Maintaining access to pharmacy services – Changes to CPCF services
Maintaining access to pharmacy services – Changes to CPCF services
This page details temporary changes to the service requirements within the NHS Community Pharmacy Contractual Framework (CPCF) which were introduced during the pandemic.
The changes were agreed by PSNC with NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC) to allow pharmacy contractors and their teams to prioritise the provision of key services to patients during periods of time when capacity in pharmacies and the wider NHS became very stretched.
Page last updated: 19th December 2021
Changes to the CPCF requirements currently in place (2021/22)
On 15th December 2021, PSNC announced that it had reached agreement with NHSE&I and DHSC on a number of measures to help ease the immediate pressures on community pharmacies being felt due to the Omicron variant of COVID-19, workforce pressures and the ongoing COVID-19 booster vaccination programme.
It was agreed that:
- There would be an extension to the deadline for meeting the requirements of the Pharmacy Quality Scheme in line with the arrangements last year;
- Contractors will not be required to complete the Community Pharmacy Patient Questionnaire for 2021/2022;
- The requirement for pharmacy teams to complete a national audit (intended to be on valproate) in 2021/22 will be waived; and
- The requirement for pharmacy teams to complete a contractor-chosen clinical audit in 2021/22 will be waived.
Under the agreement, pharmacies will still need to make the PQS declaration during the February 2022 window, but as last year, this will be a claim for work to be undertaken and evidenced by 30th June 2022. Further details will shortly be published as a Drug Tariff determination on the NHSBSA website with similar wording to last year, in 2020-21.
PSNC, NHSE&I and DHSC have also agreed to keep the situation under ongoing review.
Changes to the CPCF requirements agreed in 2020/21
In 2020, in light of the ongoing COVID-19 pandemic and the impact that this was having on community pharmacies, PSNC gained agreement from NHSE&I and DHSC on several measures to help contractors.
The following PSNC Briefing sets out the regulatory and contractual dispensations agreed 2020/21 and further information is set out in the sections below:
Terms of Service requirements
PSNC pressed for the NHS to take a pragmatic and flexible approach to the regulations and they were amended as follows.
Data Security and Protection Toolkit: contractors were given an extended deadline for completion of the 2020/21 toolkit, with submissions required by 30th June 2021.
Community pharmacy patient questionnaire (CPPQ): contractors were not required to undertake the CPPQ during 2020/21.
Clinical audits: contractors were not required to undertake an NHSE&I determined national clinical audit or a contractor chosen clinical audit during 2020/21.
Practice leaflets: NHSE&I advised that they would not take action against contractors who had not updated their practice leaflets during the period of the pandemic.
NHS complaints process: NHSE&I announced a system wide “pause” of the NHS complaints process, initially for three months from 28th March 2020. The pause was not being enforced for any healthcare providers who did wish to operate as normal with regard to complaints. As of 26th March 2020, the Parliamentary and Health Service Ombudsman has stopped accepting new NHS complaints and has stopped work on open cases. NHSE&I also did not require annual complaints report submissions from contractors during 2020/21.
Changes originally planned for July 2020: The regulations required to enact several changes to the Terms of Service due to commence in July 2020 – including the requirement for all community pharmacies to be Healthy Living Pharmacies – were delayed due to the Government focusing on the COVID-19 response. The new NHS regulations were laid on 20th October 2020 and PSNC issued a series of 14 Regs explainer articles to help pharmacy contractors and their teams to understand the new requirements – access them all here.
Pharmacy Quality Scheme (PQS)
NHSE&I and DHSC agreed to PSNC’s request for more flexible timings for completion of the work within the PQS Part 2 2020/21. Whilst the declaration still took place as planned in February 2021, contractors had until 30th June 2021 to complete any elements of the scheme they have declared as having met. Contractors who made declarations in February received any PQS payment due as part of the overall payment made by the NHSBSA to contractors on 1st April 2021.
Read more on our Pharmacy Quality Scheme – Archive page.
Discharge Medicines Service (DMS)
Whilst its introduction was delayed due to the ongoing pandemic, the DMS became an Essential service for contractors from 15th February 2021.
Read more about the service on our DMS webpage.
Community Pharmacist Consultation Service (CPCS)
Patients being referred to the CPCS are now being told to phone the pharmacy and to speak to the pharmacist. Unless there is a clinical need for the patient to be seen in the pharmacy, the pharmacist can provide a consultation by telephone, as is provided for in the service specification. If the consultation is conducted in this manner, the pharmacy is eligible to claim the fee for provision of the service.
NHS 111 Online CPCS urgent supply referrals: the NHS 111 Online service now makes CPCS referrals to community pharmacies where people need urgent access to their usual prescribed medicines. Whilst successfully piloted in the north west of England, plans to roll out the functionality across the whole of England were brought forward in response to the huge surge in demand for NHS 111 services during the early stages of the pandemic.
CPCS GP referrals: whilst previously delayed by the pandemic, this extension to the service is now underway – find out more here.
Further information can be found on our CPCS page.
Hepatitis C testing service
The planned introduction of this Advanced Service in April 2020 was delayed by five months because of the COVID-19 pandemic. However, the service has since commenced (on 1st September 2020) and further details can be found on our Hepatitis C testing service webpage.
Other Advanced Services
The choice of provision, or not, of Advanced Services is down to individual contractors. Some have decided to stop, whilst others are continuing but with safety precautions in place.
From September 2020, it was no longer a contractual requirement that written consent be obtained from patients prior to the provision of the Flu Vaccination Service, the New Medicine Service (NMS) and Appliance Use Reviews (AUR). Instead, for these services, verbal consent can be obtained and a record of that made in the pharmacy’s clinical record for the service. These changes were agreed by DHSC and NHSE&I, following a proposal to move to a verbal consent model made by PSNC.
Additionally, all NMS and AUR consultations may now be provided by phone or video consultation, without the contractor having to seek prior approval from NHSE&I. This should only happen where it is clinically appropriate to do so, and in circumstances where the conversation cannot be overheard by others (except by someone whom the patient wants to hear the conversation, for example a carer).
Phase out of MURs
The targeting requirements for MURs in 2020 were amended to retain the previous targeting requirements (70% of MURs must be for patients taking high-risk medicines or those recently discharged from hospital) until 31st December 2020. Then, as previously agreed in the five-year CPCF deal, the service was decommissioned on 31st March 2021.
Further information can be found on in our Advanced services section.
Locally commissioned services
NHSE&I regional teams were asked to review the need for any local pharmacy Enhanced services. Those that were not essential during the pandemic may have been paused. Please contact your LPC for information about local pharmacy services.
Shared-Care for substance use patients provided with supervised consumption
COVID-19 guidance for commissioners and service providers for those dependent on drugs or alcohol was published in 2020.
The updated guidance highlighted that people who misuse or are dependent on drugs and alcohol may also be at increased risk of becoming infected, and infecting others, with COVID-19. People in these groups may also be more vulnerable to poor health outcomes due to underlying conditions. The guide covers a range of topics and provides additional sources of support that community pharmacies can use to further assist people through signposting. Pharmacists who provide services to support people dependent on drugs or alcohol are encouraged to ensure they are familiar with the guidance.
PSNC and several LPCs also developed the following guidance to support contractors to continue to maintain provision of substance use patients in circumstances where pharmacies have to temporarily close.
Shared-Care service provision for people being treated for substance use during the COVID-19 pandemic (updated 25th March 2020)
For more information, see our instalment dispensing page.
Provision of Multi-compartment Compliance Aids (MCA) during the pandemic
Template letter to share with patients (Microsoft Word)
Provision of services to Care Homes during the pandemic