Pharmacy Access Scheme (PhAS)
Published on: 23rd December 2021 | Updated on: 5th July 2022
An updated Pharmacy Access Scheme (revised PhAS) began in January 2022, to continue to support patient access to isolated, eligible pharmacies. It is funded to no more than £20 million from the Community Pharmacy Contractual Framework (CPCF).
Eligibility for PhAS continues to be based on both the dispensing volume of the pharmacy, and distance from the next nearest pharmacy, although there are changes to the detailed eligibility criteria. Payments have changed from the 2016 scheme and are now based on a bell curve distribution, with, for example, larger volume dispensing pharmacies receiving lower PhAS payments.
Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I Regional pharmacy contract team, and determined by the relevant Pharmaceutical services Regulations Committee (PSRC).
For eligible pharmacies, PhAS payments are dependent on registration on the NHS Business Services Authority’s (NHSBSA’s) Manage Your Service (MYS) platform to provide the Community Pharmacist Consultation Service (CPCS). For the start of the scheme, registration is necessary by 31st December 2021. Read the contractor review guidance here.
PSNC has issued a briefing that covers the key points of the revised PhAS and the review process: PSNC Briefing 033/21: Pharmacy Access Scheme starting from January 2022
There are some changes from the 2016 scheme
Eligibility is now:
- based on pharmacies on the pharmaceutical list on 31st March 2021, rather than 1st September 2016;
- based on a narrower dispensing volume range – there is a collar (a minimum of 1,200 SAFs per year) and a cap (the maximum sized pharmacy supported is reduced from the 75th percentile to the 70th percentile);
- automatic for former ‘near miss’ pharmacies – those in very deprived areas (top 20% of the Index of Multiple Deprivation) that are more than 0.8 of a mile from the next nearest pharmacy (previously these were the subject of a review application to NHS England and NHS Improvement (NHSE&I));
- now conditional on ongoing registration for and provision of CPCS from 31st December 2021; and
- now only for pharmacies that are directly accessible to the public, so, for example, those beyond airport security will not be eligible.
- based on both volume and distance criteria;
- based on a static scheme, the pharmaceutical list of a certain date, 31st March 2021;
- based on a distance of more than 1 mile from the next nearest pharmacy in most cases and more than 0.8 of a mile in the most deprived areas;
- unavailable to appliance contractors, distance selling pharmacies and Local Pharmaceutical Services (LPS) contractors;
- possible for former LPS pharmacies returning to the pharmaceutical list (these will be considered as if they were on the pharmaceutical list on 31st March 2021);
- protected PhAS eligibility for those pharmacies that were more than 1 mile from the next nearest pharmacy based on the 2016 distance calculation, if there are no other changes regarding eligibility;
- the road distance, including footpaths, based on the Ordnance Survey Road network data; and
- broadly, for those eligible at the start of the revised PhAS, they remain eligible until the next update of the scheme, even if their dispensing volume or distance measurement changes – but with exceptions (e.g. a pharmacy that moves permanently may become ineligible for PhAS on the distance calculation to the next nearest pharmacy)
An eligibility flowchart is available here
The full list of pharmacies eligible for the 2022 PhAS can be found on the GOV.UK website.
Note, the review process for the 2022 Scheme approved 43 cases out of 63 applications submitted, bringing the total number of eligible pharmacies to 1,445. The list on the GOV.UK website has been updated to reflect this.
The revised PhAS is not a replacement to the statutory scheme for LPS pharmacies. LPS pharmacies may be commissioned by NHSE&I where a pharmacy is considered essential for the community but is not viable under the CPCF, even with PhAS eligibility and payments.
The scheme is paid for from the funding for the Community Pharmacy Contractual Framework (CPCF). The PhAS is an additional monthly payment made to all eligible pharmacies in areas where there are fewer pharmacies. The maximum expenditure on the 2022 PhAS will be £20 million per financial year. The 2022 PhAS applies from 1st January 2022 and runs until the next PhAS review.
Payments are now:
- banded and based on a bell curve – previously they were based on a top-up to income (to reduce the impact of funding cuts) minus an efficiency saving;
- for smaller pharmacies (based on dispensing volume), increase with activity up to a maximum payment of £17,500 per year; and
- for larger pharmacies, decrease as volume increases as the support they are considered to require reduces (previously larger pharmacies usually received larger PhAS payments).
Payments will continue to be paid monthly to eligible pharmacies in accordance with the provisions of the Drug Tariff
In Autumn 2021, DHSC released a list of those pharmacies deemed eligible for the updated Scheme for 2022 and in early 2022, NHSE&I invited community pharmacy contractors to apply for a review. There were two grounds on which a review could be sought, for a contractor to argue that their pharmacy should be considered eligible for the updated 2022 PhAS:
- inaccuracies in pharmacy premises location (for example if the pharmacy address was incorrect or the distance from the next pharmacy was calculated incorrectly) and,
- physical feature anomalies (such as a semi-permanent roadblock or a steep hill) meaning the viable route between two pharmacies is not as represented in the modelling
Submitted applications were reviewed by the relevant NHSE&I Regional pharmacy contract team, and determined by the relevant Pharmaceutical services Regulations Committee (PSRC).
Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the Scheme.
Q. What is the 2022 Pharmacy Access Scheme (PHAS 2022)?
A scheme which seeks to protect patient access with an additional monthly payment to qualifying or eligible pharmacies that are isolated/further away from other pharmacies.
Q. When does the new 2022 Pharmacy Access Scheme (PHAS 2022) start?
PhAS 2022 will start on 1st January 2022
Q. When is the PhAS payment made, for the first and subsequent months?
The PhAS payment for January will be made with the reconciliation payment in April 2022 and similarly after this.
Q.Do I have to apply for PhAS 2022?
No. Contractors do not need to apply to the scheme to be eligible.
Q. How are distances measured in PhAS 2022?
By road distance based on Ordnance Survey, rather than as the crow flies, which includes taking account of footpaths.
Q. Can I still access the mapping tool?
Yes, you can still access the mapping tool here PhaS Mapping Portal
Q. If I was eligible for PhAS previously, will I automatically be eligible for PhAS now?
No. A pharmacy that was eligible for PhAS may not be eligible for PhAS 2022. The scheme requirements for PhAS 2022 are different to the earlier scheme and, for example, a pharmacy may have changed location, a new pharmacy opened or another pharmacy relocated nearby; or the IMD decile of the pharmacy or dispensing volume may have changed.
Q. Does PhAS 2022 funding come from the global sum?
Yes, and the maximum expenditure is currently £20 million per financial year.
Q. Can I be ineligible because the dispensing volume of my pharmacy is too big or too small?
Yes. Eligibility is partly based on the number of Single Activity Fees (SAFs) in the year 2019 to 2020.
Q. Are distance selling pharmacies in PhAS 2022?
No. The scheme protects physical access to bricks and mortar community pharmacies.
Q. When do I have to be registered with CPCS to receive my first payment for January 2022?
A condition for the first PhAS payment is that contractors must be registered on the Manage Your Service (MYS) platform to provide the CPCS by 31st December 2021.
Q. Do I have to continue to provide CPCS to be eligible for PhAS payments?
Yes. For the pharmacy contractor to continue to receive the monthly PhAS payment as part of their reconciliation payment, they must have been registered to provide the CPCS on the MYS platform for greater than or equal to half of the number of full days in the relevant month.
Q. How long will the new PhAS last?
DHSC will continue to monitor the revised scheme and consider whether further updates and revisions are required, from April 2023 at the earliest.
PhAS review 2022
Q. For how long is the review application window open?
The review application window for contractors to submit applications is between 4th January 2022 and midnight on 4th March 2022.
Q. When will I be informed of the outcome of my review?
Subject to the overall number of applications received, it is envisaged that all contractors will have been informed about the outcome of their review by the end of May 2022.
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