Pharmacy Quality Scheme outcomes

Published on: 14th November 2021 | Updated on: 24th March 2022

The Pharmacy Quality Scheme was introduced in 2016 under the previous name for the Scheme, ‘Quality Payments Scheme’.

This page contains information on the outcomes of the different Schemes.

Pharmacy Quality Scheme 2020/21 Part 2

The Pharmacy Quality Scheme 2020/21 consisted of two parts. Contractors were required to make their declaration for Part 2 of the Scheme between 1st February 2021 and 26th February 2021.

NHS England and NHS Improvement has not published an infographic on this Scheme; however, the following information has been made available:

Suicide awareness and action plan

As part of the ‘Prevention’ Domain, all patient-facing staff* working at the pharmacy were required to complete the Zero Suicide Alliance (ZSA) training, available on the Zero Suicide alliance website. Once all members of the team (who do not fall under the exemption outlined below), had completed the training, a suicide prevention action plan was required to be prepared which included the action to take if anyone reported to staff that they were having suicidal feelings. The action plan needed to include making some demonstrable recorded changes such as compiling resources to provide to people who required support.

Results of the suicide awareness and action plan criterion

  • More than 72,000 pharmacy staff completed the ZSA training; and
  • 10,631 pharmacies trained all pharmacy staff* and completed a suicide prevention action plan.

*Staff members, who had been affected by suicide and did not wish to undertake the ZSA training, were exempt from completing it. Contractors were required to record the number of staff at the pharmacy who did not undertake the training under this exemption. 

Pharmacy Quality Scheme 2020/21 Part 1

The Pharmacy Quality Scheme 2020/21 consisted of two parts. Contractors were required to make their declaration for Part 1 of the Scheme by 29th January 2021.

NHS England and NHS Improvement has not published an infographic on this Scheme.

Pharmacy Quality Scheme - February 2020 review period

The fifth Scheme was renamed to the Pharmacy Quality Scheme (PQS). This Scheme had a review period, rather than a review point (a specific date on which contractors has to complete their declaration). The review period was between 3rd February 2020 and 28th February 2020.

NHS England and NHS Improvement hav not published an infographic on this Scheme yet; however, the following information has been made available:

Valproate safety audit

As part of the Medicines safety audits complementing General Practice (GP) Quality and Outcomes Framework (QOF) Quality Improvement (QI) module Domain, pharmacy teams were required to complete a valproate safety audit, over three consecutive months for all girls and women of childbearing potential who have had valproate dispensed from the pharmacy.

Results of the valproate safety audit

  • 10,293 (over 90%) of contractors completed the audit with 12,068 (94.3%) patients/patient representatives agreeing to take part in the audit (724 (5.7%) did not agree to take part);
  • Most pharmacies (67.8%) dispensed valproate to between 1 and 5 female patients of childbearing age during the three month audit period, while 28% did not dispense valproate to any eligible patients;
  • 675 women (5.6%) said they had not been provided with advice and information in line with the MHRA Drug Safety Update 2018 concerning the potential impact on the unborn child;
  • 10.6% did not have the Patient Guide and 11.1% did not have the Patient Alert Card;
  • 73.3% of patients reported that they had discussed their valproate medicine and the need for appropriate contraception with a GP or specialist in the last 12 months, but 17.7% had not and 9.1% were unsure;
  • 63.8% reported having highly effective contraception (e.g. LARC, IUD, sterilisation) but 36.2% reported they did not;
  • Of those reporting that they did not have highly effective contraception (4,374), 26.5% (1,159) agreed to be referred to the GP by the pharmacist and this was recorded in the PMR;
  • Pharmacy teams recorded the GP referral and/or the provision of the Patient Guide or Alert Card in the PMR for 63.6% of these patients.

High risk medicines audits

As part of the ‘Medicines safety audits complementing GP QOF QI module’ Domain, pharmacy teams were required to complete a lithium audit, over three consecutive months, aligned with requirements of the National Patient Safety Agency (NPSA) alert on lithium. If the pharmacy had no patients who had had lithium dispensed from the pharmacy in the previous three months, the contractor was required to complete a safety audit of patients prescribed one of the following medicines instead, in the following order of preference: either methotrexate; amiodarone; or phenobarbital, which were in line with alternatives suggested in the GP QOF QI Prescribing Safety Module.

Results of the high risk medicines audits

  • 10,836 contractors completed the audit with 40,419 patients agreeing to take part in the audit;
  • 163 contractors participated in the audit, but reported having no patients on lithium, methotrexate, amiodarone or phenobarbitone;
  • The number of patients  who reported that they were regularly monitored appeared high across all audited high risk drugs: lithium (95%), methotrexate (97%) and amiodarone (85%);
  • 99% of patients understood that methotrexate was a weekly dose;
  • For any question where the patients/representatives answered ‘no’ or ‘don’t know’ pharmacy teams provided additional counselling and advice a total of 23,957 times.

NSAID audit

As part of the ‘Medicines safety audits complementing GP QOF QI module’ Domain, pharmacy teams were required to complete an updated non-steroidal anti-inflammatory drug (NSAID) and gastroprotection audit for all patients 65 years and over (the previous NSAID audit was completed as part of the previous Pharmacy Quality Scheme (February 2019 review point).

Results of the NSAID audit

  • 8,557 pharmacies reviewed the safety of almost 75,000 older people prescribed oral NSAIDs;
  • 85% of patients aged 65 or over prescribed NSAIDs were co-prescribed a gastro protective agent, compared to 80% in 2018/19. Data from the NHS Business Services Authority National Medicines Safety Indicators shows further improvement since this second audit and a reduction in related hospital admissions;
  • The referral rates for patients not prescribed gastroprotection reduced from 58% in 2018/19 (the audit was originally completed as part of the previous Pharmacy Quality Scheme (February 2019 review point)) to 53%;
  • However, 17% without gastroprotection had already discussed this with the prescriber and declined treatment. Common reasons for not referring were acute/short term or occasional use;
  • 17% of patients were prescribed medicines which increase the gastrointestinal risk from NSAIDs;
  • More of this group were co-prescribed gastroprotection (89%) and patients in this group without gastroprotection were more likely to be referred;
  • Pharmacists discussed NSAID safety with 76% of patients, compared to 63% in the first audit (the audit was originally completed as part of the previous Pharmacy Quality Scheme (February 2019 review point)); improved communication with patients, a recommendation from the first audit, had been actioned; and
  • Many patients not attending the pharmacy were contacted by phone to discuss the risks of taking an NSAID without gastroprotection.

Pharmacy Quality Scheme - February 2019 review point

The fourth Quality Payments Scheme had a review point (the date on which contractors had to make their declaration) of 15th February 2019. Following this review point, NHS England published an infographic to show how many contractors had declared they had met certain criteria of the Scheme:

NHS England – Pharmacy Quality Payments infographic for the February 2019 declaration review point

Pharmacy Quality Scheme - June 2018 review point

The third Quality Payments Scheme had a review point (the date on which contractors had to make their declaration) of 29th June 2018. Following this review point, NHS England published an infographic to show how many contractors had declared they had met certain criteria of the Scheme:

NHS England – Pharmacy Quality Payments infographic for the June 2018 declaration review point

Pharmacy Quality Scheme - November 2017 review point

The second Quality Payments Scheme had a review point (the date on which contractors had to make their declaration) of 24th November 2017. Following this review point, NHS England published an infographic to show how many contractors had declared they had met certain criteria of the Scheme:

NHS England – Pharmacy Quality Payments infographic for the November 2017 review point

They also published a combined infographic for the April 2017 and November 2017 Schemes:

NHS England – Pharmacy Quality Payments infographic for the June and November 2017 review points

Pharmacy Quality Scheme - April 2017 review point

The first Quality Payments Scheme (the previous name for the Pharmacy Quality Scheme) had a review point (the date on which contractors had to make their declaration) of 28th April 2017. Following this review point, NHS England published an infographic to show how many contractors had declared they had met certain criteria of the Scheme:

NHS England – Pharmacy Quality Payments infographic for the April 2017 declaration review point

Return to the PQS hub page

For more information on this topic please email info@psnc.org.uk

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