Pharmacy Quality Scheme

Pharmacy Quality Scheme

The Pharmacy Quality Scheme (PQS)  is the new name for the Quality Payments Scheme, which forms part of the Community Pharmacy Contractual Framework (CPCF).

In July 2019, a new PQS was announced for the remainder of 2019/20 as part of the five-year deal for the CPCF. The new scheme has funding of £75 million and a review point in February 2020.

Changes to the PQS are summarised in PSNC Briefing 029/19: The Pharmacy Quality Scheme 2019/20.

PSNC is currently updating its resources and producing new resources to support community pharmacy contractors with the PQS. We will highlight these to contractors through our normal communication channels. Please ensure you are signed up to PSNC e-newsletters at: psnc.org.uk/enews  to ensure you receive updates on when resources are published.


Click on a heading below for more information.

Guidance documents

NHS England and NHS Improvement guidance

NHS England and NHS Improvement is planning to publish guidance on the PQS 2019/20. A publication date has not yet been confirmed; PSNC will alert community pharmacy contractors when this is published through their normal communication channels.

PSNC guidance

PSNC Briefing 029/19: The Pharmacy Quality Scheme 2019/20

Gateway criteria

To be eligible to collect the points necessary to claim a payment, the contractor must meet four gateway criteria:

  1. Advanced Services: Offering NHS community pharmacy seasonal influenza vaccination and/or the New Medicine Service;
  2. Pharmacy staff at the pharmacy must be able to send and receive NHSmail from their shared premises NHSmail mailbox, which must have at least two active linked accounts;
  3. Update NHS website profile for opening hours (including Bank Holidays), services and facilities and promptly update as information changes to ensure information is accurate for the public; and
  4. 80% of all pharmacy professionals have achieved level 2 safeguarding status for children and vulnerable adults in the last two years.

For further information on each criterion, click on the links above. If a link is not available for a criterion, this will be made available soon.

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

Quality criteria

Contractors passing the gateway criteria will receive a payment if they meet one or more of the quality criteria bundles/standalone criteria listed in the tables below. Some of the quality criteria are bound together in composite bundles; contractors will need to achieve all activities within a bundle to receive payment for the bundle. Each bundle/standalone criteria is designated a number of points (the number of points has not yet been finalised, PSNC will alert contractors when this information is available).


For further information on each criterion, click on the links below. If a link is not available for a criterion, this will be made available soon.

Risk management and safety composite bundle

1. 80% of all pharmacy professionals to have completed the CPPE Risk Management training and assessment.
2. 80% of all pharmacy professionals to complete CPPE sepsis online training and assessment. Apply learning to respond in a safe and appropriate way when it is suspected that someone has sepsis. Disseminate alert symptoms to staff, to ensure referral to pharmacist.
3.

The pharmacy has available, at premises level, an update of the previous risk review that the pharmacy team at the premises had drawn up for a risk in that pharmacy. This update must include a recorded reflection on the identified risk and the risk minimisation actions that the pharmacy team has been taking and any subsequent changes identified as a result of the reflection. The risk review should include the risk of missing sepsis identification as a new risk as part of the review, record demonstrable risk minimisation actions that have been undertaken to mitigate the risk.

Note: Pharmacies that did not claim for the risk management quality criterion previously and wish to claim at the next review point must have two identified risks, including the risk of missing sepsis as above, as part of completion and claiming for this whole composite bundle.

4. 80% of all pharmacy professionals to complete CPPE Reducing look-alike, sound a-like errors (LASA) e-learning and assessment.
5. A new written safety report (and subsequent actions completed in line with current criterion) at premises level available for inspection at review point, covering analysis of incidents and incident patterns (taken from an ongoing log), incorporating learnings from CPPE LASA e-learning. This should include a review of and subsequent actions where mitigation taken has failed to prevent a LASA incident from occurring, evidence of sharing learning locally and nationally, and actions taken in response to national patient safety alerts. Demonstrable evidence of actions identified in the patient safety report have been implemented.

Medicines safety audits complementing QOF QI  bundle

6.

Lithium audit aligned with requirements of the NPSA alert on Lithium.

All patients prescribed lithium:

  1. To be asked if they have had their lithium levels checked in the last 3 months and other relevant blood tests at appropriate intervals, e.g. for kidney (renal) and thyroid function every 6 months, whether this was/wasn’t the case recorded on the PMR, or appropriate form/patient record, and referred as appropriate.
  2. Asked whether they understand signs of lithium toxicity, e.g. upset stomach and go through these with the patient if they do not know what they are:
    • Record if they did/didn’t know signs of lithium toxicity.
  3. Asked whether they know what to do if they miss one or more doses:
    • Record if they did/didn’t know the appropriate action when they missed dose(s) and whether this advice was provided.
  4. Asked if they understand how to prevent toxicity, e.g. adequate fluid intake especially if exercising heavily:
    • Record whether they did/didn’t know how to prevent toxicity and whether this advice was provided.
  5. Provided with general healthy living advice.
  6. Monitored for interactions (OTC and prescription medicines) with lithium:
    • Record whether patient was taking or had taken medicines OTC which interact with lithium with/without the advice of a pharmacist or doctor.R
    • Record whether patient was given advice not to take OTC medicines, including herbal remedies or supplements, without speaking to a doctor or a pharmacist.

If the pharmacy has no patients prescribed lithium, complete a safety audit of patients prescribed phenobarbital, methotrexate or amiodarone as alternatives, in line with the QOF QI.

7.  Valproate safety audit: An audit of the provision of advice on pregnancy prevention for girls and women of childbearing potential taking valproate:

  • Ensure that all girls and women of childbearing potential who have presented a prescription for valproate, during a specified 3-month period, have been advised on the risks of taking valproate in line with all the requirements as detailed in MHRA Drug Safety Update 2018, including the potential impact on an unborn child, have been provided with a Patient Guide and have seen their GP or specialist to discuss their treatment and the need for contraception. This intervention should be recorded on the PMR, or appropriate form/patient record.
  • Report the number of patients dispensed a prescription for valproate who are old enough to become pregnant and been provided advice and information in line with the MHRA Drug Safety Update 2018
8.  NSAID audit:

  • Contractors should implement, into their day-to-day practice, the findings and recommendations from the previous clinical audit on NSAIDs prescribed for those 65 years and above without gastroprotection, undertaken as part of the Quality Payments Scheme for the February 2019 review point. The findings and recommendations from the audit will be published in a report by NHS Specialist Pharmacy Service (when this will be published is still to be confirmed. The pharmacy must then repeat the audit of NSAIDs and gastro-protection for all patients 65 years and over, including notifying the patient’s GP where professional concerns are identified, sharing their anonymised data with NHS England, and incorporating any learning from the re-audit into future practice.

Note: Pharmacies that did not claim for the NSAID audit quality criterion previously and wish to claim at the next review point as part of completion and claiming for this whole composite bundle must complete the audit for the first time and complete the other elements as described above.

Submission of information to NHS England should be reported on the MYS application as part of all above audits.

Prevention composite bundle

9. The pharmacy is a Healthy Living Pharmacy level 1 (self-assessment).
10.  All patient-facing staff are Dementia Friends.
11. The pharmacy has completed a specified dementia-friendly environment checklist and created an action plan which includes making some demonstrable recorded changes to the environment in line with the checklist, as appropriate.
12. Check all patients with diabetes who present from 1 October 2019 to 31 Jan 2020 have had annual foot and eye checks (retinopathy) – please note, eye checks are only for patients with diabetes aged 12 or over. Make a record on the PMR or appropriate form/patient record and signpost/refer as appropriate. The total number of patients who have had this intervention, the number that have not had one or either check in the last 12 months and where they have been appropriately signposted/referred should be recorded and reported as part of this criterion.  
13. The sales by the pharmacy of Sugar Sweetened Beverages (SSB) account for no more than 10% by volume in litres of all beverages sold. The pharmacy must have either achieved this by the review point or declare that they will be meeting this by 31 March 2020. 

Primary Care Networks bundle

14.  Demonstrate that pharmacies in a PCN area have agreed a collaborative approach to engaging with their PCN, including agreement on a single channel of communication, e.g. by appointing a lead representative for all community pharmacies in the PCN footprint to engage in discussions with the PCN.

Asthma bundle

15. The pharmacy can show evidence that asthma patients, for whom more than 6 short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, have since the last review point 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 prescribed an inhaled corticosteroid for asthma have a spacer device where appropriate in line with NICE TA38 and have a personalised asthma action plan. Refer to an appropriate healthcare professional where this is not the case. 

Digital enablers bundle

16. NHS 111 DoS profile – Update the pharmacy’s NHS 111 DoS profile via DoS updater, including opening hours for Bank Holidays, and promptly update as information changes, to ensure information is accurate for the public.
17. Demonstrable access to SCR.  

Claiming payments and validation of the gateway criteria

Community pharmacy contractors will be able to claim an early and advanced ‘Aspiration payment‘ of up to 70% of their earning under the PQS 2019/20 (if they participated in the QPS in 2018/19), subject to meeting gateway criteria. This declaration will need to be undertaken by the end of October 2019, with the aspiration payment being made by the end of November 2019.

Contractors will then be able to make a declaration for a payment (based on the criteria they have actually met) for the  February 2020 review point between a defined time period (the time period has not been confirmed yet).

As for previous declarations, contractors wishing to claim a PQS payment will be required to submit their declaration online to the NHS Business Services Authority (NHSBSA); however, for the February 2020 review point, contractors will only be able to claim for a payment via one route, by using the Manage Your Service (MYS) application (contractors will not be able to use Snap Survey as per previous review points to make a declaration).

Aspiration payment

Further information on the Aspiration payment can be found on the Aspiration payment page.

Registering for the Manage Your Service (MYS) application

Contractors will be required to claim their Aspiration payment and make their declaration for a PQS payment using the NHS Business Services Authority (NHSBSA) Manage Your Service (MYS) application. Contractors will not be able to use the Snap Survey like they may have done for previous Quality Payments Scheme declarations; they will be required to use MYS. Contractors will also be required to claim payment for the Flu Vaccination Service 2019/20 and notify readiness to provide the new Community Pharmacist Consultation Service (CPCS) via MYS.

Payment information

Contractors that successfully meet the requirements will receive a PQS payment which will be funded from a £75 million budget. PQS payments will be made to eligible contractors depending on how many quality criteria bundles/standalone criteria they have met (and therefore how many ‘points’ they achieved). Payment for the February 2020 review point will be paid by the end of March 2020. There will not be a reconciliation payment made to contractors, as there is only a single declaration point for this scheme and the payment made to contractors will therefore be calculated to distribute the full £75 million funding.

PharmOutcomes support

Community pharmacy contractors will be able to access support on PharmOutcomes for the PQS 2019/20. 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 support is currently being finalised and will be available shortly. PSNC will alert contractors though their normal communication channels when this becomes available.

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) is currently updating their PQS page on their website.

Declaration data for previous review points

The NHSBSA has published the declaration data for the April 2017, November 2017, June 2018 and February 2019 review points of the Quality Payments Scheme (the PQS was previously known as the Quality Payments Scheme).

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

FAQs

FAQs on the PQS are available on the Pharmacy Quality Scheme – FAQs page.

Return to the Pharmacy Quality Scheme hub page



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