Asthma referrals


NOTE: The claims deadline for February 2019’s Quality Payments was Friday 1st March 2019. We will update these pages as soon as we know whether there will be a Quality Payments scheme in 2019/20. In the meantime, these pages are here for archive purposes.

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Asthma referrals 

Points available: 20 points (£640-£1,280) available.

Key changes since last time:

  • This time you also need evidence that you have ensured all children aged 5-15 prescribed a corticosteroid inhaler for asthma also have a spacer device, where appropriate in line with NICE TA38, and that they have a personalised asthma plan. If not, you must have referred them for review by an appropriate health professional.
  • This is in addition to the previous requirements – see below.

Requirements:

You must have:

  • Evidence that, since 29th June 2018, you have referred all asthma patients who have been prescribed more than six short-acting bronchodilators without a corticosteroid in a six-month period for review by an appropriate healthcare professional.
  • You also need evidence that you have ensured all children aged 5-15 prescribed a corticosteroid inhaler for asthma also have a spacer device, where appropriate in line with NICE TA38, and that they have a personalised asthma plan. If not, you must have referred them for review by an appropriate healthcare professional.

Check: Would these patients also benefit from other pharmacy services?

Patients in the target group may need an urgent assessment of their asthma. They may also benefit from the pharmacy carrying out an inhaler technique check and a MUR to help them understand how to manage their medication and inhaler. If your pharmacy doesn’t provide inhaler technique checks, you may find this list of participating pharmacies helpful.

Evidence required:

  • Declare in your NHS BSA Quality Payments submission that you have referred these patients for review. Keep evidence of the referrals in your pharmacy.
  • If you don’t have patients in these categories, you can still claim if you can demonstrate you have worked to identify them and have systems in place to refer anyone who would be eligible.

How to meet the criteria:

Identifying patients

You can identify patients (or demonstrate you have tried) via one or more of the following:

SABAs without a corticosteroid:

  • Monitoring SABA inhalers dispensed in rolling six-month periods via your PMR or by accessing SCR where appropriate.
  • Monitoring emergency supply requests for SABA inhalers from patients / NUMSAS.
  • Monitoring out-of-hours/urgent prescriptions for SABA inhalers.
  • Monitoring repeat prescriptions for SABA inhalers.
  • Monitoring SABA inhalers dispensed in MUR/NMS.
  • Monitoring non-collection of prescriptions for steroid inhalers.
  • As a minimum, every time a SABA inhaler is dispensed without a steroid inhaler, you should check the dispensing history for SABA and steroid inhalers.

For patients aged 5-15:

  • Checking the pharmacy PMR or SCR, where appropriate, for spacer devices.
  • Asking parents/carers if they have bought spacers without a prescription.
  • Asking patients or their parents/carers if they have been given a personalised asthma action plan (PAAP).

Suggested flowcharts for checking & referring

PSNC has produced flowcharts to help pharmacies meet this Quality Payment:

Collecting evidence:

Paper data collection

You can use this PSNC template to record evidence of referrals. You may need to submit this to NHS England. If so, delete the bag label information on the left hand of the form so you don’t breach patient confidentiality when you submit it to NHS England.

PharmOutcomes

All pharmacies can access the PharmOutcomes asthma referral tool free of charge, and it will automatically send referrals to the patient’s GP where appropriate. Just log into PharmOutcomes, go to Services, and then choose:

  • ‘Quality Payment criterion – Asthma referrals’ for the SABA without corticosteroid aspect
  • ‘Quality Payment criterion – Children’s asthma referrals’ for the patients aged 5-15 aspect

If you don’t have a PharmOutcomes log-in, contact the PharmOutcomes helpdesk.

GP communications & referrals:

It’s important to notify the patient’s GP of any interventions, so they know what action you have taken to help the patient manage their asthma. If you do not currently refer patients for asthma review, you may find it useful to speak to local GP practices first and check how they prefer to receive referrals. These PSNC resources may be useful:

Full guidance from NHS England:

This tip-sheet is just a summary. You must also read the full NHS England guidance to make sure you meet the Quality Payments criteria. There are 3 key documents:

  • Updated guidance for February 2019
  • Gateway Criteria Guidance
  • Quality Criteria Guidance