Quality Payments

Quality Payments

Quality Payments Scheme, which forms part of the Community Pharmacy Contractual Framework (CPCF), was introduced on 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.

In March 2018, it was announced that the scheme would be extended 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 has a review point in June 2018 and funding of £37.5 million; it is largely similar to the 2017/18 scheme, with just a few minor changes which are summarised in a PSNC Briefing, available below.


Click on a heading below for more information.

Guidance documents

NHS England guidance

NHS England will be publishing new guidance ahead of the June 2018 review point of the Quality Payments Scheme. Details will be made available as soon as possible.

The June 2018 guidance should be read in conjunction with NHS England’s gateway criteria guidance and the 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 strongly encourages all contractors to read the new NHS England guidance, as well as the previous guidance, to ensure they are fully briefed on the requirements of the Quality Payments Scheme ahead of the June 2018 review point.

PSNC guidance

PSNC Briefing 016/18: The interim Quality Payments Scheme 2018/19 – A summary of changes to the Scheme (March 2018)

Gateway criteria

To be eligible to collect the points necessary to claim a Quality Payment, the contractor must meet four gateway criteria (click on the links below for more information):

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. The Department of Health and Social Care and NHS England have weighted these based on an assessment of the difficulty of achieving them and the benefit to patients for doing so, with each criterion being designated a number of points.

The total number of points that each contractor can qualify for is 100.

Click on the links below for more information on each of the quality criteria.

Domain Criteria Total points available at June 2018 review point
Patient Safety Written safety report (updated since 24 November 2017 i.e. the last review date where claimed before) 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. 20
Patient Safety On the day of the review 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status for children and vulnerable adults in the last two years. 10
Patient Experience On the day of the review, the results of the Community Pharmacy Patient Questionnaire from the last 12 months is publicly available on the pharmacy’s NHS Choices page or for distance selling pharmacies it is displayed on their website and the NHS Choices service desk has been notified as per the NHS England guidance document, “Pharmacy Quality Payments – Quality Criteria Guidance”. 5
Public Health On the day of the review, the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment). 20
Digital On the day of the review, the pharmacy can demonstrate a total increase in access to Summary Care Records (from Monday 1 May 2017 to Sunday 26 November 2017 compared to Monday 4 December 2017 to Sunday 1 July 2018). Where the pharmacy can demonstrate total access to Summary Care Records of 100 times or more in both time periods (Monday 1 May 2017 to Sunday 26 November 2017 and Monday 4 December 2017 to Sunday 1 July 2018) they will have been deemed to have met this criterion whether there has been an increase or not. 10
Digital On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date. 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 24 November 2017 (i.e. the last review date) been referred to an appropriate health care professional for an asthma review. 20
Workforce On the day of the review, 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’. 10
Total number of points: 100

Claiming Quality Payments

A Quality Payment can be claimed for the review point on Friday 29th June 2018.

To claim for a Quality Payment, contractors will need to complete a declaration via the NHS Business Services Authority (NHS BSA) website (the declaration portal is not yet available).

Declaration periods

The declaration period, during which a payment can be claimed, will be between Monday 11th June at 09:00am and Friday 13th July 2018 at 11:59pm.

Declaration process

Important: Once a contractor has submitted their online declaration it cannot then be altered. The contractor is responsible for the information included in the submitted declaration. It is therefore imperative that contractors check their declaration thoroughly before submitting their declaration.

Contractors will need to confirm that they have met all of the Gateway criteria before they can access the most detailed questions for the quality criteria.

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. This email should be retained by the pharmacy as proof that the declaration was submitted and the date of submission. The email will show how contractors have responded to each of the gateway and quality criteria. If you do not receive an email within 24 hours please check your junk/spam box or contact the NHS BSA.

Contractors also have the option of providing an additional email address so proof that the declaration was submitted can be sent to another in the organisation such as a pharmacy’s head office.

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).

Payment for the June 2018 review point will be paid as part of the full payment for the July 2018 submission to the Pricing Authority (which contractors will receive at the end of August or the start of September).

Pharmacies that are part of the Pharmacy Access Scheme (PhAS)

When the ‘top-up funding’ that PhAS pharmacies receive is calculated, it is assumed that the contractor will achieve 100 points within the Quality Payments Scheme and the value of those points is deducted before the final PhAS payment is set. This is described in the following diagram:

As with all other pharmacies, PhAS pharmacies should therefore seek to meet as many quality criteria as possible and should claim the appropriate funding in the same way as all other pharmacies.

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. Contractors who appear not to have met the 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.

Declaration data for the April and November 2017 review points

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

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

FAQs

Frequently asked questions (FAQs) on Quality Payments can be found on the Quality Payments – FAQs page of the PSNC website.



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