Quality Payments Scheme – what to do, when to do it and how to report and claim


Quality Payments (QP) Scheme – what is it?

As part of the changes to the Community Pharmacy Contractual Framework (CPCF) in 2017/18, the Department of Health (DH) have introduced the quality payments scheme.    This scheme is voluntary but we recommend you minimise the impact of the funding cuts by seeking to meet as many of the QP criteria as possible.

Review Points

There are two review points during the year, at which a Quality Payment can be claimed. These are:

  1. Friday 28th April 2017; and
  2. Friday 24th November 2017.  WHAT YOU HAVE TO DO FOR THIS REVIEW POINT  HAS CHANGED FOR SOME OF THE CRITERIA – quality-payments-guidance-november-2017-declaration (1)

Online Reporting Declaration and Claims

 The online declaration on the NHSBSA website will be open for claims declarations for review Point Two (24th November 2017) from:Monday 13th November 2017 at 09:00 and will close on Friday 8th December 2017 at 23:59

Some pharmacies/multiples will arrange for this to be done centrally, please to liaise with company managers/head office to find out the company procedure for your pharmacy.

IMPORTANT:

Do not click “SUBMIT” until your declaration is fully completed -once a declaration has been submitted it cannot be altered, retrieved or added to.  Clicking “SAVE” will allow you to return to add to your declaration at another time.

Once the declaration has been submitted the contractor will receive an email from 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

Where can you get information about how to achieve the Quality Payment Scheme?

The Quality Payments NHS England Gateway Criteria Guidance.

 Quality Payments NHS England

The Quality Payments NHS England Quality Criteria Guidance.

quality-payments-quality-criteria-guidance-1

The Quality Payments NHS Guidance for the November 2017 Declaration

quality-payments-guidance-november-2017-declaration (1)

 A Summary:  What are the gateway criteria and what must I do meet them?

1

Provision of one specified Advanced Service

On the day of the review, the contractor must be offering at the pharmacy Medicines Use Reviews (MURs) or the New Medicine Service (NMS); or must be registered for the NHS Urgent Medicine Supply Advanced Service (NUMSAS) Pilot. If registered you will need to be ready to start providing the service from the 3rd April – make sure you have read the detailed guidance https://www.england.nhs.uk/wp-content/uploads/2016/11/numsas-service-specification.pdf

 

This is a gateway criterion and it must therefore be complied with before any payment can be achieved
2

NHS Choices entry up to date

On the day of the review, the NHS Choices entry for the pharmacy must be up to date.

Contractors are required to edit or validate their NHS Choices profile between 00:00 on 11th September 2017 and 11:59pm on 24th November 2017 to meet the gateway criterion. Contractors are reminded that they must edit or validate the three sections of their NHS Choices profile to meet the gateway criterion:

  • their opening hours;
  • the facilities the pharmacy provides e.g. consulting room, parking etc; and
  • the services the pharmacy provides e.g. Medicines Use Reviews (MURs), New Medicine Service (NMS), etc

All three sections will need to have been edited or validated for the contractor to meet the NHS Choices gateway criterion, which is a requirement, to be eligible to then claim for a Quality Payment based on the quality criteria they meet. Even if all three sections are correct, contractors will still need to log into their profile and validate this information during the above time period.

Contractors who plan to declare to the NHS Business Services Authority that they are offering either MURs or NMS or both services under the Advanced Service gateway criterion must also ensure that the service is visible on their NHS Choices profile. 

Even if contractors have recently edited or validated their NHS Choices profiles, they will need to do this again, within the above time period, to ensure they meet the gateway criterion.

A User Guide for contractors to guide them through the process of updating or editing their NHS Choices profile to support the Quality Payments Scheme is available on the NHS Choices website.

Contractors that have previously requested editing rights but have forgotten their password or for contractors that do not currently have editing rights, further information can be found on the PSNC website.

Distance selling pharmacies – please read the changes in section 5.2.1 of the quality-payments-guidance-november-2017-declaration (1)

Since distance selling pharmacies (DSPs) do not, currently, have full NHS Choices entries, DSP contractors should refer to PSNC Briefing 065/17: Quality Payments – Process for distance selling pharmacies to meet the NHS Choices gateway criterion for the November 2017 review point which details the process DSP contractors will need to follow.

 

This is a gateway criterion and it must therefore be complied with before any payment can be achieved.
3

Ability for staff to send and receive NHS mail 

The requirements for this criterion have changed for the November review point

On the day of the review, Pharmacy staff at the pharmacy must be able to send and receive NHS mail.  IMPORTANT:  if you DO have a shared NHSMail Account  – YOU MUST MAKE SURE THAT YOU ARE USING IT TO DEMONSTRATE YOU CAN SEND AND RECEIVE EMAILS THROUGH IT.  This is essential to pass this gateway criteria in November.

If your pharmacy has applied for a shared NHSmail account, but have not yet got one, you MUST ACT NOW  to ensure you have one and are using it in time for the November review point of the Quality Payments Scheme.

Having applied for an account will NO LONGER mean you meet the gateway criterion at the November review point.

Some pharmacies/multiples will arrange for this to be done centrally, please check with your company managers/head office to find out the company procedure for your pharmacy.

What should I do – where can I get help?

You should have received an email from NHS Digital in the last few weeks, which explains how to get your account set up. The email asks you to complete the process for setting up a shared NHSmail account by providing some information on the NHSmail registration portal. This will include the creation of up to three personal accounts which will be used to access the shared account. Once you have completed your registration using the portal, you will be sent login details for the accounts so that you can activate them.

The portal can also be used by pharmacy contractors who have not previously applied for an account.

During the registration process, if you are unable to locate your pharmacy within the portal, or for ANY OTHER ISSUES please contact:  pharmacyadmin@nhs.net and they will support you through the process

Further information on the action to take can be found in the PSNC news story, Quality Payments: action required if you haven’t got a pharmacy NHSmail account.

 

Previous nhs.net pharmacy premises email accounts that were set up locally before December 2016 will not be acceptable for quality payments as these were not linked to your ODS code and are accessed by a ‘shared password’. THIS IS NOT THE SAME AS A ‘SHARED ACCOUNT’

For the Quality Payments GATEWAY CRITERIA, you must have applied for a NEW PHARMACY PREMISES NHSMAIL ‘SHARED ACCOUNT’ –  WHICH IS ACCESSED VIA LINKED PERSONAL NHSMAIL ACCOUNTS

This is a gateway criterion and it must therefore be complied with before any payment can be achieved.
4

Ongoing utilisation of the Electronic Prescription Service.

On the day of the review, the pharmacy contractor must be able to demonstrate ongoing utilisation of the Electronic Prescription Service at the pharmacy premises.

Most pharmacies are already regularly using EPS and hence will immediately meet the requirements of this gateway criterion. ‘Ongoing utilisation’ means that all EPS scripts, including release 1 prescriptions, should be dispensed via EPS.

If you are enabled for EPS, but your local GPs do not currently use EPS, you will still meet the requirements. If your pharmacy is not enabled to provide EPS, speak to your PMR system supplier about how to get enabled as soon as possible.

This is a gateway criterion and it must therefore be complied with before any payment can be achieved.

A Summary: What are the Quality Criteria and how can I meet them?

The assessment of whether a criterion has been met will need to be made in relation to two review points – 28th April 2017 and 24th November 2017. The payment to the contractor will depend on how many of the quality criteria they meet:

Domain Criteria Review points at which claims can be made Points per review Total points over the two reviews
Patient Safety

Production of a written report that demonstrates evidence of analysis, action and learning in response to near misses and patient safety incidents, including NPS alerts and having shared learning.

Reporting:  In order to meet this quality criterion, contractors should:

  • collate incidents and near misses from an ongoing log;
  • analyse these and look for patterns;
  • reflect on the learning from these;
  • take actions to minimise future risk from repeated errors; and
  • share their learning (both locally and nationally).

This should then be documented in a written patient safety report. The report must also include evidence of specific actions taken by the pharmacy in response to local errors and national patient safety alerts issued by the Central Alerting System: https://www.cas.dh.gov.uk/Home.aspx

The NPA has produced resources and templates to guide pharmacies about what to include on the Patient Safety Report, how to collate and analyse the evidence and what to do with the report.   Go to:   https://www.npa.co.uk/information-and-guidance/patient-safety-report/

One

April OR

November

20

20

Total of 20 points

(£1,280)

Patient Safety

On the day of the review 80% of registered pharmacy staff working at the pharmacy to have achieved level 2 safeguarding status for children and vulnerable adults in the last two years.

Registered pharmacy staff are pharmacists and registered pharmacy technicians. This includes locums, so you should encourage temporary staff, such as locum pharmacists, to undertake the training and assessment.  Pre-registration pharmacists are not included although it is sensible for pre-registration students to undertake safeguarding training.

The CPPE Safeguarding children and vulnerable adults e-learning and e-assessment meets the level 2 requirements and can be accessed here

A record sheet from the PSNC website is available here:  Safeguarding record sheet (Word)  to help you keep a record of your pharmacists and pharmacy technicians, that have undertaken level 2 safeguarding training.  You should keep a copy of any certificates that staff receive once they have completed the training and assessment as evidence of compliance with this QP criterion.

Two

April AND

November

5

10

Total of 10 points

(£640)

Patient Experience

On the day of the review, results of the patient experience survey from the previous 12 months to be published on the pharmacy’s NHS choices web page.

 The results of the Community Pharmacy Patients’ Questionnaire 2016/2017 must be uploaded to the pharmacy’s NHS Choices profile in a PDF format.

Guidance on uploading documents to NHS choices: www.nhs.uk/aboutNHSChoices/professionals/Documents/how-to-upload-the-community-pharmacy-patient-questionaire.pdf

One

April OR

November

5

5

Total of 5 points

(£320)

Public Health

On the day of the review, the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment).

The Healthy Living Pharmacy: Level 1 quality criteria set out the quality criteria that pharmacies must achieve to gain HLP level 1 status.  You can access this here

Reporting:

New HLP’s and those accredited before 1st December 2014

  • Register online as a self-assessed Healthy Living Pharmacy level 1.

www.rsph.org.uk/our-services/registration-healthy-living-pharmacies-level1.html

Or for Brighton and Hove HLPs a copy of the signed and dated documentation that demonstrates that between 1 December 2014 and 28 April 2017 the pharmacy was accredited as a HLP level 2 locally. Pharmacies that have been accredited between 1 December 2014 and 28 April 2017, do not need to go through the profession-led self-assessment process led by PHE to qualify for the quality payment and therefore do not need to register with the RSPH registry.

Resources to help you plan and record evidence for this criteria:

HLP-Level-1-checklist

This is a simple checklist for you to make sure your portfolio is complete.  You can use the same piece of evidence for more than one of the items on the list.  If you have any problems identifying suitable evidence please contact LPC@communitypharmacyss.co.uk for guidance

HLP-Self-Assessment-Tool

This can be used to record the one piece of evidence you need for each item on the checklist.  You do not need to record anything next to the RPS text – this is for guidance only.

HLP-Action-Plan-template

This needs to be completed and kept in your portfolio.  If you need additional guidance please contact LPC@communitypharmacyss.co.uk

Health Champion Training:

One of the requirements to be compliant for HLP level 1, is to have at least one Full Time Equivalent Health Champion in your pharmacy trained to RSPH Level 2.

There are remaining places on the FREE HEALTH CHAMPION TRAINING Event scheduled for pharmacy staff for the Surrey & Sussex area as listed below.   If you have one champion already, consider training another for business continuity.

 18th October 2017, 09:30-16:30 at Cooden Beach Hotel, Cooden Sea Road, Bexhill-On-Sea, East Sussex, TN39 4TT – REGISTER HERE

This Health Champion Training is FREE for all pharmacies in the Sussex & Surrey area to attend (applicants outside this area may be refused). It has been commissioned by Health Education England to support pharmacies to achieve their HLP level 1 accreditation and claim the HLP Quality Payment in November.

On-line Health Champion training is also available to attain the necessary Level 2 qualification in Understanding Health Improvement accredited by the Royal Society for Public Health (RSPH) for HLP level 1.  The LPC does not endorse a particular provider, example providers are the NPA and Buttercups.

Leadership Training:

CPPE have produced a Leadership for HLP e-learning course which can be accessed here

 

One

April OR

November

20

20

Total of 20 points

(£1,280)

Digital

Access summary care records and demonstrate increased use since the previous review point

The requirements for this criterion have changed for the November review point

Reporting:  Review point 2: 24 November 2017

Pharmacies who have used SCR less than 100 times in periods 1 and 2 must show they have used SCR on at least one more separate occasion during period 2, Monday 1 May 2017 to Sunday 26 November 2017, than during period 1, Monday 3 October 2016 to Sunday 30 April 2017.

Where a pharmacy has used SCR 100 times or more in both period 1 and period 2, they will not need to demonstrate an increase in access. This recognises pharmacies who are consistently accessing the SCR to support patient care.

NHS England will accept an increase from period 1 to period 2 shown in the NHS Digital calculator available:

https://digital.nhs.uk/summary-care-records/community-pharmacy/calculate-scr-use-quality-payments

Periods for reviewing access to SCR in relation to the reviews for 24th November 2017 review point

 

Period 1 is Monday 3rd October 2016 to to Sunday 30th April 2017 Period 2 is Monday 1st May 2017 to Sunday 26th November 2017.

For help accessing SCR, training requirements or if you have any problems going live with SCR please visit the Community Pharmacy Surrey & Sussex (CPSS) website Summary Care Record webpage here

Link to SCR Support materials and Demo on how to access SCR video clip:

https://www.digital.nhs.uk/summary-care-record/community-pharmacy

NHS Digital also has information

https://www.digital.nhs.uk/search?q=Summary+Care+Records+Access&s=s

Two

April AND

November

5

10

Total of 10 points

(£640)

Digital

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

The requirements for this criterion have changed for the November review point

The Directory of Services (DoS) is a central directory which provides NHS 111 call handlers and clinicians with real time information about services available to support a particular patient.

For the November declaration, contractors will be required to edit or confirm the information about their pharmacy is correct on theThe new Directory of Services (DoS) profile updater by 11:59pm on 24th November 2017 to meet the quality criterion. This process is the same for ‘bricks and mortar’ pharmacies and distance selling pharmacies.

Guidance and a video and a video  on how to edit or confirm the information about a pharmacy is correct is available on the DoS profile updater website. Please read the guidance and/or watch the video to ensure they fully understand how to meet the quality criterion.

Once the details on the DoS profile updater have been submitted, the contractor will receive an email to confirm this. This email should be retained as evidence of meeting the DoS quality criterion.

The email should be received instantaneously after submitting the information on the DoS profile updater; however, please allow up to two hours for the email to be delivered. If the email is not received after this time period, please check your junk/clutter folders to ensure the email has not been inappropriately filed in this folder. If this is not the case, please email: Exeter.helpdesk@nhs.net for further advice.

technical difficulties accessing the DoS Profile Updater then
they can email the NHS Digital help desk at exeter.helpdesk@nhs.net or call them on
0300 303 4034.

Reporting:  The following demographic information will need to be confirmed:

  • ODS code;
  • full address details (including postcode);
  • normal opening hours;
  • bank holiday opening hours until the next review date:

For review point 2 (November 2017)

25th December 2017 Christmas Day

26th December 2017 Boxing Day

1st January 2018 New Year’s Day

  • contact telephone number
  • Contact email address for non-patient identifiable data.

Two

April AND

November

2.5

5

Total of 5 points

(£320)

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, are referred to an appropriate health care professional for an asthma review.

Reporting

Contractors will be required to declare that they have identified any asthma patients receiving more than six short acting bronchodilator (SABA) inhalers within a six-month period without any corticosteroid inhalers being dispensed and they have referred them to an appropriate health care professional. Contractors should retain evidence that this has been carried out in the pharmacy. If no referrals made evidence should be retained to show a search of patients has been undertaken.

A suggested process for pharmacy teams to follow to incorporate this Quality Payment criterion into their daily practice can be found below.

Asthma referrals – Suggested process for referring patients for an asthma review (Word)

An PharmOutcomes asthma referral tool has also been created to assist contractors in meeting the Quality Payment criterion,

This tool allows contractors to record patient details who have consented to be referred to their GP practice because of them having been dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6 month period. When this data is saved on PharmOutcomes a referral will automatically be sent to the patient’s GP practice (if a secure email address is held for that GP practice on PharmOutcomes).

This module is found under the Services tab on PharmOutcomes.  It is listed within the services alphabetically, and is highlighted blue “Quality Payments”

OR:  Where the notification to the GP practice is undertaken via hardcopy/fax the Community pharmacy referral form can be used.

Community pharmacy referral form (Word)

A data collection form is provided below which could be used to provide evidence for having met this Quality Payment criterion. Please note, if this form is used, the left-hand side of the form containing patient information, should be hidden if it is shown to NHS England representatives to prevent a breach of patient confidentiality.

Data collection form – Patients referred for an asthma review (Word)

Two

April AND

November

10

20

Total of 20 points

(£1,280)

Workforce

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

Reporting:  On the day of the review, 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’.

www.dementiafriends.org.uk

Pharmacy staff with a patient-facing role should include all registered pharmacy professionals, all pre-registration graduates, everyone working in the dispensary, all medicines counter assistants and all delivery drivers (it also includes locums). In order to calculate the total number of staff working in patient-facing roles in the pharmacy on the day of the review each full or part-time member of staff working in roles listed above counts as one.

Contractors will be required to declare via the NHS BSA online declaration page that they meet this criterion. Contractors should keep evidence that staff have become Dementia Friends in the pharmacy. This could be a copy of the email sent to request badges.

A record sheet from the PSNC website is available here: Dementia friends record sheet (Word) to help you keep a record your staff members and temporary staff, such as locums, that have become Dementia Friends. You should keep a copy of any certificates/letters that staff receive once they become a Dementia Friend as evidence of compliance with this QP criterion.

Two

April AND

November

5

10

Total of 10 points

(£640)

      Total No. of points 100