Quality Payments Scheme 2018/19


The Quality Payments Scheme 2018/19 – A summary of  the second Quality Payments Scheme 2018/19

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. The scheme was extended in March 2018 for the first six months of 2018/19, as part of interim arrangements.

In September 2018, a new Quality Payments Scheme was announced for the remainder of the 2018/19 financial year. The new scheme has a review point in February 2019 and several revisions from previous scheme criteria. This PSNC Briefing provides a summary of key information on the Quality Payments Scheme for the second half of 2018/19.

The review date

There agreed review point for this cycle is Friday 15th February 2019, at which a Quality Payment can be claimed. Payments will need to be claimed between 9am on Monday 4th February 2019 and 11:59pm on Friday 1st March 2019.

 

NHS England guidance

On 27th November NHS England published their latest guidance to provide more information ahead of the February 2019 review point of the Quality Payments Scheme. The guidance document provides information on how community pharmacy contractors can meet the revised gateway and quality criteria requirements.

The guidance document also details the new declaration process via the NHS Business Services Authority Manage Your Service application and highlights the new process for validation of the gateway criteria.

Contractors are strongly advised to read the NHS England guidance in order to understand the Quality Payments Scheme requirements. The new guidance should be read in conjunction with previously published NHS England guidance documents on the Quality Payments Scheme:

  • 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).

All three guidance documents can be found on the NHS England website.

The gateway criteria

For the second half of the Quality Payments Scheme 2018/19, there are five gateway criteria which contractors must meet. As per previous declarations, passing the gateway criteria will not, in and of itself, earn a quality payment for the pharmacy.

1. Advanced services

‘The contractor must be offering at the pharmacy Medicines Use Review (MUR) or New Medicine Service (NMS); ormust be registered for NHS Urgent Medicine Supply Advanced Service Pilot’.

If a contractor is declaring that they provide MURs and/or NMS at the pharmacy to meet the Advanced Services gateway criterion, they should ensure that either or both of these services are listed on their NHS.UK profile (this does not apply to distance selling pharmacies).

2. NHS.UK entry (previously known as NHS Choices)

‘On the day of the review, the NHS.UK entry, including bank holiday opening hours for the pharmacy must be up todate’.

Contractors must edit and/or validate their NHS.UK entry between 12am on 3rd December 2018 and 11.59pm on 15th February 2019.

Distance selling pharmacy contractors must send an email to the NHS.UK service desk; the timeframe will be outlined in NHS England guidance (please note, this has not yet been published).

3. Community Pharmacy Patient Questionnaire (CPPQ) – new

‘The results of the last completed Community Pharmacy Patient Questionnaire is publicly available on the pharmacy’sNHS.UK page or for distance selling pharmacies it is displayed on their website’.

This was previously a quality criterion but is now a gateway criterion.

Contractors that claimed for this quality payment in June 2018 are likely to have already uploaded their last completed CPPQ results to their NHS.UK profile. Contractors are not required to undertake a new survey to meet this Gateway criterion in February 2019.

Distance selling pharmacy contractors must display the results of the last completed CPPQ on their website.

4. NHSmail – new

‘Pharmacy staff at the pharmacy must be able to send and receive NHSmail from their shared premises NHSmailaccount, which must have at least two live linked accounts’.

A live account is one that has been activated and not been dormant for over 90 days. Staff members who already have personal NHSmail accounts should be aware that passwords should be changed every 90 days. Accounts not accessed for more than 90 days will be suspended and if they are not accessed for a further 90 days they will be deleted.

Each pharmacy’s designated mailbox owner can add and remove personal NHSmail addresses to or from apharmacy’s premises-shared NHSmail account as required. If your pharmacy does not have a shared NHSmail account or two live linked accounts, PSNC’s NHSmail page contains further guidance.

5. IT operating system compliance with the NHS Digital Warranted Environment Specification (WES) – new

‘The contractor must have consulted the NHS Digital Warranted Environment Specification (WES) and/or their SystemSupplier(s) and have reassured themselves, and can demonstrate, that all their operating system and browser versions currently in use in their pharmacy to link to NHS Digital systems, such as the Electronic Prescription Service and Summary Care Record, comply with the WES; and are therefore supported by NHS Digital for connectivity to NHS Spine systems’.

The NHS Digital WES defines the versions of software required to be installed on computers in order that they are supported by NHS Digital to access NHS Spine systems and applications requiring a Smartcard, such as the SCR portal or EPS tracker. It is already a requirement that contractors comply with these requirements when they connect to NHS Spine systems. WES compliance aims to improve cybersecurity, by preventing the use of out of date and unsupported operating systems and web browsers.

‘On the day of the review, the NHS.UK entry, including bank holiday opening hours for the pharmacy must be up todate’.

Contractors need to check that the computers they use to access NHS Spine services are using operating systems and web browsers which are compliant with the NHS Digital WES. The operating systems listed in the current WES are:

  • Windows Server 2012 R2
  • Windows 7 SP1 32-bit / 64-bit
  • Windows 8.1 32-bit / 64-bit
  • Windows 10 64-bit

The browser versions listed in the current WES are:

  • Microsoft Internet Explorer (IE) 11
  • Microsoft Edge
  • Google Chrome
  • Mozilla Firefox

NHS Digital will be able to assess contractor compliance with these requirements when they log onto the SCR portal.

The Quality criteria – worth 100 points in total

Several changes have been made to the quality criteria, including the number of points allocated for each criterion.

Meeting the gateway criteria and achievement of some or all of the quality criteria set for the scheme, described below, will mean a contractor is eligible for payments under the scheme.

Patient Safety – new

Safety and Incident Reports – new

Worth 20 points

Criteria

  • A written patient safety report (updated since 28 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 happenedin the NRLS report, the contractor must include the text ‘LASA’ as aunique 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.

Risk Management new

Worth 20 points

Criteria

  • 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.

NSAID Audit – new

Worth 20 points

Criteria

  • On the day of the review the pharmacy must have completed the audit of non-steroidal anti-inflammatory drugs and gastro-protection available under the following link –https://www.sps.nhs.uk/articles/nsaid-safety-audit-2018-19/, forpatients 65 or over, notified the patient’s GP where professionalconcerns were identified, share their anonymised data with NHS England and incorporated the learning of the audit into future practice.

 

Public Health– new

HLP and Oral Health – new

Worth 15 points

Criteria

  • 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 that provide healthcare adviceto the public have successfully completed the CPPE children’s oralhealth training assessment

 

Digital / Urgent Care

NHS111 Directory

Worth 2.5 points

Criteria

  • On the day of the review, the pharmacy’s NHS 111 Directory ofServices entry is up to date.

Clinical Effectiveness – new

Asthma

Worth 20 points

Criteria

  • 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 (28 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 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.

 

Workforce

Dementia Friends

Worth 2.5 points

Criteria

• On the day of the review, 80% of all pharmacy staff working inpatient facing roles are trained ‘Dementia Friends’.

Funding and Payment Information

Contractors who successfully meet the requirements will receive Quality Payments 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 of £32 (based on all pharmacy contractors achieving maximum points). As with previous versions of the Scheme, payments will be made to eligible contractors depending on how many criteria they have met and hence points claimed.Payment for the February 2019 review point will be paid as part of the full payment for the March 2019 submission to the Pricing Authority (which contractors will receive in June 2019).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 £37.5 million funding.

Claiming a Quality Payment

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 9am Monday 4th February 2019 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.

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.

Further resources

PSNC is currently reviewing their website and producing new guidance and resources, where appropriate, to assist contractors to meet the criteria of the Scheme. PSNC will also be issuing regular communications to remind contractors of various actions required, so please ensure you have signed up to receive them.

In addition we will make information available on the LPC website and will send out information via the LPC newsletter.