Post-payment verification of community pharmacy Advanced Services
Each month we ask a sample of pharmacy contractors to submit evidence to support the payment claims they've made for advanced services.
We review payment claims for:
- Medicine Use Reviews (MURs)
- New Medicine Service (NMS)
- community pharmacy seasonal influenza vaccinations (flu vaccines)
We accept signed patient consent forms as evidence.
If you send us the original patient consent forms, we'll return them to you once we've finished reviewing them.
If you send us photocopies of the patient consent forms, we'll destroy them once we've finished reviewing them.
There are 3 possible outcomes of the review:
- Payment claims are verified by submitted evidence and no further action is required.
- We provide best practice feedback and payment claims are verified by submitted evidence.
- We provide feedback because the evidence provided does not match the submitted payment claims.
If the evidence provided does not match the payment claims, the contractor may:
- let us know what the discrepancy is because the advanced service was carried out in one month, but not claimed for until a later month. In this case, we'll ask the contractor to provide evidence for a different time period (up to 12 months within the financial year)
- accept the evidence does not match the payment claims and agree to a financial adjustment
If any investigation concludes an overpayment has been made, the contractor will receive notification of the payment recovery and will be given the option to appeal.
We share our findings with NHS England and NHS Improvement local teams. Sometimes, the local team might contact the contractor to discuss our findings.
Our telephone line for Pharmaceutical Services is currently closed due to the coronavirus (COVID-19) outbreak. For common queries see our FAQ document (Word: 229KB). You can email other queries to firstname.lastname@example.org.
What do contractors need to do?
Contractors may want to review how they currently file signed patient consent forms.
For example, if forms are filed alphabetically by patient surname, a change to filing the forms in chronological order may be worth considering to make retrieval of forms for any specified time period easier.
If you're selected to take part in this work, you’ll receive a letter which includes full instructions on how to submit your MUR / NMS consent forms.
Only pharmacy contractors that we contact need to submit their MUR / NMS consent forms.
Pharmacy provider assurance briefing NMS briefing (January 2018) (PDF: 83KB)Pharmacy provider assurance MUR briefing (September 2017) (PDF: 88KB)MUR / NMS post payment verification process (PDF: 108KB)Example MUR evidence request letter (PDF: 147KB)