i


Amendment to be permanent from this week (tick)ii


Justification for Application to Proposed Change to Contractual Hoursiii:

     

Proposed Change to Contractual Hoursiv:

I / we apply to make the proposed change to the contractual hours of the pharmacy

Signed


Date

     

Contact for queries relating to this form

     

Telephone number

     


i This field of the Application Form is to apply to change core contractual hours on a single occasion only. The individual pharmacy contractor concerned will revert to their original contractual hours as previously agreed with their PCT immediately after close of business on the date specified e.g. from the following day. A contractor must make a separate application to the PCT for every single date upon which they propose to change their core contractual hours commitment.

ii This field of the Application Form is to apply for a permanent change to core contractual hours from the date specified and so onwards.

iii PSNC would recommend that the pharmacy contractor provides a comprehensive summary of the justification for this change to contractual hours, including providing evidence of changes to pharmaceutical needs so that when the PCT considers the submitted application, it does so in the complete knowledge of the individual pharmacy contractor’s position and the circumstances which have precipitated this request. This may, for example, describe changes to the patterns of patients presenting prescriptions, or refer to the opening hours of surgeries or other pharmacies to ensure the PCT is aware of the access of patients to pharmaceutical services.

The PCT should consider all applications for proposed changes to core contractual hours within 60 days. The PCT assessment of an application will take into consideration current pharmaceutical service needs and so the information you provide will support your proposal and may aid the PCT to grant your application more readily.

PSNC would like to remind pharmacy contractors that they must apply at least 90 days in advance to the PCT of the date of the proposed change to core contractual hours.

iv PSNC would also advise all pharmacy contractors wishing to notify the PCT of proposed changes to supplementary hours (alongside an application to proposed changes to core contractual hours), that they complete the Notification to amend Supplementary Hours Form.

Application to amend core hours form

(further copies of this form can be obtained from www.psnc.org.uk)

APPLICATION TO AMEND CORE HOURS NAME OF PRIMARY CARE



2018 INTERNATIONAL SUMMER SCHOOL COURSE TEACHING APPLICATION FORM
20XX WRITTEN QUESTIONS ON APPLICATION GUIDELINES AS WE
23 DATE FEBRUARY 23RD 2009 SUBJECT APPLICATION


Tags: amend core, to amend, amend, primary, hours, application