IT and EPS allowances
IT and EPS allowances
Read more generally about EPS at EPS home.
The costs of establishing the UK’s National Medicines Verification System are to be borne by manufacturers of branded and generic medicines and parallel distributors. Under the Delegated Regulation, each sector, including pharmacy, is responsible for its own costs for connecting to the NMVS. Each of the four national community pharmacy negotiators, including PSNC, is working to ensure that contractors’ FMD-related costs are recognised in future NHS funding settlements. Some of the costs involved include initial set-up, IT, both software and hardware, plus ongoing operational costs.
Initial EPS allowances
EPS Release 1 allowance
All contractors received £2,600 in 2005/06 linked to deploying Release 1 of the Electronic Prescription Service. Contractors who opened new premises (other than a minor relocation) after December 2005 and who did not receive the allowance when it was initially paid-out were able to claim the allowance up until 31st July 2009.
EPS Release 2 allowance
A further allowance of £1,000 is being paid linked to a pharmacy deploying EPS Release 2. Payment is automatically triggered, when a pharmacy submits a synthetic reimbursement message to the Pricing Authority. There is no need to complete a claim form and the local NHS England team don’t need to authorise the payment. A contractor will be given a barcode of a digitally signed test prescription during deployment of Release 2 in the pharmacy. When the contractor sends the test electronic reimbursement message to the spine, this will trigger both the Release 2 £1000 allowance and a contractor being classified as enabled for nomination (i.e. information being fed to NHS Choices that the contractor is enabled). Confirmation of payment will appear on a contractor’s schedule of payments.
The one-off set up fee for EPS Release 2 will cease from April 2017.
Where a pharmacy contractor had been able to operate the Electronic Prescription Service (EPS) Release 1 or Release 2, up until the end of November 2016, they were entitled to receive a £200 monthly allowance to contribute towards EPS costs where the one-off claim form was submitted. It was also important to check that payments were started, and follow up if not.
The process for claiming the monthly allowance had been as follows:
- Getting live with EPS R1 or R2
Once the pharmacy was live with EPS (either Release 1 or Release 2), the contractor was entitled to complete the process below in order to receive the £200 monthly allowance – which was able to be claimed during and up until November 2016.
- Submit a one-off claim form
The £200 monthly allowance was only initiated once the monthly allowance claim form (external link) had been sent to the local NHS England team once the pharmacy first went live with EPS. If the form was submitted by the end of the first month EPS was operating, the contractor was eligible to receive the monthly allowance for that month and subsequent months. To guard against the claim forms going missing, it was recommended that it was sent by recorded delivery and a check was made that delivery had taken place, but it may also have been useful to send a copy by email, requesting delivery receipt and keeping a copy.
- Check the payment is appearing on your Schedule of Payment
For dispensing months up to November 2016, the £200 monthly allowance was listed as ‘ETP allowance’ on the FP34 Schedule of Payment. The allowance appears in the ‘Details of local amounts authorised’ section:
Where the relevant claim form was submitted but there was a delay with the initiation of the monthly payments, the contractor should request back-payment from the NHS England local team. The back-payment should cover the month from which the form was originally submitted. If needed, the Local Pharmaceutical Committee may provide support in such circumstances. As the EPS monthly allowance has been halted it therefore won’t appear on the December 2016 Schedule of Payments (see ‘recent changes’ below).
- Submitting a cancellation letter if EPS is stopped
If the contractor ever ceased operating the EPS (Release 1 or 2) and had therefore needed to halt payment of the allowance whilst it was still in place, it must have written to the local NHS England team so that payment of the ongoing monthly allowance would not be provided. The template cancellation letter which had been used is available here.
Single Activity Fee
Following the October 2016 announcement of the imposition for community pharmacy funding, for the dispensing month December 2016 and after, the Single Activity Fee (SAF), will replace a number of other fees: the monthly EPS allowance, Professional Fee, Practice Payment, Repeat Dispensing Annual Payment. No claim form is required to be used. This fee will be set at a level to deliver the target funding. The SAF value is listed in the Drug Tariff as of December at £1.13 per item.
Additional funding linked to EPS
In late 2009, PSNC published an update on funding discussions with DHSC on EPS. There are three key cost areas that need to be reflected in funding for contractors:
- The impact of introducing a new service, for example the costs of setting up new processes, engaging in training and obtaining smartcards;
- The impact of dual running: DHSC acknowledged that running both paper and electronic systems would involve more work;
- The cost implications of the permanent impact that introducing new work processes may have.
As part of the 2009-10 funding settlement, the DHSC agreed to make provision against the excess margin over the £500m, for a number of one-off costs pharmacy contractors are facing, including preparing for EPS2.
A decision on any cost/saving implications of EPS on an on-going basis could not be made during the early stage of Release 2 implementation as there needs to be a period for widespread bedding in, for contractors to make changes to their processes so as to maximise the efficiencies in running the service. There may also be increased on-going costs linked to connectivity and maintaining PMR systems.
A 2016 EPS costing exercise was conducted.
Claiming the £200 SCR allowance (expires after March 2017)
The March 2016 Drug Tariff Part VIA notified pharmacy contractors that to support the implementation of the Summary Care Record (SCR) to community pharmacies, they will be paid an allowance of £200 from the 1 March 2016, subject to certain conditions being met.
The £200 allowance will be triggered when the pharmacy contractor has submitted the SCR in Community Pharmacy Usage Agreement to the NHS Digital and accessed the SCR. The allowance will only be paid once, irrespective of any subsequent premises merger, sale or relocation. The allowance will be time-limited and ceased on the 31 March 2017.
In order to have received the allowance pharmacy contractors had some requirements to fulfil. These were laid out within this last year’s SCR checklist.
The relevant regulations which pharmacy contractors must adhere to are set out in Schedules 4 and 7 of the National Health Service (Pharmaceutical and Local Pharmaceutical Services (England) (Amendment) Regulations 2016.
SCR and quality payments
Accessing SCR has also been included as one of the criteria in the new Quality Payments scheme: increased usage could be worth up to £640 in 2017/18. NHS Digital has published an SCR usage calculator tool to assist contractors in monitoring and increasing their SCR usage to meet the SCR quality criterion.
PSNC comment on the SCR funding
PSNC is pleased that the rollout of community pharmacy access to the NHS Summary Care Record (SCR) is moving ahead. It will be an important enabler for the more clinically focussed community pharmacy service that the profession wants to see develop. Additionally, in time it should help us to make the case for full read and write access to shared care records which will further enhance patient care and collaboration with other healthcare professionals, particularly those working in general practices.
The costs that pharmacy contractors will incur if they choose to rollout SCR access will vary depending on the individual pharmacy; the £200 payment to pharmacy contractors included in the March 2016 Drug Tariff represented a contribution to those costs. When the Secretary of State for Health provided funding to NHS England to enable SCR access in community pharmacies, he made this conditional on pharmacy contractors sharing the cost of rollout with the NHS.
The Quality Payments Scheme was introduced as part of the Community Pharmacy Contractual Framework in 2017/18. This involves payments being made to community pharmacy contractors meeting specific quality criteria. Some of the criteria relates to the digital domain items:
- EPS utilisation.
- NHS Choices entry updated as required.
- NHS 111 Directory of Services updated as required.
- NHSmail criteria is met.
- SCR – required number of accesses have been made.
Read more at: Quality Payments.
EPS funding for low volume pharmacies
Q. I’m an LPS Contractor and haven’t received my EPS Release 1 allowance?
The EPS/IT Allowances were agreed as part of the funding arrangements for the National NHS Pharmacy Contract. LPS Contracts[LINK] are locally negotiated and agreed with the local NHS England team. LPS Contractors are advised to discuss funding for IT upgrades with their local NHS England team.
Claiming the EPS Release 2 Allowance (£1,000) (had been applicable until March 2017)
Q. What is the time limit for obtaining the £1,000 allowance?
Contractors must have gone live with EPS R2, and the test prescription had been sent (see FAQ below) before the end of March 2017. The one-off set up fee for EPS Release 2 ceased from April 2017.
Q. What is the synthetic reimbursement endorsement message that triggers the EPS Release 2 payment?
As a final test for successful deployment of Release 2, an individual dispensing contractor will be given a barcode of a digitally signed test prescription to download and dispense. The contractor will then request and download the digitally signed test prescription from the Spine. The contractor will ‘dispense’ the script then send a notification and a synthetic electronic reimbursement endorsement message to the spine. The spine will then forward the pharmacy’s “synthetic” message to the Pricing Authority. This will act as the trigger for:
- the Release 2 £1000 allowance (if before end of March 2017); and
- a contractor being classified as enabled for nomination (and hence this information being fed through to NHS Choices)
System suppliers will provide pharmacies with the test prescription. Further guidance can be found on the NHS Digital website.
Monthly EPS Allowance (£200/month) (had been applicable until November 2016)
Q. I work for the head office of a multiple pharmacy group. Did each pharmacy have to make the claim for the monthly allowance individually? (had been applicable until November 2016″)
A. Staff working in the Head Office of a multiple pharmacy chain could have submitted a claim to the appropriate local NHS England team on behalf of a pharmacy in the area.
Q. My local NHS England team has told me that they will only initiate payment of the EPS monthly allowance if I scan a test prescription and return a copy of the printed label. Do I have to? (had been applicable until November 2016″)
A. If the local NHS England team has concerns about a contractor’s ability to operate EPS, they have been advised by the Department of Health and Social Care (DHSC) to follow due process to check the contractor’s ability to operate the service, for example visiting the pharmacy. The DHSC have also emphasised the need to ensure that there is not delayed payment to pharmacies.
Q. My local NHS England team has sent me a different Form to the ETP monthly allowance claim form to complete to claim the on-going IT Allowance. Can local NHS England teams design their own form? [had been applicable until November 2016″]
A. No, the requirement for the payment of the on-going IT payment is set out in the Drug Tariff Part VIA and states that the form ‘ETP Monthly Allowance Claim Form’ must be sent to the local NHS England team. The form ‘Monthly Allowance Claim Form’ is a national form and has a ‘gateway’ reference. Therefore, our view is that the local NHS England team is not at liberty to amend the form.
Q. Can my local NHS England team withhold payment of the ETP monthly Allowance? [had been applicable until November 2016″]
A. The DHSC has previously advised that “If the PCT receives a claim form from a Contractor but has concerns about a contractor’s ability to operate Release 1 of EPS it should follow due process to check the Contractor’s ability to operate the service.
If on following due process the local NHS England team has evidence that a contractor is not in a position to operate Release 1 of EPS, the local NHS England team can withhold payment and not authorise the Pricing Authority to make the monthly payment. However, the contractor should be notified in writing that payment is being withheld and highlight why. Alternatively, in some circumstances, it may be appropriate before withholding payment to allow the contractor the opportunity rectify the position and withhold payment if the position is not rectified within a reasonable, specified timeframe. “
Q. Can my local NHS England team withhold payment if on a particular day the locum in the pharmacy does not have a smartcard? [had been applicable until November 2016″]
A. DHSC has previously advised PCTs that ‘it may be considered unreasonable of a PCT to withhold payment during the course of deployment of Release 1 because a contractor is unable to operate Release 1 of EPS while a locum without a smartcard is on duty for a day or two a week.
However the local NHS England team will want to apply a reasonable judgment depending on whether the pharmacy is usually staffed by a pharmacist(s) with a smartcard(s) or pharmacist(s) without smartcard(s). ‘
If payment is being withheld, the DHSC advised that the contractor should be advised in writing that payment is being withheld and highlight why. Alternatively, in some circumstances, it may be appropriate before withholding payment to allow the contractor the opportunity rectify the position and withhold payment if the position is not rectified within a reasonable, specified timeframe.
Q. I am in a position to use the EPS but I am not using the service routinely to dispense barcoded prescriptions; can the local NHS England team suspend my £200/month on-going funding? (had been applicable until November 2016″)
A. No. The Drug Tariff Part VIA is very clear that the pharmacy contractor is entitled to the funding when they are in a position to ‘operate the EPS if an appropriate prescription is presented or requested’. At this stage, there is no requirement to use the service to dispense all barcoded prescriptions received.
Return to the EPS sections relating to: Overview / Preparing&enhancing EPS / Nomination / Dispensing&Supply EPS / CDs / EPS/IT contingency planning / Submission / Cancelling/changing EPS / RTEC / Future