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Community Pharmacy Quality Payments Scheme

The Community Pharmacy Quality Payments Scheme 2017/18 forms part of the Community Pharmacy Contractual Framework which is effective from 1 December 2016 until 31 March 2018. The Quality Payments Scheme rewards contractors for delivering quality criteria in three quality dimensions: Clinical Effectiveness, Patient Safety and Patient Experience.

The details of the Quality Payments Scheme are outlined in Part VIIA of the Drug Tariff.

There are two review dates during the year, at which quality payments can be claimed; the first in April 2017 and the second in November 2017. The online declaration on the NHSBSA website will open for declarations:

For review Point Two (24 November 2017) from Monday 13 November 2017 at 09:00 and will close on Friday 8 December 2017 at 23:59

We're holding webinar sessions providing guidance on submitting your declaration for the Quality Payment Scheme November review. Click here for details and to book your place.

In order to be eligible for payments under the Quality Payments Scheme, contractors must meet the gateway criteria. 

Gateway criteria

The gateway criteria are composed of four elements:

  • the NHS Choices entry for the pharmacy must be up to date; for pharmacies that have existing profile editing rights for their NHS Choices entry, but who have forgotten/lost their password there is a password reset facility which is available at https://www.nhs.uk/Personalisation/ResetPassword.aspx. Pharmacies that wish to request profile editing rights for their NHS Choices entry will need to complete the registration form at https://www.nhs.uk/web-editor. All contractors are advised to ensure they know their password before November 2017; and
  • pharmacy staff at the pharmacy must be able to send and receive NHS mail. Details of how a contractor can apply for an NHSmail account for a pharmacy, in order to meet the Quality Payments Scheme NHSmail gateway criterion are available at http://support.nhs.net/joiningnhsmail; and
  • the pharmacy contractor must be able to demonstrate ongoing use of the Electronic Prescription Service at the pharmacy premises.

NHS England guidance on the Quality Payments gateway criteria can be found at https://www.england.nhs.uk/commissioning/primary-care-comm/pharmacy/framework-1618/pqp/ Contractors are advised to ensure they are able to meet the gateway criteria ahead of the online declaration on the NHSBSA website opening.

Passing the gateway criteria will not itself earn any payment for the contractor. Meeting the gateway criteria and achievement of some or all of the quality criteria set for the scheme, will mean a contractor is eligible for payments under the scheme.

Contractors should make sure they have read NHS England Pharmacy Quality Payments Scheme Guidance documents prior to completing the declaration. The documents can be found at: https://www.england.nhs.uk/commissioning/primary-care-comm/pharmacy/manual/pqp/

Quality payments will only be paid to LPS contractors who are eligible to claim under the terms of their LPS contract. If in doubt LPS contractors should confirm with their NHS England Regional Team whether they are eligible for quality payments.

Quality payments will be based on how many of the quality criteria the contractor achieves and declares via the Quality Payments Scheme declaration.

From Monday 13 November 2017 at 09:00 contractors will be able to make their declaration by completing the declaration form here. The declaration will require the contractor to confirm that they have met the four gateway criteria; this will enable the contractor to then declare which quality criteria have been achieved and therefore claim for the associated payment.  A valid declaration can only be made via this website. 

A csv file providing the declarations made by contractors for the April 2017 review date can be found here.

A glossary detailing the questions asked for both the gateway criteria and the quality criteria can be found here.

Quality Payments Scheme April 2017

Following the declaration period for the April 2017 Quality Payments Scheme closing, the NHSBSA has been requested to collate information on behalf of NHS England to validate or verify contractors’ declarations.

NHS Choices gateway criterion

The first part of this process was to contact contractors who had only partly edited or validated their NHS Choices profile; for example they only edited or validated one or two of the three sections of their profile instead of the required three sections.

Those contractors who failed to update all three parts received an email on Thursday 10 August 2017 advising that they had until 10 September 2017 to edit or validate any sections of their NHS Choices profile that they failed to edit or validate by 28 April 2017, which was the deadline for meeting for NHS Choices gateway criterion.

Read the content of the email

Distance selling pharmacies

Distance selling pharmacy (DSP) contractors who provided some but not all of the required information to meet the NHS Choices gateway criterion will also receive an email from the NHSBSA on 10 August 2017 requesting that they provide the NHS Choices help desk with all the required information by 10 September 2017.

Read the content of the email

Other gateway criteria and quality criteria

Further information on how NHS England and the NHSBSA will validate and verify contractors’ declarations that they met the other three gateway criteria and quality criteria for the April 2017 review point will be published at a later date.

Gateway criteria verification for the April review point

Community pharmacy contractors who claimed for a Quality Payment at the April review point, but appear to have not met the gateway criteria, will receive an email from the NHS Business Services Authority (NHS BSA) on Monday (18th September 2017), which requires urgent action.

Following the declaration period for the April 2017 Quality Payments Scheme closing, NHS England has been working with NHS BSA to validate contractors’ declarations for the gateway criteria. If NHS BSA has not been able to validate that a contractor has met the gateway criteria, the contractor will receive an email from NHS BSA on Monday stating the criteria that cannot be validated and the contractor will be asked to provide information to show how the criteria was met.

If contractors do not provide this information by the deadline, Sunday 8th October 2017, the NHS BSA will not be able to confirm to NHS England that the contractor has met the gateway criteria, which will result in NHS England taking further action; this could include NHS England reclaiming the Quality Payment paid to the contractor in June 2017 for the April review point.

Contractors are advised to check their junk/clutter folder in case the email goes into this folder.

Read the content of the letter which will be sent to contractors by email

Validation of quality criteria for the April review point

NHS England is currently working with the NHSBSA to validate contractors’ declarations for the quality criteria; communications on this will be sent out to contractors in due course.