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. Pharmacies that make arrangements to provide Advanced Services before 1st October in any financial year are able to conduct and be paid for a maximum of 400 reviews in the financial year (1st April – 31st March). The limit for pharmacies that enter arrangements on or after 1st October in any financial year is 200 for the financial year.
The Department of Health (DH) has issued guidance on the procedure to follow in the event that a contractor claims payment for MURs in excess of the annual cap:
Claims made by contractors for MURs are paid on trust. However, NHS Protect has confirmed that as with other systems where remuneration is paid based on a self-declaration, the NHS has monitoring arrangements in place to detect fraudulent activity. To avoid any suggestion of a fraudulent claim, or simply poor practice in making claims for payment, PSNC recommends carrying out the following checks:
1. Before submitting any claim for payment of MURs (using Form FP34C), contractors should ensure that copies of the certificates of accreditation for every pharmacist who may undertake MURs at the pharmacy have been sent to the local NHS England team (the local NHS England team may monitor this during the monitoring visits);
2. Each month, carefully check the pharmacy records of MURs undertaken that month, to ensure that the pharmacist who undertook the MUR consultation is accredited (and the certificate has been sent to the local NHS England team as above);
3. Each month count carefully the number of MUR reports for consultations carried out that month, to ensure that an accurate claim is made. These reports should be filed safely as they are the main evidence that an MUR has been carried out. Contractors may be required to produce them in the event of a Counter Fraud investigation;
4. Maintain a cumulative log of numbers claimed, so that the limit is not exceeded (currently 400 reviews per year);
5. If any MUR consultations are to be conducted away from the pharmacy premises, contractors should check that they have written confirmation of the consent of the local NHS England team, which should be carefully filed in the pharmacy.
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 £7.98 per administered dose of vaccine plus an additional fee of £1.50 per vaccination (i.e. a total of £9.48 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 either the paper claim form or the webform provided by the NHS BSA (but not both).
NHS Urgent Medicine Supply Advanced Service
Funding from the Pharmacy Integration Fund is being used to test and evaluate the service in order to inform possible future commissioning, i.e. the funding for the service is not from the main community pharmacy contractual framework (CPCF) funding.
In summary, the following fees will be paid for provision of the service:
(a) For ANY referral received from NHS 111 for a request for an urgent medicine or appliance supply, whether or not a supply is made and irrespective of the reason for any non-supply:
(i) a Consultation fee of £10, AND
(ii) an Administration fee of £2.50 per consultation to reflect the additional work/documentation required to support evaluation of the service.
(b) Where a medicine or appliance has been supplied, a supply fee of £1.50 will be made for the first item and an additional £0.50 will be paid for each additional item supplied.
Full details of the payments and when they can be claimed are set out in the service specification.