Advanced Service payments
Advanced Service payments
This page contains details on the funding available for the Advanced Services within the Community Pharmacy Contractual Framework (CPCF).
Click on a heading below for more information.
New Medicine Service (NMS)
Payments are based on the number of prescription items dispensed, i.e. the actual count of physical items processed by the Pricing Authority. Certain items where multiple fees are paid, e.g. FP10MDA items, ACBS flavoured food items and combination packs, only count as one item when assessing the NMS volume. Contractors claim payments by stating on their monthly FP34C the number of completed NMS they have undertaken in a given month.
There are four target payment levels (20%, 40%, 60% and 80%). Under the payment structure the price per completed NMS increases with each target level; this means that contractors will be rewarded for providing the NMS to as many patients as possible:
- All completed NMS provided by a contractor that fall below the 20% target will paid at £20 each;
- Once a contractor reaches the 20% target all completed NMS (including those which fall below the 20% target) will be paid at £25 each;
- Once a contractor reaches the 40% target all completed NMS (including those which fall below the 40% target) will be paid at £26 each;
- Once a contractor reaches the 60% target all completed NMS (including those which fall below the 60% target) will be paid at £27 each;
- Once a contractor reaches the 80% target all completed NMS (including those which fall below the 80% target) will be paid at £28 each.
The number of completed NMS that each contractor needs to provide in order to reach the four target levels, and the maximum number of interventions for which payment will be received, is outlined in the table below.
Volume of prescription items per month
|Number of completed NMS per month necessary to achieve each target||Maximum number of completed NMS per month for which payment will be received|
|20 per cent target||40 per cent target||60 per cent target||80 per cent target|
Payment is limited to 0.5% of the contractors’ eligible monthly prescription volume; contractors can provide NMS above this limit but will not be paid for them.
Medicines Use Review (MUR)
The fee for providing the MUR and the Prescription Intervention Advanced Service is set out in Part VIC of the Drug Tariff; these fees are claimed via the FP34C Submission Form. The fee for provision of an MUR is £28.
To free up capacity and funding for the CPCS, and also in recognition that NHSE&I does not consider MURs to be offering good value for money, MURs will be decommissioned. In 2019/20 contractors can deliver a total of 250 MURs and in 2020/21 this will reduce to 100, with the service being decommissioned at the end of that year. These changes were agreed as part of the five-year Community Pharmacy Contractual Framework agreement.
New MUR target requirements from 1st October
New targeting requirements apply to Medicines Use Review (MURs) conducted from 1st October 2019, so community pharmacy contractors will need to update their standard operating procedure for the service to reflect these changes. These changes were agreed as part of the five-year Community Pharmacy Contractual Framework agreement.
Seventy percent of MURs conducted from 1st October 2019 to 31st March 2020 must be within the following two target groups:
- patients taking high-risk medicines; or
- patients recently discharged from hospital who had changes made to their medicines while they were in hospital.
From 1st October 2019, patients with respiratory disease and patients at risk of or diagnosed with cardiovascular disease and regularly being prescribed at least four medicines are no longer target groups for MURs.
Between 1st April 2019 and 31st March 2020, contractors can undertake up to 250 MURs per pharmacy, but no more than 200 may be undertaken between 1st April 2019 and 30th September 2019.
Appliance Use Review (AUR)
The fees for providing the AUR service are set out in Part VIE of the Drug Tariff. These fees are claimed via the FP34C Submission Form.
The fee for an AUR is £28 for an AUR conducted on pharmacy premises or £54 for an AUR carried out in a patient’s home. If more than one AUR is conducted in the same location within a 24-hour period £54 will be paid for the first AUR, and £28 for each subsequent AUR.
The maximum number of AURs for which claims for payment may be made is not more than 1/35 of the aggregate number of specified appliances dispensed during that financial year.
Stoma Appliance Customisation (SAC)
The fees for providing the SAC service are set out in Part VIE of the Drug Tariff. When this service is provided, £4.32 is paid per qualifying* Part IXC item dispensed, regardless of whether customisation was required.
*Qualifying Part IXC items for stoma customisation are one-piece closed bags (under “colostomy bags” chapter heading of current Drug Tariff), drainable bags (under “ileostomy bags” chapter heading) and bags with tap (under “urostomy bags” chapter heading), items under “two piece ostomy system” and “flanges” chapter headings, as well as Skin Protectors and Stoma Caps.
Flu Vaccination Service
Contractors providing the Flu Vaccination Service will be paid £8.08 per administered dose of vaccine plus an additional fee of £1.50 per vaccination (i.e. a total of £9.58 per administered vaccine). The additional fee is in recognition of costs incurred relating to the provision of the service including training and disposal of clinical waste. Such costs are not reimbursed elsewhere in the CPCF.
Contractors will also be reimbursed for the vaccine costs at the basic price (list price) of the individual vaccine administered and an allowance at the applicable VAT rate will also be paid.
Funding for the service will be in addition to and outside of total agreed community pharmacy funding for the financial year, instead coming from NHS vaccination budgets. The total delivered will be dependent on uptake of the service, but no cap has been set for this.
Claims for payment for the service and reimbursement of vaccine costs are to be made via the NHS Business Services Authority Manage Your Service (MYS) application.
NHS Community Pharmacist Consultation Service (CPCS)
Funding for the CPCS included an initial supplement to the Transition payment for contractors that registered to provide the service before the below deadlines:
- Registered by 1st December 2019 – £900 supplement
- Registered by 15th January 2020 – £600 supplement.
The supplement to the Transition payment will be paid, following registration for the service, as follows:
- For registrations (£900) from 1st November up to and including the end of the day on Sunday 1st December, these will be paid in the January Schedule of Payments (Payment date 31st January, in relation to November prescription claims); and
- For registrations (£600) from 2nd December up to and including the end of the day on Wednesday 15th January, these will be paid in the February Schedule of Payments (Payment date 28th February, in relation to December prescription claims).
When a pharmacy provides the service, they can claim a £14 fee per completed consultation.
This payment model will be reviewed for 2021/22 onwards, depending on factors such as volume of service.
The anticipated funding profile for the initial (NHS 111 referral) service is:
|£4 million||£9 million||£13 million||£16 million||£19 million|
Claiming payment for the service
All payments must be claimed via the NHSBSA Manage Your Service (MYS) portal; no paper-based claims process is available for the service. The CPCS IT system (Sonar or PharmOutcomes) will be able to pre-populate claim information in MYS each month, so that the contractor then just needs to login to MYS at the start of the following month to confirm that the information is correct and to submit the claim.