CPCF and PQS
Community Pharmacy Contractual Framework (CPCF)
Pharmacy Quality Scheme (PQS) 2020/21
Following the peak of the COVID-19 pandemic, PSNC agreed the requirements for a new Pharmacy Quality Scheme (PQS) for 2020/21 with the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I).
The scheme has two parts, the first of which was announced on 13th July 2020. The focus of the Part 1 scheme is ensuring community pharmacy contractors and their teams have put in place all reasonable measures to respond to the COVID-19 pandemic, protecting both themselves and the people using their services.
That scheme is also a Gateway requirement for the Part 2 scheme, which is also focused on activities that support the response to and recovery from the COVID-19 pandemic. An early view of the contents of the Part 2 scheme was published on 6th August 2020, with the full details being released in the September 2020 Drug Tariff on 27th August 2020.
Part 1 PQS 2020/21
Details and the action checklist can be found at:
A new Pharmacy Quality Scheme (PQS) for the first part of 2020/21 has been announced today (13th July 2020). The focus of the scheme is ensuring community pharmacy contractors and their teams have put in place all reasonable measures to respond to the COVID-19 pandemic, protecting both themselves and the people using their services.
This scheme and the second part of PQS in 2020/21, which is being developed for the second half of the year, replace the original 2020/21 scheme that PSNC had agreed with the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I), and which, prior to the start of the pandemic, had been due to commence in April 2020.
To meet the requirements of the new scheme, contractors need to complete all 14 actions set out in a checklist, all of which relate to the response to the pandemic; many contractors will already have undertaken most if not all of the actions in the checklist over the last few months.
PSNC has also developed the following support materials for contractors:
Funding and claims
The funding made available for the scheme is £18.75m and all contractors meeting the requirements can claim a payment of £1,630 via the NHSBSA’s Manage Your Service (MYS) portal.
Claims via MYS can be made between 14th July 2020 and 23:59 on 29th January 2021.
Any residual funding not paid to contractors within the Part 1 scheme will be distributed as part of payments in the Part 2 2020/21 scheme. Payments will be made by the NHSBSA as soon as possible after a claim has been submitted, with, for example, any claims submitted by 5th August 2020 being paid on 1st September 2020.
A few important points to note:
Any claims submitted by 5th August 2020 will be paid to contractors on 1st September 2020. Contractors submitting after 5th August 2020 will be paid in line with the payment schedule below:
You have to claim for completion of the whole checklist – there is no payment for completing part of it
This Part 1 of PQS will be funded by £18.75m so each contractor that completes it will receive £1630
Details of Part 2 of PQS are expected soon (likely to start in October 2020) and will be funded by £56.25m. Any money from Part 1 PQS not claimed by contractors will be re-allocated into Part 2.
THE COMPLETION OF PART 1 PQS IS A GATEWAY REQUIREMENT TO PART 2 PQS
Part 2 PQS 2020/21
Part 2 of the scheme formally commenced on the 1st October 2020. This second part also focuses on the response to, and the recovery from, the pandemic. As we settle towards a new normal where COVID-19 remains in circulation, the PQS has been developed to incentivise quality improvement in areas that support the COVID-19 response by including criteria that improve patient safety and outcomes.
The full details were first published in the September 2020 Drug Tariff, however to support early contractor engagement, PSNC published an early view of the requirements on 6th August 2020. NHS England and NHS Improvement (NHSE&I) have now published guidance on the Part 2 Pharmacy Quality Scheme (PQS) 2020/21.
The remainder of the £75m PQS annual budget (£56.25m plus any unclaimed funding from the £18.75m attributed to PQS Part 1) will be applied to this scheme.
Contractors will receive a PQS payment if they have demonstrable evidence of meeting one or more of the 5 domains (please note, contractors must meet all of the quality criteria in each domain to be eligible for a PQS payment in respect of that domain). The overall level of the PQS payment will depend on how many of the domains the pharmacy declares that it meets.
The PQS must be claimed for between 09:00 on 1st February 2021 and 23:59 on 26th February 2021.
Completion of and claiming for the Part 1 scheme is a Gateway requirement for the Part 2 scheme.
Part 2 PQS Contractor Bandings Published
Pharmacy contractors will already be aware that a new approach to allocating the funding has been introduced in the Part 2 Pharmacy Quality Scheme (PQS) for 2020/21, with each domain having points allocated to it, but these varying dependent on the prescription volume of the contractor.
This change has been introduced to better recognise the varying workload and hence costs incurred by different contractors complying with the requirements of the scheme. While some costs will be common to contractors of all sizes, most of the elements of this new scheme involve variability of costs related to the number of staff employed at the pharmacy and staffing levels generally vary in relation to prescription volume.
Each PQS domain has a varying number of points dependent on the participating contractor’s total prescription volume in 2019/20.
So that contractors can be sure of which volume band they sit within the scheme, the NHSBSA has now published their allocation of contractors to the bands.
Click HERE to see which band your pharmacy falls within. Contractors can search, using the ODS code of their pharmacy, to view which banding they have been placed into. The bandings are based on the NHSBSA’s payment data for 2019/20. Any questions regarding the calculation of the bands can be sent to the NHSBSA Provider Assurance team at firstname.lastname@example.org
For further guidance click here
Read the PQS Part 2 GMLPC Training Log
The GMLPC, in collaboration with Halton, St Helens and Knowsley LPC have prepared a summary to support you and your pharmacy team to complete the required training for PQS Part 2. Available here. We would encourage contractors and pharmacy teams to start planning to complete the training requirements early to manage the workload.
To support contractors the GMLPC have also produced a training tracker to help ensure all required staff complete all the necessary training for PQS Part 2. This resource is available here.
GMLPC – PQS 2020/21 Briefing
Pharmacy Quality Scheme 2020/21 – Part 1
1)Pharmacy Premises Risk Assessment
1a) The contractor has conducted a COVID-19 infection control risk assessment for the pharmacy premises and where risks have been identified, has implemented mitigating actions, e.g. physical barriers such as above head height protective screens, where possible and appropriate.
To achieve this criterion please ensure you have completed one of the risk assessments below and ensure you have an up to date copy available.
There are a variety of risk assessment tools that contractors can use to assess their premises and their procedures.
For further information and resources on risk assessments please visit the GMLPC COVID-19 Resources page here
1b) The contractor has made appropriate adjustments to maximise social distancing in accordance with the latest government guidance on COVID-19 secure workplaces: Working safely during coronavirus
Following the completion of the risk assessment criteria set out in 1a, please review any risks identified regarding social distancing. Reasonable adjustments will need to be made to ensure your pharmacy is complying with the guidance set out in the Working safely during the coronavirus guide.
To implement this consider keeping evidence, such as, action plans, pictures of any physical changes made in response to the action plan and staff training records.
PSNC has published a risk assessment template that will help pharmacy teams to identify further potential changes which could be made to their pharmacy environment or procedures during the pandemic to increase the safety of staff and patients.
The Community Pharmacy Patient Safety Group has developed guidance on the safe use of consultation rooms during the pandemic, to help pharmacy teams consider how they can minimise risk when using them: Safe use of consultation rooms: COVID-19
2) Standard Operating Procedures (SOPs)
The contractor has updated the pharmacy Standard Operating Procedures (SOPs) or related guidance, where appropriate, to minimise the risk of transmission of SARS-CoV-2, having considered the guidance within the latest NHSE&I COVID-19 Pharmacy SOP. All staff have been briefed on changes relevant to their role in the pharmacy and a record of this is maintained.
In order to achieve this criterion, contractors are required to evidence the fact that they have updated or amended their SOPs in order to minimise the risks associated with COVID-19, in line with the guidance from the current NHSE&I COVID-19 Pharmacy SOP.
Contractors may wish to create a list or summary of SOP amendments as well as a record showing that staff have been briefed about these changes and have been given the necessary support and/or training to implement them in the pharmacy.
A staff briefing record sheet has been created by PSNC to enable contractors to easily document any briefing or training that has taken place.
Other useful guidance
The Royal Pharmaceutical Society (RPS) has a page which collates important information and updates for pharmacists, including contingency planning and FAQs.
Public Health England has also produced a flow chart for management of suspected COVID-19 cases
Further resources and contractor guidance have also been collated by PSNC.
3) Display Information
3a) The contractor has appropriate and up to date COVID-19 posters, warnings and information displayed so they are visible at entry points to the pharmacy premises.
In order to achieve this criterion, contractors may consider taking photographs of current posters published by Public Health England and other relevant sources on display at entry points to their pharmacy.
To assist with this, PSNC has compiled a list of up to date posters and other materials from a range of relevant sources. Contractors can use this page to locate key materials referring social distancing and the use of PPE to print and display on their premises.
GMLPC have also produced a range of posters for display. These can be found within the GMLPC Resources for Contractors section of our COVID resources page.
Additional materials and resources have also been published by Public Health England available here
3b) For Distance Selling Pharmacies, there are appropriate and up to date COVID19 warnings and information displayed prominently on their website.
In order for Distance Selling Pharmacies to achieve this criterion they should download and publish any relevant resources from the NHS Resources Hub onto their website.
Contractors should consider saving screenshots of their website pages on which these posters and information are displayed prominently for visitors. The resources displayed to patients may include the following key information:
4) Staff Risk Assessments
Members of staff have been informed of risk factors for poorer outcomes of COVID-19 such as gender, age, BAME and comorbidities. Individual COVID-19 risk assessments have been offered to all members of staff. Where the staff members accepted the offer, the contractor has conducted an individual risk assessment for each member of staff and put in place any appropriate mitigations. A record of this is maintained.
To achieve this criterion please ensure you have a copy of individual risk assessments or waivers on file and you have evidence of actions taken to mitigate risks identified.
All Pharmacy contractors will have received a letter from the BSA to complete a declaration confirming that a risk assessment has been completed for all staff.
Community Pharmacy contractors are being asked to declare their progress in performing COVID-19 risk assessments for staff by completing the NHSBSA snap survey which has been sent to you with a unique link via your NHSmail account.
The next window to declare your progress will be starting at 9am on 24th July to 11.59pm on 31st July.
GMLPC, Bolton LPC and the CPPB have worked in partnership with the GMHSCP to develop a BAME risk assessment tool in Greater Manchester.
The recently published Public Health England report confirms that people from Black, Asian and Minority Ethnic (BAME) backgrounds are being disproportionately affected by COVID-19. Therefore, community pharmacy teams should continue to risk assess all staff, particularly those who may be at increased risk.
The link to the BAME Risk Assessment tool as well as other reputable risk assessment tools can be found below
Contractors have a choice to use whichever risk assessment they think is appropriate.
NHS England and NHS Improvement (NHSE&I) held a webinar on risk assessments in community pharmacy. Aiming to help and support community pharmacy employers and managers to carry out the requested staff risk assessments within the given time frame, the webinar included speakers from the National Pharmacy Association and Royal Pharmaceutical Society.
GMLPC website – Useful links
5) Staff COVID Testing Referral
The contractor has a process in place to advise and refer staff with symptoms of COVID-19 for testing in accordance with Government guidance
To complete this criterion, contractors may consider providing evidence that they have produced briefing document or notification for staff containing information about the process of referring staff with symptoms of COVID-19 for testing in accordance with government guidelines. They can also keep a record of where the most up to date information can be found and share this with their staff.
A staff briefing record sheet has been created by PSNC to enable contractors to easily document any briefing or training that has taken place.
The information and government guidelines may be subject to change. Thus, it is imperative that any advice compiled for staff is reviewed and amended if/when necessary to ensure that it remains in line with government guidelines.
The government currently advise anyone to take a test within the first 5 days of having coronavirus symptoms. There are two main types of swab tests available to check if you currently have coronavirus.
You can choose to take the test:
Both types of tests can be booked using the government portal.
PSNC has also created a page with information on how pharmacy team members can access testing for COVID-19.
6a) The contractor has available facilities and resources (e.g. alcohol handrub) to support staff to conduct hand hygiene procedures frequently, to reduce the transmission risk of SARS-CoV-2 and support infection control.
In order to achieve this criterion, contractors should have sufficient hand sanitiser or hand-rub available to ensure that all staff are able to frequently wash their hands. To evidence this you may wish to take photographs of where hand sanitisers are positioned within the pharmacy.
6b) The contractor has posters displayed in relevant areas to promote best hand hygiene practice. Example shown here
To achieve this criterion contractors should clearly display posters within the pharmacy which promote good hand hygiene and provide guidance to staff and patients about how to thoroughly wash their hands.
Current guidance advises that you should wash your hands for 15-20 seconds to ensure they are washed thoroughly.
Public Health England have published a poster detailing the step by step process for washing hands. You may wish to display this in your pharmacy.
Contractors may wish to take photographs of this and other relevant posters on display in relevant areas, to evidence that they have met this criterion.
6c) The contractor has posters displayed in relevant areas to promote best practice use of handrub. Example shown here
To achieve this criterion contractors should clearly display posters within the pharmacy which promote best practice in relation to using handrub or sanitiser to wash hands.
Public Health England has published a poster containing instructions on how handrub should be used.
Contractors may wish to take photographs of this and other relevant posters on display in relevant areas such as alongside sanitiser, to evidence that they have met this criterion.
7) PPE Provisions
The contractor has reviewed and adopted, as a minimum, the PPE recommendations, for their staff working in the pharmacy.
To complete this criterion pharmacies at a minimum must provide their pharmacy team with Fluid-resistant (Type IIR) surgical masks when they will be working in an area with possible or confirmed case(s) and unable to maintain 2 metres social distance. However, we would encourage pharmacies to implement as many recommendations as they deem necessary to protect their staff and patients. e.g. disposable gloves, disposable plastic apron and disposable fluid-repellent coverall/gown.
PSNC have compiled a large number of resources and information on the use of personal protective equipment (PPE) to protect workers during the COVID-19 pandemic on a dedicated page. Available here
The page covers topics such as;
GMLPC and Bolton LPC have been working to access PPE for contractors locally in Greater Manchester. We would advise contractors to take the following steps to access PPE:
Please contact your wholesaler in the first instance.
If you cannot get PPE from your wholesaler, please complete the following form.
As a final resort, an urgent request can be made via the national NSDR helpline by telephoning 0800 915 9964.
For further information click here
8) Business Continuity plan
The contractor has reviewed and, as appropriate, updated business continuity plans for the COVID-19 pandemic including Emergency Business Continuity Planning for any potential closure(s), identifying one or more local pharmacies, which can support and provide pharmaceutical services to their patients, whilst the pharmacy is closed
To complete this criterion Pharmacy teams must ensure they have Copies available of their up to date Business Continuity plan reflecting plans for COVID-19 interruptions.
Emergency and Business Continuity Planning templates
All businesses and NHS providers, including community pharmacy contractors, need to have an ability to cope with emergency situations, so that wherever possible, they can continue to provide services to patients and the public.
PSNC has updated its hub for community pharmacy teams on the COVID-19 coronavirus to include new business continuity guidance and details of measures to support contractors.
Advice and information on shared care clients, nursing and care home patients, and providing Multi-compartment Compliance Aids (MCAs) has been added to the business continuity section of the hub.
These documents have been drafted to help pharmacies assess their business mix and decide how they can improve their dispensary efficiency, whilst still supporting their most vulnerable patients, in the event of multiple members of staff being off work to COVID-19.
Business Continuity Plan Template
PSNC and GMLPC has developed the following business continuity plan templates for use by contractors; this includes planning for business continuity during periods of disruption to IT services
Further Resources available from PSNC are available here
Test and Trace – business continuity planning
Actions that NHS providers should take to help support Test and Trace. NHSE&I has asked all primary care contractors – including community pharmacy contractors – to take the following actions:
An increase in cases in Greater Manchester increases the likelihood that a member of your pharmacy team will contract COVID-19 and therefore the pharmacy be contacted by Test and Trace.
Since the launch of the Government’s NHS Test and Trace programme, a number of pharmacy teams across England have been asked to self-isolate in accordance with the service.
GMLPC suggest that contractors read the PSNC Briefing 022/20: NHS Test and Trace – Key points for contractors as Q&As. This briefing provides further information on the programme, gives advice on patient and staff contacts, and outlines the relevant mitigations that may help to avoid the need for whole pharmacy teams to self-isolate if one member tests positive for COVID-19.
GMHSCP has now published Test and Trace programme guidance for Community Pharmacy with input from the Community Pharmacy Provider Board. Please see here for the test and trace guidance for GM.
If your pharmacy is impacted by Test and Trace please inform GMLPC by emailing email@example.com
Management of outbreaks – minimising the risks
Contractors need to consider COVID related risks to staff and patients and put in mitigations, and may wish to refer to PSNC’s Social Distancing and Infection Control Risk Review Template (this is available here.
This recently published template provides suggestions on how contractors can reduce the risk of infection and maintain 2m social distancing and it will be reviewed and updated by PSNC as required.
The RPS has also information on protecting your team in the pharmacy.
The GMLPC also has a wide variety of resources available here
Use of face masks
This update was published on the 24th July 2020. Public Health England (PHE) has updated its guidance on the wearing of facemasks in primary and community health care settings. In summary, the recommendation is that all pharmacy staff now wear facemasks, unless the pharmacy is COVID-19 secure, including all staff being able to maintain a social distance from one another.
This aligns the PHE guidance with PSNC’s guidance to contractors, issued in mid-June.
The recommendation is for a Type l or Type ll face mask to be worn to prevent the spread of infection from the wearer. If Type IIR face masks are more readily available, and there are no supply issues for their use as personal protective equipment, then these can be used as an alternative to Type I or Type II masks.
The extended use of face masks does not remove the need for other measures to help to protect staff, patients and the public and contractors should ensure that all appropriate and relevant steps continue to be taken to make the pharmacy COVID-19 secure.
Please ensure you keep up to date with the latest guidance, which will be posted on PSNC
9) Patient Isolation
The contractor has identified an area of the pharmacy where symptomatic patients could be isolated if they are unable to leave the premises, e.g. if an ambulance is required, and can follow the process outlined in the latest COVID19 Pharmacy SOP (including decontamination of the identified area after the symptomatic patient has left).
To achieve this criterion, it is recommended that a record sheet detailing the names of members of staff who have been briefed on the actions to take if a symptomatic patient presents in the pharmacy and the specified location for isolation. It is recommended staff have signed and dated this to confirm they have been briefed.
Preparation of your pharmacy
Identify at least one suitable space/room in the pharmacy for patient/patient group isolation. If there is no suitable isolation room, identify an isolated area within the pharmacy that can be cordoned off and maintains a 1-metre space from other patients and staff. De-clutter and removal of non-essential furnishings and items: this will assist if decontamination is required post-patient transfer. If possible, retain a telephone in the room for remote assessment. Place a card/sign in the isolation room/area with pharmacy contact details, e-mail, telephone numbers, pharmacy location and post code, include the name of the lead pharmacist in attendance (this information is to be available to the patient when they contact NHS 111).
Pharmacy preparation for incident management
Pharmacies may wish to draw on their existing protocols for dealing with medical emergencies in the pharmacy, the incident management principles are the same:
Remote consultations should be used wherever possible to minimise risk of transmission.
The government advice regarding shielding and self-isolation must be followed by staff as well as patients. Staff at risk may be able to provide services remotely or from a non- public area. Risks to individual staff should be assessed on an ongoing basis
10) Good Practice
The contractor has reviewed examples of good practice during the pandemic and has adopted them as considered appropriate for the individual pharmacy. These include examples collated by the GPhC
To achieve this criterion the pharmacy must have a record of examples reviewed, and any actions agreed to implement changes in the pharmacy to support their introduction.
11) Covid-19 Guidance
The contractor and registered staff working at the pharmacy have read relevant COVID-19 guidance on the GPhC website and a record of this is maintained.
To meet this criterion a record sheet detailing the relevant COVID-19 guidance which has been read by named GPhC registered members of staff. It is recommended that the GPhC registered staff sign and date the record once they have read the guidance.
Pharmacy Quality Scheme 2020/21 – Part 2
Domain 1 – Infection Prevention and Control and Antimicrobial Stewardship
To minimise nosocomial infections in the NHS, several measures need to be adopted. These include the use of non-pharmaceutical interventions, such as social distancing, as well as ongoing, consistent implementation of national infection prevention and control guidance. Such measures are paramount in reducing the transmission of COVID-19 as well as all healthcare associated infections.
Infection Prevention and Control
The aim of this criterion is to reduce the risk of transmission of COVID-19 within community pharmacies and potential harm caused by the pandemic by increasing awareness and implementing actions following training to improve infection prevention and control practices.
The aim of this criterion is to reduce the potential harm caused by antimicrobial resistance (AMR) through the promotion of antimicrobial stewardship activity in community pharmacy.
Domain 2 – Prevention
The COVID-19 pandemic has identified risk factors and inequalities that have resulted in poorer patient outcomes for those who have contracted the disease. There is therefore renewed focus on tackling modifiable risk factors such as obesity as well as mental health.
Suicide Awareness and Action Plan
The aim of this criterion is to contribute towards prevention of suicide by enabling all community pharmacy patient facing staff to appropriately discuss suicide with anyone who either raises that they are having suicidal thoughts, or is displaying behaviours that prompt pharmacy staff to start a conversation on this matter.
Sugar Sweetened Beverages
The aim of this quality criterion is to support community pharmacies in creating an environment conducive to healthy living and to align with the NHS standard contract requirements in helping both staff and the public avoid sugar sweetened beverages. This quality criterion builds on the training on Children’s oral health, which was introduced, in the 2018/19 Quality Pharmacy Scheme and supports the aims of the weight management criterion in this scheme.
The aim of this criterion is to prevent ill health by raising awareness with pharmacy service users of the impact of weight and waist circumference on health and the relevance of body mass index (BMI) to their overall health and wellbeing.
Domain 3 – Risk Management
This domain and its requirements links to the ongoing NHS priority to continually improve patient safety as outlined in the NHS England & NHS Improvement Patient Safety Strategy.
The aim here is to support contractors to add to and reflect on the work they have done in relation to this in previous years. All pharmacy professionals should understand their professional practice and how to identify, review, assess and mitigate against these risks in the pharmacy.
Domain 4 – Primary Care Network – Prevention (Flu Vaccination Service)