The Department of Health (DH) is introducing a Quality Payments Scheme as part of the Community Pharmacy Contractual Framework in 2017/18. This will involve payments being made to community pharmacy contractors meeting certain quality criteria, with funding taken from the overall funding for 2017/18 of £2.592 billion.
PSNC Briefing 067/16: Quality Payments – what pharmacy contractors need to do (November 2016) explains how the scheme will work and it details guidance and resources for community pharmacy contractors on what they need to do to engage successfully with it.
Contractors and their teams will need to decide how to approach achieving the gateway and quality criteria in a way that works for them; there will be no ‘one size fits all approach’, but we suggested one approach which contractors may want to consider adopting. The plan covers all elements of the Quality Payment Scheme and we have prioritised the plan so that criteria that can be achieved at both review points are generally first, as it is important that an early start is made on achieving them.
Click on a heading below for more information.
The gateway criteria
To be eligible to collect the points necessary to claim the Quality Payment, the contractor must meet four gateway criteria (click on the links below for more information):
- provision of at least one specified Advanced Service;
- have their NHS Choices entry up to date;
- have the ability for staff to send and receive NHS mail (Note for the April 2017 Review, evidence of application for an NHSmail account by 1st February 2017 will be acceptable); and
- ongoing utilisation of the Electronic Prescription Service.
Contractors passing the gateway criteria will only receive a Quality Payment if they meet one or more of the criteria listed in the table under the ‘Quality Payment criteria’ subheading below. Therefore, meeting the gateway criteria will not, in itself, attract a Quality Payment; it is subject to how many of the quality criteria the contractor meets.
NHS England has issued guidance on the gateway criteria.
Quality Payment criteria
Contractors passing the gateway criteria will receive a Quality Payment if they meet one or more of the criteria listed in the table below. DH has weighted these based on an assessment of the difficulty of achieving them and the benefit to patients for doing so, with each criterion being designated a number of points.
The total number of points that each contractor can qualify for over the two reviews is 100. Three of the quality criteria, which account for 45 points between them, only need to be met once in the year and therefore can only be claimed for once at one of the two review points.
Click on the links below for more information on each of the Quality Payment criteria.
There are two review points during the year, at which a Quality Payment can be claimed. These are:
- Friday 28th April 2017; and
- Friday 24th November 2017.
At each review point, in order to receive payment where the gateway criteria and some or all quality criteria have been fulfilled, pharmacies will need to make a declaration to the NHS Business Services Authority (NHS BSA) using the approved form. (The form is not yet available).
Community pharmacy contractors are now able to access support on PharmOutcomes for the Quality Payments Scheme.
This support is available to all contractors as PSNC has agreed to use their licence to provide access to the Quality Payments Scheme framework and asthma referrals service on PharmOutcomes.
Contractors who own multiple pharmacies can view the progress that each of their pharmacies are making to achieving the Quality Payments criteria by using their PharmOutcomes head office/administrator viewer login.
LPCs are able to view the progress contractors are making on to achieving the Quality Payment criteria, which may help identify additional support that contractors require by using their LPC viewer login.
Quality Payments Scheme framework
A Quality Payments Scheme framework has been created on PharmOutcomes, which will allow contractors to track their progress with achieving the quality payments criteria. The assessment also contains links to the PSNC website to provide contractors with additional information on each criterion and links to other PharmOutcomes services to assist contractors with collating evidence.
Once a contractor has logged into PharmOutcomes, the framework can be accessed by clicking on the ‘Assessments’ tab on the PharmOutcomes homepage and a User Guide for the framework is available from the Help tab on the PharmOutcomes website.
Quality Payment criterion: asthma referrals
An asthma referral tool has also been created to assist contractors in meeting the Quality Payment criterion, ‘On the day of the review, the pharmacy can show evidence of asthma patients, for whom more than 6 short acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, are referred to an appropriate health care professional for an asthma review’.
This PharmOutcomes tool allows contractors to record patient details who have consented to be referred to their GP practice because of them having been dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6 month period. When this data is saved on PharmOutcomes a referral will automatically be sent to the patient’s GP practice (if a secure email address is held for that GP practice on PharmOutcomes).
Once a contractor has logged into PharmOutcomes, the tool can be accessed by clicking on the ‘Services’ tab on the PharmOutcomes homepage and a User Guide for the tool is available from the Help tab on the PharmOutcomes website.
PharmOutcomes log in details
If a contractor requires PharmOutcomes login details for one of their team members, these can be obtained by sending a message to the PharmOutcomes helpdesk. Contractors will need to provide details of the pharmacy, contact information and an email address to issue the login details to.
If a contractor does not have a head office/administrator viewer login this can be obtained by sending a message to the PharmOutcomes helpdesk. Contractors will need to provide details of pharmacy sites, contact information and an email address to issue the login details to.
The Centre for Pharmacy Postgraduate Education (CPPE) has published a document which highlights their available resources and materials to support contractors in meeting the Quality Payment criteria.
DH has said it will allocate £75 million to fund the Quality Payments in 2017/18, which will be funded from the overall funding for 2017/18 of £2.592 billion.
Payments will be made to eligible contractors depending on how many criteria they have met (and therefore how many ‘points’ they achieved). DH expects the value of each point to be set at £64. This is set at a level that would deliver £75 million assuming 100% of pharmacies achieved all 100 points.
Payments due from each review point will be paid as part of the full value of services for that month, i.e. payment from April’s review point will be paid at the end of June/beginning of July.
However, it may be the case that not all pharmacies will achieve all of the quality criteria across the two review points. Therefore, after the two review points, there will be a reconciliation process, at which the remaining funding will be divided between qualifying pharmacies based on the number of points they have achieved over the two review points. This reconciliation payment will not have to be claimed and will be paid with the full value of services payment for March 2018 (i.e. end of May/beginning of June).
To ensure the overall amount earned by one contractor for Quality Payments remains proportionate, a cap of £128 per point will be allowed in totality including the reconciliation payment. To reach the cap would require less than 50% of pharmacies achieving less than 50% of the quality criteria.
Frequently asked questions (FAQs) on Quality Payments can be found on the Quality Payments – FAQs page of the PSNC website.
Quality Payments webinar and Slide Deck
PSNC held a webinar about Quality Payments on Wednesday 23rd November. An on-demand version of the webinar is now available to watch.
PSNC slide deck on Quality Payments for LPCs (PowerPoint) (updated 20/1/17)
This slide deck is based on the presentation used in the Quality Payments webinar.
PSNC slide deck on Quality Payments for LPCs (PDF) (updated 20/1/17)