Why the gap exists at all
You pay the wholesaler on their terms. You dispense. You submit by the 5th. NHSBSA pays an advance from day 8 for prescriptions dispensed a month earlier, priced as items declared on the FP34C multiplied by your latest average Net Ingredient Cost, less prescription charges you collected. Then it settles properly on the first working day of the month two months after submission.
On the verified 2026 dates that means an item dispensed on 1 June reaches an estimated advance on 9 July and final settlement on 1 September — 38 days and 92 days. An item dispensed on 30 June reaches the same two points in 9 days and 63 days. This calculator models the midpoint, because your real answer depends on your daily dispensing profile.
The part that catches people
Negative reconciliation is recovered from your next advance payment. It does not arrive as an invoice you can query, schedule or dispute — it is simply netted off what turns up next. So a difficult pricing month lands on a bank balance that is already funding the gap this calculator is showing you.
Concessions arrive after the month they cover
This is the working-capital problem people describe as a pricing problem. Where no product is available at the Part VIII price, a concessionary price can be granted — but it is granted in tranches, and the tranches land late. For July 2026 dispensing, DHSC-agreed prices were issued on 22, 29 and 31 July and 4 August, the last of those after the month had been dispensed. Eight July concessions were then rolled into August. Multiple rounds a month is the norm, and the final position for a month is typically not known until the first days of the following one — long after the stock was bought and the patients served.
Concessions can also be deliberately held down. Clause 8B2 says that whenever recouping of over-delivered medicine margin is taking place, the Department may constrain concessionary prices so as not to undermine that recouping — and that the prices granted may therefore be lower than they otherwise would have been. That is not a theoretical power: April to June 2024 concessions were constrained to reflect a £16.2 million downward adjustment.
There is a retrospective top-up, three quarters late
Clause 8F and Part VIIIE provide for a quarterly retrospective top-up to concessionary prices granted three quarters earlier, applied automatically by NHSBSA by the volume you were paid for. Items dispensed April to June are topped up the following January; July to September in April; October to December in July; January to March in the October of the same year.
Two things follow. First, money you are owed for a difficult month can be nine months away, which belongs in a forecast rather than in a surprise. Second — and this catches sellers — if the pharmacy ceased trading before the top-up determination is made, NHSBSA will not pay it, even though you were trading in the month it relates to. That has applied since April 2024, and it is worth valuing before a sale rather than writing off after one.