Pharmacy PPE Claim process FAQs

Pharmacy PPE Claim process FAQs

This page contains the answers to Frequently Asked Questions (FAQs) on the Pharmacy PPE claim process.

Page last updated: 26th February 2021

Q. What PPE is covered by this process?

The overall items covered are aprons, gloves, Type IIR masks and hand sanitiser. In addition, between 27th February 2020 and 30th June 2020, the cost of equipment used in substitution for these is also allowed (given supply problems).

This process is part of a larger scheme across Primary Care, with funding for this scheme restricted to these distinct categories.

Other impacts to ensure COVID related infection control (including costs relating to ensuring social distancing, increased cleaning and sanitation costs, thermometers, and other protective measures) are part of our wider overall negotiations with DHSC.

Q. What level of detail do I need to declare?

You need to declare one overall amount for each pharmacy for the first period (27th February 2020 to 31st October 2020), and a second overall amount for each pharmacy for the period from 1st November 2020 to 31st December 2020 (if you’ve purchased PPE since 31st October 2020).

For the first claim period, this can either be for the standard claim amount or a higher exceptional claim (if you’ve been able to rebuild your purchase history for this time and are able to evidence this on request).

For the second claim period, any claimed amount is treated as an exceptional one and you must be able to provide evidence of the amount claimed on request.

Where exceptional claims are made, these must exclude VAT and delivery charges.

Q. How do I make a claim?

The main way for doing this is through the MYS portal, and login details will be the same as for other payments claimed through this route.

Additionally, group pharmacies (with six or more pharmacies) have the option to make a central claim on a spreadsheet, providing the equivalent claim data by pharmacy.

Q. What period does the standard claim cover?

The standard claim amount covers spend in the first period (between 27th February 2020 and 31st October 2020).

As previously stated, you are allowed to claim a higher amount for this period as an exceptional claim. However, to do this you must have been able to rebuild your purchase history for this period, and evidence this higher amount (excluding VAT and delivery charges) on request.

Q. How do I know how much I’m eligible for under the standard claim?

The volume bandings used are the same as for the Transitional Payment. The band assigned to each pharmacy is the one they’ve most frequently been in over the nine months from February 2020 to October 2020* (updated February 2021). Where there is a joint most frequent band (e.g. 4 times in two different bands), the highest band is used. Although this can be individually worked out by pharmacies, most pharmacies received an email from NHSBSA on 11/01/21 to confirm which band they were in.
*previously understood to be the eight months from March 2020 to October 2020

Q. How was the standard claim amount calculated?

This amount was modelled by NHSE&I, with the item volume in each band (taken at 75% between the lower and upper item thresholds) being translated into an expected sessional mask use. Hand sanitiser use, apron and glove use was also estimated for each band. This was reviewed by PSNC and contractors that are part of the Negotiating Team for reasonableness, with the exceptional claim mechanism for this period allowed where individual contractors have been able to rebuild their purchase cost over the standard claim period and are able to evidence they have incurred this greater PPE expense.

Q. If I want to make a standard claim for the 27th February 2020 – 31st October 2020 period, what amount should I enter in the PPE Claims tab on the MYS portal?

For standard claims (covering spend on PPE during the first claim period between 27th February 2020 and 31st October 2020), the claim amount figure to enter should follow the item volume banding table below. For example, if a pharmacy is in Band 4 and was open for 60 hours or less per week during the first claim period, a contractor will input 1640 in the pounds section and 00 in the pence section on the MYS PPE claim form. Where the portal asks “Is this an exceptional claim?” the answer would be “No”.

Band Range of number of items dispensed per month Standard claim, <=60 opening  hours Standard claim, >60 opening hours
1 0 – 100 £830 £1,650
2 101 – 2,500 £830 £1,650
3 2,501 – 5,000 £1,030 £1,850
4 5,001 – 12,500 £1,640 £2,460
5 12,501 – 19,167 £2,490 £3,310
6 19,168 + £3,240 £4,060

If more has been spent on PPE during this period, and you’re able to evidence this spend (on request), the claim for the higher amount can be submitted as an exceptional claim on this page instead. To make an exceptional claim for this period, input the value of the total amount being claimed (and select “Yes” in response to the question “Is this an exceptional claim?”).

Q. How do I claim expenditure on PPE from 1st November 2020 to 31st December 2020?

The process also allows for this later period to be claimed, with this inputted as a separate amount. Any claim for this second period will be an Exceptional Claim by default (i.e. you need to have documentation available on request to evidence the value of this claim). This amount must be excluding VAT and delivery charges

Q. Why is there the distinction between use up to 31st October 2020, and then after this period?

The DHSC PPE portal has been available since August for emergency supply, with routine supply allowed since late September. The end of October cut-off was a balance between recognising many contractors had not signed up to the PPE portal by this stage, but that others would have lower ongoing expenditure due to earlier use of the portal.

Q. Why is there the distinction between pharmacies operating more than sixty hours per week, and those operating at less than or equal to sixty hours per week?

In calculating the standard claim amounts, items dispensed were used as the biggest underlying driver of PPE usage. However, it was also recognised that this would underestimate PPE usage in pharmacies with much higher operating hours (where items dispensed were spread over a higher number of opening hours).

Q. I can’t evidence all my PPE spend, given the difficulties in simply maintaining patient care in the pandemic. Is this a problem?

Backup evidence is not required if you are only making a standard claim – the standard claim amount has been calculated given the very difficult operating conditions during the pandemic and to avoid the need to rebuild a purchase history.

However, if the standard claim amount is not enough for the period up to the 31st October 2020, you can declare the higher amount as an exceptional claim but you must be able to provide evidence (if requested) to backup this amount.

Similarly, if you claim PPE cost for 1st November 2020 to 31st December 2020 (when many contractors were using the NHS portal to source this), you must be able to provide evidence for this amount (if requested). It is envisaged that evidencing spend for this much more recent period will also be more practical.

Exceptional claims must not include VAT or delivery charges.

If you make a standard claim for the first period and an exceptional claim for the second period, you only need to be able to provide evidence (on request) for the second period’s exceptional claim.

Q. I don’t have invoices at individual pharmacy level and want to make an exceptional claim – what do I do?

It is recognised that one pharmacy may source PPE for others under common ownership, or it may be bought collectively and then sent out to individual pharmacies from a central warehouse. Given the PPE would not have been for resale, it is unlikely that accounting entries would have been made to transfer the cost of the PPE to (or between) individual grouped pharmacies.

In these instances, please take a pragmatic approach to splitting the central spend between the individual pharmacies that have used this PPE. It may be there are internal delivery records that can be used to do this, or another approach may be necessary. Please keep any record of how this apportionment has been done to backup any audit of your exceptional claims.

Q. Staff in my head office or centralised warehouse have also used PPE. How is this claimed?

Unfortunately, only pharmacy level usage is covered by this payment. PPE used by staff in head office or centralised warehouse settings is not covered.

PPE spend is only one part of the much higher impact on pharmacy of COVID, and these additional factors are being included in discussions with DHSC.

The eligibility of PPE spend in centralised hubs (where they support the dispensing process for their spokes) is less clear. If you’re looking to include this spend within an exceptional claim for each spoke, please contact NHSBSA to discuss both the eligibility of this spend and the evidence requirements that would be needed.

Q. PPE expenditure was centrally managed, and I don’t know how much it would have cost for my individual pharmacy or know how much it cost. How can I make a declaration?

A central claim process is being allowed for pharmacies that are part of a multiple group, with a template spreadsheet that can be filled in centrally and submitted to NHSBSA by email. This can be centrally declared to ensure that the individual with best access to the cost and allocation information to specific pharmacies within that group can make the declaration.

The spreadsheet is available at: Reimbursement for PPE costs | NHSBSA

Where independents centrally bought PPE stock across several branches, a central decision will be needed by your pharmacy owner whether to simply claim the standard amounts for each pharmacy, or whether exceptional claims are needed instead / as well (and if so, to determine those amounts). Claims will still be needed to be made via MYS, with individual login and claiming by pharmacy.

Q. Given the difficulties in sourcing PPE, I sourced PPE that is now considered non-standard (e.g. non Type IIR masks; visors). Can this be reimbursed?

No analysis between PPE types is needed for a standard claim, so if this is sufficient any non-standard spend would effectively be covered as part of the paid standard claim amount.

Where an exceptional claim is being made, the cost of non-standard PPE can be included where it was used up to 30/06/20 in substitution for the covered types of spend. Where this is included, the contractor may need to evidence the need for that PPE if requested to do so – this could be a staff risk assessment or similar.

Q. I bought / opened my pharmacy in the period being reimbursed. Can I make a claim, and am I eligible to make a standard claim?

Except in limited circumstances, you are only able to claim expenditure that you have incurred whilst owning the pharmacy. Any claims made must be exceptional ones and evidencable on request. This is for both the first period (27th February 2020 – 31st October 2020), as well as the second period (1st November 2020 – 31st December 2020). These pharmacies are not eligible to make a claim under the simplified standard claim process.

The potential exception is if there has been a change of ownership that has not required an ODS code, but this depends on further factors. In these instances, please contact NHSBSA for further guidance.

Q. My pharmacy closed permanently (or I sold my pharmacy) in the period, can I make a claim under this process?

No. Unfortunately, claims can only be made by current owners where the pharmacy is still open.

Q. My pharmacy introduced protected time (where pharmacy staff worked behind closed doors for part of the day given the pandemic pressures). Does this need to be included in determining whether I’d be able to make a standard claim (pharmacies open for less than 90% of their usual times needing to make an exceptional claim for the 27th February 2020 to 31st October 2020 period)?

Providing staff carried on working in the pharmacy during the protected time, this does not count as a reduction in opening times for these claims.

Q. Am I eligible for the reimbursement as a Distance Selling Pharmacy?

Yes. The infection risk of large numbers of staff working in close proximity is recognised as requiring PPE (despite patients being dealt with remotely). As such, the claim process, banding, and opportunity to make an exceptional claim is identical for DSPs.

Q. I’ve bought more PPE than I’ll be able to use by the end of March 2021. Is this covered under the exceptional claims process?

No. It’s only possible to claim for unused PPE (under the exceptional claims process) where it’s been invoiced before 31/12/20 and used by 31/03/21. Any remnant that is likely to be unused by 31/03/21 should be excluded from any exceptional claim.

Q. When and how will my claim be paid?

Claims are being paid within the normal Schedule of Payment process. The payment month will vary by pharmacy between the November 2020 dispensing month (paid 01/02/21) and January 2020 dispensing month (paid 01/04/21). The precise month will depend on when contractors submitted their claim, whether further evidence for exceptional claims is requested by NHSBSA for payment verification, and whether the provided evidence can be validated in time for the payment run for that month.

NHSBSA have confirmed that claims made by the end of 5th February 2021 will be paid in the December 2020 dispensing month Schedule of Payment, unless they have made exceptional claims that are selected for payment verification and where this cannot be completed in time for the actual payment run, or there are other queries relating to the claim submission. Where evidence is requested for exceptional claims, it is recommended that contractors provide this as soon as possible to support timely payment.

The amount paid will be shown on the Schedule of Payments under the ‘Details of other amounts authorised’ section as ‘PPE Claims’.

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