{"text_format":"1","workbook":"xlsx","n_sheets":4,"sheets":["Amendment Form","ICB","Guidance Notes","Revision History"],"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":70,"n_cols":10,"rows_kept":70,"cut":false,"hidden":false,"merged":[[36,2,37,5],[38,2,39,5],[34,6,35,9],[36,6,37,9],[38,6,39,9],[42,2,43,9],[45,2,46,9],[51,2,52,9],[47,1,48,1],[47,2,48,9],[49,1,50,1],[49,2,50,9],[44,1,44,9],[40,2,41,5],[30,6,31,9],[32,6,33,9],[10,1,10,9],[13,8,13,9],[11,1,11,9],[14,1,14,9],[16,1,17,1],[16,2,17,9],[13,2,13,6],[15,1,15,9],[12,1,12,9],[26,6,27,9],[26,2,27,5],[40,6,41,9],[34,2,35,5],[51,1,52,1],[42,1,43,1],[38,1,39,1],[32,1,33,1],[45,1,46,1],[40,1,41,1],[34,1,35,1],[36,1,37,1],[24,9,25,9],[24,7,25,7],[24,3,25,3],[24,6,25,6],[30,0,31,0],[30,1,31,1],[28,1,28,9],[29,1,29,9],[54,8,54,9],[18,1,19,1],[18,2,19,9],[30,2,31,5],[32,2,33,5],[20,1,21,1],[20,2,21,9],[23,2,23,5],[24,4,25,4],[26,1,27,1],[23,6,23,9],[22,1,22,9],[24,5,25,5],[24,1,25,1],[24,2,25,2],[24,8,25,8]]}
[]
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[]
[]
[]
[]
[]
[]
[null,"Change of Private CD Prescriber Details"]
[null,"Authorised signatory should complete form and send to: prescriptioninformation@nhsbsa.nhs.uk"]
[]
[null,"ICB Name:","Please Select ICB",null,null,null,null,"ICB Code (autopopulates):",{"$f":"VLOOKUP(C14,ICB!$A$2:$B$44,2,FALSE)","v":"N/A"}]
[]
[null,"Prescriber Type:"]
[null,"Please select from the dropdown box:","Please Select"]
[]
[null,"Type of Change:"]
[]
[null,"Private CD prescriber code:"]
[]
[]
[null,null,"Existing private CD prescriber details:",null,null,null,"New Private CD Prescriber details:"]
[null,"Private CD Prescriber Name (max. 28 characters including spaces):","Surname:",null,"Initial(s):",null,"Surname:",null,"Initial(s):"]
[]
[null,"Title (please select from drop down box):","Please Select",null,null,null,"Please Select"]
[]
[]
[null,"Address Details (max. 25 characters including spaces per line):"]
[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,"Date of Change:"]
[]
[]
[null,"Authorised signatory:"]
[]
[null,"Print name:"]
[]
[null,"Contact Number:"]
[]
[null,"Date:"]
[]
[]
[null,null,null,null,null,null,null,null,"v4.9 Feb 2025"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,"Please Select",null,null,"Please Select","Please Select"]
[null,null,null,null,null,"Doctor",null,null,"Dr","Change of surname/title/initials"]
[null,null,null,null,null,"Nurse",null,null,"Mr","Change of address/postcode"]
[null,null,null,null,null,"Paramedic (for CD requisition use only)",null,null,"Mrs","Change of telephone number"]
[null,null,null,null,null,"Optometrist",null,null,"Miss"]
[null,null,null,null,null,"Pharmacist",null,null,"Ms"]
[null,null,null,null,null,"Physiotherapist",null,null,"Mx"]
[null,null,null,null,null,"Radiographer",null,null,"Sister"]

{"sheet":"ICB","index":1,"n_rows":44,"n_cols":2,"rows_kept":44,"cut":false,"hidden":true,"merged":[]}
["Integrated Care Board Name ","ICB Code"]
["Please Select ICB","N/A"]
["BATH&NE SOMERSET,SWINDON & WILTSHIRE ICB","QOX"]
["BEDFORDSHIRE, LUTON & MILTON KEYNES ICB","QHG"]
["BIRMINGHAM AND SOLIHULL ICB","QHL"]
["BLACK COUNTRY ICB","QUA"]
["BRISTOL, N SOMERSET & SOUTH GLOS ICB","QUY"]
["BUCKS, OXFORDSHIRE & BERKSHIRE WEST ICB","QU9"]
["CAMBRIDGESHIRE & PETERBOROUGH ICB","QUE"]
["CHESHIRE AND MERSEYSIDE ICB","QYG"]
["CORNWALL AND THE ISLES OF SCILLY ICB","QT6"]
["COVENTRY AND WARWICKSHIRE ICB","QWU"]
["DERBY AND DERBYSHIRE ICB","QJ2"]
["DEVON ICB","QJK"]
["DORSET ICB","QVV"]
["FRIMLEY ICB","QNQ"]
["GLOUCESTERSHIRE ICB","QR1"]
["GREATER MANCHESTER ICB","QOP"]
["HAMPSHIRE AND ISLE OF WIGHT ICB","QRL"]
["HEREFORDSHIRE AND WORCESTERSHIRE ICB","QGH"]
["HERTFORDSHIRE AND WEST ESSEX ICB","QM7"]
["HUMBER AND NORTH YORKSHIRE ICB","QOQ"]
["KENT AND MEDWAY ICB","QKS"]
["LANCASHIRE AND SOUTH CUMBRIA ICB","QE1"]
["LEICESTER, LEICESTERSHIRE & RUTLAND ICB","QK1"]
["LINCOLNSHIRE ICB","QJM"]
["MID AND SOUTH ESSEX ICB","QH8"]
["NORFOLK AND WAVENEY ICB","QMM"]
["NORTH CENTRAL LONDON ICB","QMJ"]
["NORTH EAST AND NORTH CUMBRIA ICB","QHM"]
["NORTH EAST LONDON ICB","QMF"]
["NORTH WEST LONDON ICB","QRV"]
["NORTHAMPTONSHIRE ICB","QPM"]
["NOTTINGHAM AND NOTTINGHAMSHIRE ICB","QT1"]
["SHROPSHIRE, TELFORD & WREKIN ICB","QOC"]
["SOMERSET ICB","QSL"]
["SOUTH EAST LONDON ICB","QKK"]
["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":"Guidance Notes","index":2,"n_rows":16,"n_cols":2,"rows_kept":16,"cut":false,"hidden":false,"merged":[]}
[]
["ICB Name","The name of the ICB that the NHS Pharmacy Contractor is to be attached to"]
["ICB Code","The code of the ICB. (Q**)"]
["Prescriber Type","Choose from drop down box"]
["Type of Change","Choose from drop down box"]
["Private CD prescriber code","State the prescriber code of the Private CD Prescriber"]
["Private CD Prescriber Name","The surname and initials of the private CD prescriber (max.28 characters including spaces)"]
["Title","Choose from the drop down box"]
["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 private CD prescriber"]
["Date of Change","Date of the changes of the private CD prescriber"]
["Authorised Signatory","This is the authorised signatory at the ICB (or an agency on their behalf) "]

{"sheet":"Revision History","index":3,"n_rows":22,"n_cols":4,"rows_kept":22,"cut":false,"hidden":true,"merged":[]}
["Version","Date","Reason for change","Editor"]
[3,"2022-02-01","New file created from 2017 forms","LAMAT"]
[3.1,"2022-06-10","Changed area team reference to ICB, removed 'for prescription services only'","LAMAT"]
[4,"2022-06-20","All Area Team References in guidance sheet changed to ICB","MICBU"]
[4,"2022-06-20","Conditionally reformatted all data input boxes","MICBU"]
[4,"2022-06-20","Inserted dropdown for ICB Names, automated ICB code population","MICBU"]
[4,"2022-06-20","change type dropbox replaced with tick boxes","MICBU"]
[4,"2022-06-20","\"please select\" added to dropdown boxes","MICBU"]
[4.0999999999999996,"2022-06-27","Spelling in optometrist corrected from optomotrist","MICBU"]
[4.0999999999999996,"2022-06-27","bracketed text size increased from 8 to 10","MICBU"]
[4.0999999999999996,"2022-06-27","general text input colour changed from black to 'dark red', in line with other forms","MICBU"]
[4.0999999999999996,"2022-06-27","added heading column: 'Address Details (max. 28 characters including spaces per line)'; merged cells B26:G26","MICBU"]
[4.0999999999999996,"2022-06-27","data validation max 28 letter limit set for cells C30:J41","MICBU"]
[4.0999999999999996,"2022-06-27","unlocked all data input cells & drop downs","MICBU"]
[4.2,"2022-06-28","adjusted font size & made bold, renamed files","LAMAT"]
[4.3,"2022-07-12","Adjusted character limits for address to 25 incl.spaces","LAMAT"]
[4.4000000000000004,"2022-08-12","Increased spacing between sections","LAMAT"]
[4.5,"2023-05-11","Added org data email migration information","FAEVE"]
[4.5999999999999996,"2023-05-25","updated migration date to June 2023","MICBU"]
[4.7,"2023-06-27","updated email info on form header","MICBU"]
[4.8,"2023-08-31","edit Objects' ticked on sheet security for image insertions","MICBU"]
[4.9000000000000004,"2025-02-10","added Mx into titles lists","MICBU"]