{"text_format":"1","workbook":"xlsx","n_sheets":5,"sheets":["Amendment Form","Guidance Notes","Revision History","ICB","HWB"],"not_rendered":{"charts":0,"images":1,"macros":0,"external_links":0,"defined_names":6,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Amendment Form","index":0,"n_rows":111,"n_cols":8,"rows_kept":111,"cut":false,"hidden":false,"merged":[[30,1,31,1],[30,2,31,7],[82,1,82,6],[83,1,84,1],[83,2,84,2],[83,3,84,3],[83,5,84,6],[80,3,81,4],[67,3,68,4],[67,2,68,2],[28,1,29,1],[80,2,81,2],[80,5,81,6],[79,1,79,6],[72,1,73,1],[70,1,71,1],[74,1,75,1],[76,1,77,1],[80,1,81,1],[61,2,62,2],[61,3,62,3],[61,4,62,4],[61,5,62,5],[61,6,62,6],[45,2,46,7],[47,2,48,7],[33,0,34,0],[43,1,44,1],[37,1,38,1],[39,1,40,1],[33,1,34,1],[41,2,42,7],[43,2,44,7],[45,1,46,1],[67,1,68,1],[67,5,68,6],[55,7,56,7],[57,1,58,1],[57,2,58,2],[57,3,58,3],[57,4,58,4],[57,5,58,5],[57,6,58,6],[57,7,58,7],[55,1,56,1],[55,2,56,2],[55,3,56,3],[55,4,56,4],[55,5,56,5],[61,1,62,1],[47,1,48,1],[24,1,25,1],[22,1,23,1],[41,1,42,1],[35,1,36,1],[26,1,27,1],[49,1,49,7],[67,7,68,7],[51,6,52,6],[51,7,52,7],[53,1,54,1],[53,2,54,2],[53,3,54,3],[53,4,54,4],[53,5,54,5],[53,6,54,6],[53,7,54,7],[51,1,52,1],[51,2,52,2],[51,3,52,3],[51,4,52,4],[51,5,52,5],[55,6,56,6],[59,2,60,2],[59,3,60,3],[59,4,60,4],[59,5,60,5],[63,5,64,5],[63,7,64,7],[65,4,66,4],[65,5,66,5],[65,6,66,6],[65,7,66,7],[63,6,64,6],[59,6,60,6],[59,7,60,7],[10,1,10,7],[11,1,11,7],[16,2,17,7],[18,2,19,7],[14,1,14,7],[13,2,13,5],[15,2,15,5],[20,1,20,7],[21,1,21,7],[12,1,12,7],[16,1,17,1],[18,1,19,1],[69,1,69,7],[78,1,78,7],[70,2,71,7],[72,2,73,7],[74,2,75,7],[76,2,77,7],[22,2,23,7],[24,2,25,7],[26,2,27,7],[28,2,29,7],[32,1,32,7],[33,2,34,7],[35,2,36,7],[37,2,38,7],[39,2,40,7],[65,1,66,1],[65,2,66,2],[65,3,66,3],[63,1,64,1],[63,2,64,2],[63,3,64,3],[63,4,64,4],[61,7,62,7],[59,1,60,1]]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"New NHS Appliance Contractor "]
[null,"Authorised signatory should complete form and send to: prescriptioninformation@nhsbsa.nhs.uk"]
[]
[null,"ICB Name","Please select ICB",null,null,null,"ICB Code (automatically populated)",{"$f":"VLOOKUP(C14,ICB!A1:B43,2,FALSE)","v":"N/A"}]
[]
[null,"Health and Wellbeing Board Area","Please select HWB",null,null,null,"HWB Code (automatically populated)",{"$f":"VLOOKUP(C16,HWB!A1:B162,2,FALSE)","v":"N/A"}]
[null,"Is the appliance contractor VAT registered?"]
[]
[null,"VAT Number:"]
[]
[null,"Please note: Contractor banking details must be submitted to NHS Prescription Services by following the instructions on our website at: www.nhsbsa.nhs.uk/PrescriptionServices/4031.aspx"]
[null,"New Appliance Contractor Details"]
[null,"Start date (no earlier than the first of the current month)"]
[]
[null,"Contractor/Owner name (max. 40 characters including spaces)"]
[]
[null,"Contractor Trading Name (max. 40 characters including spaces)"]
[]
[null,"Email address of owner/head office"]
[]
[null,"NHS Shared Email Address"]
[]
[null,"Address details (max. 25 characters per line including spaces)"]
[null,"Address line 1"]
[]
[null,"Address line 2"]
[]
[null,"Address line 3 (town or city only)"]
[]
[null,"Address line 4 (county or London only)"]
[]
[null,"Postcode"]
[]
[null,"Telephone number"]
[]
[null,"Distance selling Pharmacy?"]
[]
[null,"Distance selling Pharmacy website address (URL)"]
[]
[null,"Opening Hours ( up to three sets of opening times using 24 hour clock)"]
[null,null,"Opening Time","Closing Time","Opening Time","Closing Time","Opening Time","Closing Time"]
[null,"Example","06:00:00","12:00:00","12:30:00","17:00:00","18:00:00","23:00:00"]
[]
[null,"Monday"]
[]
[null,"Tuesday"]
[]
[null,"Wednesday"]
[]
[null,"Thursday"]
[]
[null,"Friday"]
[]
[null,"Saturday"]
[]
[null,"Sunday"]
[]
[null,"EPS R2 Active System?",null,"EPS R2 Go Live Date?\n(if different to start date)"]
[]
[]
[null,"Authorised signatory:"]
[]
[null,"Print name:"]
[]
[null,"Contact Number:"]
[]
[null,"Date:"]
[]
[]
[null,"For NHS Prescription Services use only"]
[null,"New appliance contractor code",null,"Date sent to Wakefield division/CPS"]
[]
[]
[null,"Date letter sent to ICB",null,"MDR input (Date & Initials)"]
[]
[null,null,null,null,null,null,null,"v2.9 April 2024"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,"Walk-in Centre"]
[null,null,null,"Out-of-Hours Service"]
[null,null,null,"Walk-in Centre and Out-of-Hours Service"]
[null,null,null,"Public Health Service"]
[null,null,null,"Community Health Service"]
[null,null,null,"Hospital Service"]
[null,null,null,"Optometry Service"]
[null,null,null,"Urgent and Emergency Care"]
[null,null,null,"Hospice"]
[null,null,null,"Care Home/Nursing Home"]
[null,null,null,"Other"]
[]
[null,"Yes",null,"Yes (Please provide VAT Number below)",null,null,"Yes (please provide details below)"]
[null,"No",null,"No",null,null,"No"]

{"sheet":"Guidance Notes","index":1,"n_rows":24,"n_cols":2,"rows_kept":24,"cut":false,"hidden":false,"merged":[]}
[]
["ICB Name","The name of the Integrated Care Board that the NHS Pharmacy Contractor is to be attached to (choose from drop down box)"]
["ICB Code","The code of the ICB. (***) - automatically generated"]
["Health and Wellbeing Board Area","The name of the Health and Wellbeing Board Area the NHS Pharmacy Contractor is in (choose from drop down box)"]
["HWB Code","The code of the HWB - automatically generated"]
["Is the appliance contractor VAT registered?","Choose from drop down box"]
["VAT number","State VAT number of "]
["Start Date","The date the NHS Appliance Contractor starts"]
["Contractor/Owner name"," The name of the Contractor/Owner (max. 40 characters including spaces)"]
["Contractor Trading Name","The Contractor trading name (max. 40 characters including spaces)"]
["Email address of owner/head office","The email address of the owner/head office"]
["Address","The address must adhere to the following format.  Each line has 25 characters including spaces"]
[null,"1st Line - address details"]
[null,"2nd Line - address details"]
[null,"3rd Line - Town/City only"]
[null,"4th Line - County/London only"]
["Telephone Number","Please state telephone number of NHS Appliance Contractor"]
["Is a Private CD Pharmacy code required?","Choose from drop down box"]
["Distance selling Pharmacy?","Choose from drop down box"]
["Distance selling Pharmacy website address (URL)","If a Distance Selling pharmacy, quote website address"]
["Opening Hours","Please input opening hours for the service."]
["EPS R2 Active System?","Is there an active EPS system for the contract (choose from drop down box)"]
["EPS R2 Go Live Date","Date system goes live if different to that of start of contract"]
["Authorised Signatory","This is the authorised signatory at the Area Team (or an agency on their behalf) "]

{"sheet":"Revision History","index":2,"n_rows":14,"n_cols":4,"rows_kept":14,"cut":false,"hidden":true,"merged":[]}
["Version","Date","Reason for change","Editor"]
[2,"2022-05-01","New document created from old Excel forms","LAMAT"]
[2.1,"2022-06-29","Changed dropdown to ICB, added opening hours","ALGRA"]
[2.2000000000000002,"2022-06-30","Fixed conditional formatting issues. Changed remained references to STPs and added revision history. Removed 'for prescription services only' at bottom","LAMAT"]
[2.2999999999999998,"2023-05-04","added migration note - new email","ANSCU"]
[2.4,"2023-05-04","added migration note - new email","ANSCU"]
[2.6,"2023-06-28","updated email info on form header","MICBU"]
[2.6,"2023-06-28","updated HWB list to include Westmorland and Furness (HW167) and Cumberland (HW168)","MICBU"]
[2.6,"2023-06-28","updated ICB names of QUA, QNC, QOC, QOQ, QT6","MICBU"]
[2.6,"2023-06-28","added conditional formatting to 'VAT number' box","MICBU"]
[2.7,"2023-08-31","edit Objects' ticked on sheet security for image insertions","MICBU"]
[2.8,"2024-01-29","Bedford Borough HWB name updated from Bedford","MICBU"]
[2.9,"2024-04-02","Northamptonshire North added to HWB list","MICBU"]
[2.9,"2024-04-02","added NHS Shared Email Address section","MICBU"]

{"sheet":"ICB","index":3,"n_rows":43,"n_cols":2,"rows_kept":43,"cut":false,"hidden":true,"merged":[]}
["Please select ICB","N/A"]
["Bath and North East Somerset, Swindon and Wiltshire ICB","QOX"]
["Bedfordshire, Luton and Milton Keynes ICB","QHG"]
["Birmingham and Solihull ICB","QHL"]
["Black Country ICB","QUA"]
["Bristol, North Somerset and South Gloucestershire ICB","QUY"]
["Buckinghamshire, Oxfordshire and Berkshire West ICB","QU9"]
["Cambridgeshire and Peterborough ICB","QUE"]
["Cheshire and Merseyside ICB","QYG"]
["Cornwall and the Isles of Scilly ICB","QT6"]
["Coventry and Warwickshire ICB","QWU"]
["North East And North Cumbria ICB","QHM"]
["Devon ICB","QJK"]
["Dorset ICB","QVV"]
["North East London ICB","QMF"]
["Frimley ICB","QNQ"]
["Gloucestershire ICB","QR1"]
["Greater Manchester ICB","QOP"]
["Hampshire and the Isle of Wight ICB","QRL"]
["Lancashire and South Cumbria ICB","QE1"]
["Herefordshire and Worcestershire ICB","QGH"]
["Hertfordshire and West Essex ICB","QM7"]
["Humber and North Yorkshire ICB","QOQ"]
["Derby And Derbyshire ICB","QJ2"]
["Kent and Medway ICB","QKS"]
["Leicester, Leicestershire and Rutland ICB","QK1"]
["Lincolnshire ICB","QJM"]
["Mid and South Essex ICB","QH8"]
["Norfolk and Waveney ICB","QMM"]
["North Central London ICB","QMJ"]
["North West London ICB","QRV"]
["Northamptonshire ICB","QPM"]
["Nottingham and Nottinghamshire ICB","QT1"]
["South East London ICB","QKK"]
["Shropshire, Telford and Wrekin ICB","QOC"]
["Somerset ICB","QSL"]
["South West London ICB","QWE"]
["South Yorkshire ICB","QF7"]
["Staffordshire and Stoke-on-Trent ICB","QNC"]
["Suffolk and North East Essex ICB","QJG"]
["Surrey Heartlands ICB","QXU"]
["Sussex ICB","QNX"]
["West Yorkshire ICB","QWO"]

{"sheet":"HWB","index":4,"n_rows":162,"n_cols":2,"rows_kept":162,"cut":false,"hidden":true,"merged":[]}
["Please select HWB","N/A"]
["Ashford","HW162"]
["Barking and Dagenham ","HW001"]
["Barnet ","HW002"]
["Barnsley ","HW003"]
["Bassetlaw ","HW004"]
["Bath and North East Somerset ","HW005"]
["Bedford Borough","HW006"]
["Bexley ","HW007"]
["Birmingham ","HW008"]
["Blackburn with Darwen ","HW009"]
["Blackpool ","HW010"]
["Bolton","HW011"]
["Bournemouth and Poole ","HW013"]
["Bracknell and Ascot ","HW014"]
["Bradford and Airedale ","HW015"]
["Brent ","HW016"]
["Brighton and Hove ","HW017"]
["Bristol ","HW018"]
["Bromley ","HW020"]
["Buckinghamshire ","HW021"]
["Bury ","HW022"]
["Calderdale ","HW023"]
["Cambridgeshire ","HW024"]
["Camden ","HW025"]
["Canterbury and Coastal","HW163"]
["Central Bedfordshire","HW026"]
["Cheshire East ","HW027"]
["Cheshire West and Chester ","HW028"]
["City of London ","HW029"]
["Cornwall ","HW030"]
["Coventry ","HW031"]
["Croydon ","HW032"]
["Cumberland","HW168"]
["Cumbria ","HW033"]
["Darlington ","HW035"]
["Derby City ","HW036"]
["Derbyshire ","HW037"]
["Devon ","HW038"]
["Doncaster ","HW039"]
["Dorset ","HW040"]
["Dudley ","HW041"]
["Durham ","HW042"]
["Ealing ","HW043"]
["East Riding Of Yorkshire ","HW044"]
["East Sussex ","HW045"]
["Enfield ","HW046"]
["Essex ","HW047"]
["Gateshead ","HW048"]
["Gloucestershire ","HW049"]
["Greenwich ","HW050"]
["Hackney ","HW051"]
["Halton ","HW052"]
["Hammersmith and Fulham ","HW053"]
["Hampshire ","HW054"]
["Haringey ","HW055"]
["Harrow ","HW056"]
["Hartlepool ","HW057"]
["Havering ","HW058"]
["Herefordshire ","HW059"]
["Hertfordshire ","HW060"]
["Hillingdon ","HW061"]
["Hounslow ","HW062"]
["Hull ","HW063"]
["Isle Of Wight ","HW066"]
["Isles of Scilly ","HW067"]
["Islington ","HW068"]
["Kensington & Chelsea ","HW069"]
["Kent ","HW070"]
["Kingston ","HW071"]
["Kirklees ","HW072"]
["Knowsley ","HW073"]
["Lambeth ","HW074"]
["Lancashire ","HW075"]
["Leeds ","HW076"]
["Leicester City ","HW077"]
["Leicestershire ","HW078"]
["Lewisham ","HW079"]
["Lincolnshire ","HW080"]
["Liverpool ","HW081"]
["Luton ","HW082"]
["Manchester ","HW084"]
["Medway ","HW085"]
["Merton ","HW086"]
["Middlesbrough ","HW087"]
["Milton Keynes ","HW088"]
["Newcastle ","HW089"]
["Newham ","HW090"]
["Norfolk ","HW091"]
["North East Lincolnshire ","HW092"]
["North Lincolnshire ","HW093"]
["North Somerset ","HW094"]
["North Tyneside ","HW095"]
["North Yorkshire ","HW096"]
["Northamptonshire ","HW097"]
["Northamptonshire North","HW169"]
["Northumberland ","HW098"]
["Nottingham City ","HW099"]
["Nottinghamshire ","HW100"]
["Oldham ","HW102"]
["Oxfordshire ","HW103"]
["Peterborough ","HW104"]
["Plymouth ","HW105"]
["Portsmouth ","HW106"]
["Reading ","HW107"]
["Redbridge ","HW108"]
["Redcar & Cleveland ","HW109"]
["Richmond ","HW110"]
["Rochdale ","HW111"]
["Rotherham ","HW112"]
["Rutland ","HW113"]
["Salford ","HW115"]
["Sandwell ","HW116"]
["Sefton ","HW117"]
["Sheffield ","HW118"]
["Shropshire ","HW119"]
["Slough ","HW120"]
["Solihull ","HW121"]
["Somerset ","HW122"]
["South Gloucestershire ","HW123"]
["South Kent Coast","HW164"]
["South Tyneside ","HW124"]
["Southampton ","HW125"]
["Southend on Sea ","HW126"]
["Southwark ","HW127"]
["St Albans ","HW128"]
["St Helens ","HW129"]
["Staffordshire ","HW130"]
["Stockport ","HW131"]
["Stockton-on-Tees ","HW132"]
["Stoke-On-Trent ","HW133"]
["Suffolk ","HW134"]
["Sunderland ","HW135"]
["Surrey ","HW136"]
["Sutton ","HW137"]
["Swale","HW165"]
["Swindon ","HW138"]
["Tameside ","HW139"]
["Telford & Wrekin ","HW140"]
["Thanet","HW166"]
["Thurrock ","HW141"]
["Torbay ","HW142"]
["Tower Hamlets ","HW143"]
["Trafford ","HW144"]
["Wakefield ","HW145"]
["Walsall ","HW146"]
["Waltham Forest ","HW147"]
["Wandsworth ","HW148"]
["Warrington ","HW149"]
["Warwickshire ","HW150"]
["West Berkshire ","HW151"]
["West Sussex ","HW152"]
["Westminster ","HW153"]
["Westmorland and Furness","HW167"]
["Wigan ","HW154"]
["Wiltshire ","HW155"]
["Windsor and Maidenhead ","HW156"]
["Wirral ","HW157"]
["Wokingham ","HW158"]
["Wolverhampton ","HW159"]
["Worcestershire ","HW160"]
["York ","HW161"]