Quality Payments: the 2017/18 reconciliation payment

Quality Payments: the 2017/18 reconciliation payment

March 25, 2018

The 2017/18 Quality Payments Scheme included the potential for a reconciliation payment to be made following the April and November review points, which would distribute any remaining money from the £75m funding to contractors that had participated in the scheme. The approach to be taken in calculating this payment is explained in the Drug Tariff (the relevant extract is copied below).

The reconciliation payment will be paid automatically in the full payment for March 2018’s submission to the Pricing Authority; contractors do not have to claim the payment. PSNC has audited the Pricing Authority’s payments to contractors for the scheme and based on the summary data recently issued by the NHS BSA and NHS England, has calculated the likely value of the reconciliation payment. This is estimated to be £7.71 per point achieved, meaning that the full value of each point within the scheme would be £71.71.

The Drug Tariff wording:

2.5 Where not all pharmacy contractors achieve all of the quality criteria across the two reviews, 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 reviews. However, a cap of £128 per point per pharmacy contractor will be applied during the reconciliation process. This reconciliation payment will not have to be claimed and will be paid with the full value of services payment for March 2018.

2.6 For example: Assuming 11,674 pharmacy contractors and 80% of them on average achieved 60 points, we can calculate how many total points were delivered and therefore how much out of the £75 million was paid to contractors over the two review points and hence what any reconciliation payment per point would be:

80% of 11,674 contractors are 9,339 contractors.

Each delivering 60 points gives a total of 560,340 points over the two review periods,

which means £35.86 million was paid out – leaving £39.14 million of the £75 million.

Dividing the remaining money out over the total number of points would give a further payment of £69.85 for each point delivered.

However £69.85 plus the original £64 would give a total of £133.85 per point but each point is capped at a total of £128. So the contractor would receive a further £64 per point at the reconciliation. This would mean that £3.28 million (out of the £75 million) would remain undelivered through the Quality Payments Scheme and would be taken into account in the delivery of the overall Community Pharmacy Contractual Framework funding agreement.



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