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Community Pharmacy Quality Payments Scheme

A Community Pharmacy Quality Payments Scheme, which forms part of the Community Pharmacy Contractual Framework (CPCF), was introduced in December 2016.

The Quality Payments Scheme was designed to reward community pharmacies for delivering quality criteria in all 3 of the quality dimensions:

  • clinical effectiveness
  • patient safety
  • patient experience

There's been 3 previous review points in April and November 2017 and in June 2018. An additional interim arrangement has been agreed for the second 6 months of 2018/19 with a further £37.5 million to be invested in a February 2019 review point.

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

NHS England has published guidance for the February 2019 review point of the Quality Payments Scheme.

The new guidance should be read in conjunction with NHS England’s previously published gateway criteria and quality criteria guidance:

  • NHS England – Pharmacy Quality Payments Gateway Criteria Guidance (published 23 December 2016)
  • NHS England – Pharmacy Quality Payments Quality Criteria Guidance (published 27 February 2017).

These documents are available on the NHS England website.

PSNC has also published resources to help contractors with meeting the gateway and quality criteria of the Quality Payments Scheme.

NSAID audit quality criterion - Snap survey

On the day of the review, contractors must have submitted their audit results to NHS England to meet the NSAID audit quality criterion. This can either be done using our audit data collection tool or other platforms that allows this data to be shared with NHS England. The PSNC webiste has more information.

More information on the NSAID audit quality criterion can be found on pages 28-30 in the NHS England guidance on the Quality Payments Scheme for the February 2019 review point.

Contractors will be able to claim for a quality payment either by::

  • the Manage Your Service (MYS) application
  • SNAP survey tool

Pharmacy teams should check with their business owner or head office which route they should use to make a declaration before completing the MYS registration form.

Manage Your Service application

The MYS application provides added benefits over the SNAP survey tool.

It has the ability to give contractors confirmation that their pharmacy has been assessed against national datasets as either meeting or not meeting the gateway criteria. Confirmation is sent at the time of making their declaration.

If contractors have not met the 5 gateway criteria, they have the opportunity to take corrective action before they make their declaration.

There's also longer-term benefits of MYS outside of the Quality Payments Scheme.

If contractors choose to use this option, they are encouraged to register with the MYS application as soon as possible, to make sure the registration process is complete before the declaration period.

The completion of the registration process for MYS provides an existing additional feature of MYS, which allows contractors to request and view the front and reverse of their pharmacy’s processed paper prescription forms submitted for payment.

MYS access authorisation

If you have any problems with the user authorisation process, contact the NHSBSA Provider Assurance team by:
Email: nhsbsa.pharmacysupport@nhs.net

Registration

Once your MYS access authorisation form has been submitted, we'll create user accounts for each person named on the form.

Each person will receive an email to their personal NHSmail address to register online for their individual MYS account.

Email our Provider Assurance Team nhsbsa.pharmacysupport@nhs.net if you do not receive this email to your personal NHSmail account within 48 hours or if you need any help.

Further guidance will also be available from Friday 14 December 2018.
More information can be found on the Manage Your Service Application page.

SNAP survey tool

The SNAP survey tool will be available as an alternative option similar to previous Quality Payment Scheme declarations.

If contractors decide to use this option, verification of the gateway criteria cannot be confirmed in real time, as in MYS, which reduces the possible time for corrective action.

Information on the declaration process can be found on pages 5-7 in the NHS England guidance on the Quality Payments Scheme for the February 2019 review point.

A new process for validation of the gateway criteria has been introduced for the February 2019 review point.

An assessment of whether a contractor has met the gateway criteria or not will now be made when the contractor makes their declaration.

Our 'Manage Your Service' application will pull information from national datasets so that when a contractor starts their declaration, the gateway criteria that the contractor has met will be displayed.

Information on the validation process can be found on pages 7-9 in the NHS England guidance on the Quality Payments Scheme for the February 2019 review point.

Contractors will be able to to see a list of contractors who have been assessed and met 4 of the gateway criteria, using national datasets. These are:

  • advanced services
  • NHS website
  • community pharmacy patient questionnaire
  • NHSmail account

This is so contractors can be confident that they meet the gateway criteria before they complete their declaration.

A spreadsheet will be available on this page on Friday 7 December 2018 and will be updated every week (by close of business on the Friday) until the end of the declaration window. This excludes Friday 28 December 2018.

Any changes made after each Friday will not be shown until the following week's update. For example, if a pharmacy’s NHS website profile is updated on Monday 10 December 2018, it will not show on the spreadsheet on this webpage until Friday 14 December 2018.

As the spreadsheet will not be updated on Friday 28 December 2018, any changes made after Friday 21 December 2018 will not be shown until the update on Friday 4 January 2019.

Our publishing schedule is available:

Friday 7 December 2018

Friday 18 January 2019

Friday 14 December 2018

Friday 25 January 2019

Friday 21 December 2018

Friday 1 February 2019

Friday 28 December 2018 – no update

Friday 8 February 2019

Friday 4 January 2019

Friday 15 February 2019

Friday 11 January 2019

Friday 22 February 2019

Contractors are advised to review this webpage regularly to check whether the reports show they meet these 4 gateway criteria.

The live gateway criteria validation dataset is available. This will be uploaded each week by COB on each Friday listed above.

Gateway criteria validation information (Excel: 1.05MB)
NHS website dates will be blank and CPPQ will show as a 'X' for Distance Selling Pharmacy's (DSP's) if they have not contacted the Provider Assurance Team.

In regards to this, it's a requirement for the February 2019 review that between Monday 3 December 2018 and Friday 15 February 2019 DSP's contact us by:
Email: nhsbsa.pharmacysupport@nhs.net

Information on how the data in the Gateway criteria validation spreadsheet is produced

NHS Website/CPPQ

A dataset is provided to us on a weekly basis from the NHS website detailing all contractors who have or have not updated or validated their information or uploaded the CPPQ.

NHS Website/CPPQ (DSP’s)

We provide this information based on information received from DSP’s to the Provider Assurance team.

Advanced Services

We provide this information based on whether a pharmacy has claimed for MUR / NMS in the last 12 months, or if a pharmacy is registered for NUMSAS. If a contractor is not showing as validated for this criterion, they'll need to provide additional information to demonstrate how they meet this criterion.

NHSmail

NHS Digital provide us with this dataset on a weekly basis. It has all NHS pharmacy shared mailboxes and how many active mailboxes are attached to this.

For security reasons, the details of the fifth gateway criterion – compliance with the NHS Digital Warranted Environment Specification (WES) – will be sent by the NHSBSA to each pharmacy contractor’s shared NHSmail account.

Each contractor will be informed of whether their operating system and browser versions have met this requirement during the first 2 weeks of December 2018.

Contractors that have been assessed as not meeting this gateway criterion will get further regular updates of this assessment sent to their shared NHSmail account until the end of the declaration window (1st March 2019). The schedule for sending these emails will be posted on this page when available.

More information on the datasets can be found on page 9 in the NHS England guidance on the Quality Payments Scheme for the February 2019 review point.

Declaration data

April 2017 declaration data November 2017 declaration data

June 2018 declaration data

April 2017 declaration data (CSV: 2.2MB) November 2017 declaration data (CSV: 2.3MB) June 2018 declaration data (CSV: 2.4MB)
April 2017 gateway and quality criteria glossary (Word: 232KB) November 2017 gateway and quality criteria glossary (Word: 232KB) June 2018 gateway and quality criteria glossary (Word: 233KB)
NHS England has published summary information on the number of contractors who took part in the Community Pharmacy Quality Payments Scheme in 2017/18.

Quality Payments Scheme April 2017 review point

Following the declaration period for the April 2017 Quality Payments Scheme closing, we were  asked 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 2 of the 3 sections of their profile instead of the required 3 sections.

Those contractors who failed to update all 3 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. This was the deadline for meeting for NHS Choices gateway criterion.

The contractors who did not update any sections of their profile were not given a second opportunity.

Letter sent to pharmacy contractors for NHS Choices gateway validation (PDF: 252KB)

Distance Selling Pharmacies

DSP contractors who provided some but not all of the required information to meet the NHS Choices gateway criterion also received an email from the NHSBSA on 10 August 2017. It requested that they provide the NHS Choices help desk with all the required information by 10 September 2017.

Letter sent to DSP contractors for NHS Choices gateway validation (PDF: 270KB)

Gateway criteria verification for the April 2017 review point

Following the declaration period for the April 2017 Quality Payments Scheme closing, NHS England worked with us to validate contractors’ declarations for the gateway criteria.

If the we were not able to validate that a contractor met the gateway criteria from data available, the contractor received an email from us in September 2017 stating the criteria that could not be validated and asking the contractor to provide information to show how the criteria was met.

We worked with contractors to establish evidence / information to verify declarations made. This information was collated and shared with NHS England to decide on the next course of action.

Where suitable, information was provided the pharmacy was verified. Where insufficient or no information was provided NHS England determined a quality payment had been made where it was not due and an overpayment recovery should be progressed.

Contractors were advised to check their junk/clutter folder in case the email went into this folder.​​​​​

Letter sent to contractors April 2017 (PDF: 207KB)

Quality Payments Scheme November 2017 review point

Verification of the QPS November 2017 declarations will be undertaken in a number of steps:

  • liaising with other organisations (such as NHS Digital) to obtain data sets to validate the declarations submitted by contractors
  • engage with contractors to seek evidence / information where the contractor has not been verified in step 1
  • collate and share information with NHS England
  • NHS England determines outcome
  • where an overpayment recovery is required, we'll process this on behalf of NHS England

Quality Payments Scheme June 2018 review point

Verification of the QPS June 2018 declarations will be undertaken in a number of steps:

  • liaising with other organisations (such as NHS Digital) to obtain data sets to validate the declarations submitted by contractors
  • engage with contractors to seek evidence / information where the contractor has not been verified in step 1
  • collate and share information with NHS England
  • NHS England determines outcome
  • where an overpayment recovery is required, we'll process this on behalf of NHS England