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 will be publishing guidance ahead of the February 2019 review point of the Quality Payments Scheme.

The new guidance, when published, 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 will alert contractors through their normal communication channels when the February 2019 guidance is published.

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.

Information on this quality criterion will be available shortly.

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.

Information on this quality criterion will be available shortly.

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.

Information on this quality criterion will be available shortly.

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.

Information on this quality criterion will be available shortly.

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

A Quality Payment can be claimed for the review point on Friday 15th February 2019. To claim for a Quality Payment, contractors will need to complete a declaration via the NHS Business Services Authority (NHS BSA) website.

The declaration period, during which a payment can be claimed, will be between Monday 4th February 2019 at 9am and Friday 1st March 2019 at 11.59pm.

Once the declaration has been submitted, the contractor will receive an email form 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

Validation of the declarations submitted by contractors will be carried out by the NHS BSA on behalf of NHS England, using nationally and locally available information as part of their post-payment verification work.

The NHS BSA will validate the gateway criteria declaration within a week of it being submitted by the contractor and will advise contractors if they have passed or failed the validation. Contractors who appear not to have met the criteria in relation to their declaration will be informed by the NHS BSA within one week of submitting their declaration and will be required to provide further evidence to support their claim.

Contractors who appear not to have met the quality criteria in relation to their declarations will be required to provide further evidence to the NHS BSA as part of their post-payment verification work.

Further information on the validation and verification process can be found on the NHS BSA website.

Pharmoutcomes support

PSNC is currently in discussions to see what support will be available on PharmOutcomes for contractors.

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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