Quality Payments

Quality Payments

Following the announcement of changes to the second Quality Payments Scheme for 2018/19, PSNC is currently reviewing this section of the website and will be producing new guidance, where appropriate, to assist contractors to meet the criteria of the Scheme.

A Quality Payments Scheme, which forms part of the Community Pharmacy Contractual Framework, was introduced from 1st December 2016. The original version of the scheme ran until 31st March 2018 and a total of £75 million was paid to community pharmacies for meeting the specified quality criteria.

The scheme was extended in March 2018 for the first six months of 2018/19, as part of interim arrangements prior to substantive negotiations for 2018/19 being undertaken. The extended Scheme had a review point in June 2018 and funding of £37.5 million.

In September 2018, a new Quality Payments Scheme was announced for the remainder of the 2018/19 financial year. The new scheme has funding of £37.5 million and a review point in February 2019. Changes to the Scheme are summarised in PSNC Briefing 051/18: A summary of the second Quality Payments Scheme 2018/19.


Click on a heading below for more information.

Guidance documents

NHS England guidance

NHS England has published guidance for the February 2019 review point of the Quality Payments Scheme. The new guidance should be read in conjunction with NHS England’s previously published gateway criteria and quality criteria guidance:

  • NHS England – Pharmacy Quality Payments Gateway Criteria Guidance (published 23rd December 2016); and
  • NHS England – Pharmacy Quality Payments Quality Criteria Guidance (published 27th February 2017).

These documents are available on the NHS England website.

PSNC guidance

PSNC Briefing 051/18: A summary of the second Quality Payments Scheme 2018/19

PSNC is currently reviewing previously issued guidance and producing new guidance and resources, where appropriate, to assist contractors to meet the criteria of the Scheme.

Gateway criteria

To be eligible to collect the points necessary to claim a Quality Payment, the contractor must meet five gateway criteria:

Click on the link below for more information on each gateway criterion:

Contractors passing the gateway criteria will only receive a Quality Payment if they meet one or more of the quality criteria listed in the table under the ‘Quality criteria’ subheading below. Therefore, meeting the gateway criteria will not, in itself, attract a Quality Payment; it is subject to how many of the quality criteria the contractor meets.

Quality criteria

Contractors passing the gateway criteria will receive a Quality Payment if they meet one or more of the quality criteria listed in the table below. Each criterion is designated a number of points and the total number of points that each contractor can qualify for is 100.


Click on the link below for more information on each quality criterion:

Domain Criteria Points
Patient Safety

A written patient safety report (updated since 29 June 2018, i.e. the last review date or covering the last year if not previously claimed) at premises level available for inspection at review point covering analysis of incidents and incident patterns (taken from an ongoing log), evidence of sharing learning locally and nationally, and actions taken in response to national patient safety alerts;

and Demonstrably, the pharmacy contractor actively identifies and manages the risks at premises level associated with specified look-alike sound-alike errors (LASA) identified from the National Reporting and Learning System NRLS)**. Demonstrably, the pharmacy contractor has put in place actions to prevent these, for example physical separation, staff awareness raising, visual warnings, tags or labels on shelving, fatigue reduction strategies, enhanced checking procedures for these medicines. 

Demonstrably, the pharmacy contractor uploads any LASA incident reports to the NRLS and keeps a record for confirmation of this activity at the pharmacy premises or within any electronic reporting system used by the contractor. In the description of what happened in the NRLS report, the contractor must include the text ‘LASA’ as a unique identifier to facilitate future national learning.

** NHS Improvement top combinations by likelihood and harm caused – propranolol and prednisolone, amlodipine and amitriptyline, carbamazepine and carbimazole, azathioprine and azithromycin, atenolol and allopurinol.

20
Patient Safety

On the day of the review, 80% of all registered pharmacy professionals working at the pharmacy have satisfactorily completed the CPPE Risk Management training;

and the pharmacy has available for inspection at the review point, at premises level, an example of a risk review that the pharmacy team at the premises have drawn up for a risk in that pharmacy that has been identified and prioritised with identified risk minimisation actions that the pharmacy team is taking.

20
Patient Safety On the day of the review the pharmacy must have completed the audit of non-steroidal anti-inflammatory drugs and gastro-protection for patients 65 or over, notified the patient’s GP where professional concerns were identified, share their anonymised data with NHS England and incorporated the learning of the audit into future practice. 20
Public Health

On the day of the review the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment) and;

80% of staff working at the pharmacy (including pharmacy professionals) that provide healthcare advice to the public have successfully completed the CPPE children’s oral health training assessment.

15
Digital/Urgent Care On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date. 2.5
Clinical Effectiveness

On the day of the review, the pharmacy can show evidence of asthma patients, for whom more than 6 short acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, have since 29th June 2018 (i.e. the last review date) been referred to an appropriate health care professional for an asthma review; and 

Can evidence that they have ensured that all children aged 5-15 years prescribed an inhaled corticosteroid for asthma have a spacer device where appropriate and have a personalised asthma action plan. Refer to an appropriate healthcare professional where this is not the case.

20
Workforce On the day of the review, 80% of all pharmacy staff working in patient facing roles are Dementia Friends (Alzheimer’s Society). 2.5
Total number of points: 100

Claiming Quality Payments

As for previous declarations, contractors wishing to claim a quality payment will be required to submit their declaration online to the NHS Business Services Authority (NHS BSA).

The February 2019 declaration will be hosted on the NHS BSA Manage Your Service application rather than the previous SNAP survey tool. This is a new process that has been developed in conjunction with this interim Quality Payments Scheme which provides added benefits over the previous SNAP survey tool. This includes the ability to provide contractors with real time confirmation when they have met the gateway criteria – as well as longer term benefits outside of this scheme.

Although this approach has been tested with a sample of contractors, it has not been possible to trial the application more widely ahead of the February 2019 declaration. To avoid the potential theoretical risk of some contractors experiencing difficulties in accessing the Manage Your Service application, an alternative arrangement has been put in place. This will be made available should any repeated difficulties with accessing the Manage Your Service application declaration process arise.

Should the alternative arrangement be necessary this will be communicated to contractors via email to their shared NHSmail accounts. PSNC will also alert contractors via their normal communication channels.

New declaration process

Following the publication of NHS England’s guidance for the Quality Payments Scheme February 2019 review point, NHS Business Services Authority NHS BSA have distributed via email further information on how contractors can claim for a quality payment when the declaration window opens on Monday 4th February 2019.

Contractors will be able to claim for a quality payment via two routes:

  1. Manage Your Service (MYS) applicationThe MYS application provides added benefits over the SNAP survey tool. This includes the ability to provide contractors, at the time of making their declaration, with confirmation that their pharmacy has been assessed against national datasets as either meeting or not meeting the gateway criteria. This means if contractors have not met the five gateway criteria, they have the opportunity to take corrective action before they make their declaration.There are also longer-term benefits of MYS outside of the Quality Payments Scheme; further information can be found here.If contractors choose to use this option, they are encouraged to register with the MYS application as soon as possible, to ensure the registration process is complete before the declaration period. Information on how to register is included within the email being distributed by the NHS BSA.
  2. SNAP survey tool (as used for previous declarations)The SNAP survey tool will be available as an alternative option similar to previous Quality Payment Scheme declarations. If contractors decide to use this option, verification of the gateway criteria cannot be confirmed in real time, as in MYS, thus reducing the possible time for corrective action.Contractors will however be able to check the status of their compliance with the gateway criteria by accessing a spreadsheet which will be published shortly by the NHSBSA (this spreadsheet will not contain confirmation on compliance with the Warranted Environment Specification gateway criterion, but that will be separately confirmed to contractors via an email which will be sent by the NHS BSA).Contractors will have their gateway criteria verification confirmed by email within a week of their SNAP submission.

Pharmacy teams should check with their business owner or head office which route they should use to make a declaration before completing the MYS registration form.

Pharmacy teams that work for an organisation that are part of the Company Chemists’ Association or the Association of Independent Multiples pharmacies will not have received this email to the pharmacy shared NHSmail account; head office teams will therefore provide guidance in due course on the process they want pharmacy teams to follow for completing declarations for the February 2019 review point.

The Manage Your Service application will open for declarations for the 15th February 2019 review point on Monday 4th February 2019 at 09:00 and will close on Friday 1st March 2019 at 23:59. Responses can be entered as soon as the system goes live and must be submitted before the closure of the declaration website. Please note that actions to demonstrate compliance with criteria must be completed by 15th February 2019.

Once the declaration has been submitted, the contractor will receive an email from the NHS BSA confirming that the declaration has been successfully submitted and confirming the details that have been declared.

Payment information

Contractors that successfully meet the requirements will receive a Quality Payment which will be funded from a £37.5 million budget. The funding will be divided between qualifying pharmacies based on the number of points they have achieved, up to a maximum of £64 per point. Each point will have a minimum value worth £32 (which is the value of each point if all pharmacy contractors achieved maximum points). Payments will be made to eligible contractors depending on how many quality criteria they have met (and therefore how many ‘points’ they achieved).

Validation and verification of claims

A new process for validation of the gateway criteria has been introduced for the February 2019 review point. An assessment of whether a contractor has met the gateway criteria or not will now be made when the contractor makes their declaration. The NHS BSA Manage Your Service application will pull information from national datasets so that when a contractor starts their declaration, the gateway criteria that the contractor has met will be displayed.

Where gateway criteria have been validated during the declaration submission, this will be confirmed to contractors in their declaration submission email. If the contractor has met all five gateway criteria, they can continue and declare which quality criteria they wish to claim payment for. These contractors will not be asked to provide any further evidence of how they have met the gateway criteria.

If the contractor is not assessed as meeting all five gateway criteria this will be stated by the NHS BSA Manage Your Service application. In such cases the contractor is encouraged to postpone completing the declaration until they have reviewed the gateway criteria, taken any corrective action, and once sure all five gateway criteria are met, complete the declaration.

If a contractor wishes to continue with the declaration at the point when they are told they do not meet the five gateway criteria, the system will allow for this. However, contractors will need to email the NHS BSA Provider Assurance Team (nhsbsa.pharmacysupport@nhs.net) after the declaration to provide details of corrective action undertaken to demonstrate how they meet the gateway criteria where the system has not verified this. The deadline for this is 29th March 2019.

Datasets for gateway criteria

Community pharmacy contractors are now able to view the weekly gateway criteria report on the NHS BSA website, which details contractors who have been assessed, using national datasets, as meeting four of the five gateway criteria (Advanced Services, NHS website, Community Pharmacy Patient Questionnaire (CPPQ) and NHSmail).

Contractors are therefore encouraged to check this report to see if the national datasets show they have met the four gateway criteria as detailed above and if not, take corrective action as soon as possible to ensure they meet the criteria by the review point.

The gateway criteria report will be updated each week and will be available by close of business every Friday until the end of the declaration window (1st March 2019); the publication schedule for the report can be found below. Any changes made after each Friday will not be shown until the following week’s update. For example, if a pharmacy’s NHS website profile is updated on Monday 10th December 2018 this will not show on the report on the NHSBSA website until the updated report is published on Friday 14th December 2018.

For cyber security reasons, confirmation of meeting the fifth gateway criterion – compliance with the NHS Digital Warranted Environment Specification (WES) – will be sent by NHSBSA to each contractor’s shared NHSmail account during the first two weeks of December 2018.

Pharmoutcomes support

Community pharmacy contractors are now able to access support on PharmOutcomes for the Quality Payments Scheme’s February 2019 review point. This support is available to all contractors free of charge as PSNC has agreed to use their licence to provide access to this support.

The following support is available on PharmOutcomes to assist contractors:

  • Quality Payments Scheme assessment framework: contractors and their teams can track their progress with achieving the Quality Payments criteria;
  • Patient safety report quality criterion: Contractors can complete their annual patient safety report on PharmOutcomes and a report of this can then be printed out, if required, as evidence of meeting the patient safety report element of the quality criterion;
  • Non-steroidal anti-inflammatory drugs (NSAID) audit quality criterion: contractors can use PharmOutcomes to directly enter their audit data and submit this to the NHS BSA; a permanent patient record will be stored on PharmOutcomes and contractors can send automatic referrals to the patients’ GP practices (if required); and
  • Asthma referrals quality criterion: contractors can use PharmOutcomes to send electronic referrals to GP practices in relation to the asthma criterion for patients that may benefit from an asthma review.

The Quality Payments Scheme assessment framework can be accessed by logging in and selecting ‘Assessments’. The other support listed above can be found under the ‘Services’ section; the NSAID audit is listed under the ‘National audits’ section and the other support is listed under ‘Quality Payment Criteria’.

If a contractor has not used PharmOutcomes before, log in details can be obtained by sending a message to the PharmOutcomes helpdesk. Contractors will need to provide details of the pharmacy, contact information and an email address to issue the login details to. 

CPPE support

The Centre for Pharmacy Postgraduate Education (CPPE) has created a Quality Payments page on their website. The page provides links to the CPPE training which is required to be completed to meet the Healthy Living Pharmacy and risk managament quality criteria.

Declaration data for previous review points

The NHS BSA has published the declaration data for the April 2017, November 2017 and June 2018 review points of the Quality Payments Scheme.

Further information can be found on the Quality Payments Scheme – Statistics page.

PSNC webinar and slide deck

FAQs

FAQs on the Quality Payments Scheme are available on the Quality Payments – FAQs page.



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