How to make sure you get paid for the Pharmacy Quality Scheme


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By PSNC services team

15 Nov 2019

With NHS data showing that a third of community pharmacies have yet to meet key Pharmacy Quality Scheme criteria, the PSNC services team explains how to rectify this by the 30th November deadline.

A key change in the 2019/20 Pharmacy Quality Scheme (PQS) to previous quality schemes has been the introduction of stages to the completion process.

In order to claim PQS payments, community pharmacy teams will need to prove they have met criteria, such as medicine safety audits and checking that patients with diabetes have had foot and eye checks, prior to the February 2020 declaration period. This should help with workload, but it also means that contractors need to keep track of multiple deadlines.

PSNC has created a list of PQS ‘dates for the diary’ to assist – download it from psnc.org.uk/PQS – but here we want to alert you to an important upcoming deadline of 11.59pm on Saturday 30th November 2019. This is the time by which contractors must have edited or validated their NHS website entry for their pharmacy and edited or confirmed their directory of services (DoS) profile.

If this deadline is missed, the pharmacy will not be eligible to receive any payment for PQS because the NHS website element is a gateway criterion for the 2019/20 scheme.

Read on to find out what steps to take to ensure your pharmacy is compliant.

 

1. NHS website: 3,993 pharmacies currently* non-compliant

A pharmacy’s profile on the NHS website (NHS.uk, formerly NHS Choices) must be up to date to meet this gateway criteria. This involves updating or validating three sections: opening hours (including bank holidays), facilities and services. Read the NHS website user guide, which provides step-by-step instructions on how to do it.

Some contractors may have reviewed their profile and know they are up to date, but it is vital they validate this information to confirm they have checked it by 30th November 2019. If you have only updated and/or validated one or two sections of the pharmacy’s profile, and not the required three sections, the pharmacy does not currently meet the gateway criteria.

Additionally, the NHS Business Services Authority (NHSBSA) has data to show that 548 pharmacies* have made a claim for the new medicine service or the flu vaccination service, but their NHS website profile is not showing that they offer the service. If you offer either of these services and intend to meet the advanced services gateway criteria, the service must be listed on your pharmacy’s NHS website profile.

Since distance-selling pharmacies do not have full NHS profiles, they need to follow a different process to meet this criterion (outlined on pages 14-16 of the NHS England and NHS Improvement guidance).

PSNC’s top tip: Once you’ve updated and/or validated all three sections, visit the patient-facing page of your NHS profile to check whether the information and dates listed on the pages reflect when you last did this. If possible, take screenshots as evidence of having met this gateway criteria.

 

2. Director of services profile: 3,595 pharmacies currently* non-compliant

A pharmacy’s NHS 111 directory of services (Dos) profile must be up to date to meet this quality criterion. This can be done using the DoS Profile Updater. Read the Profile Updater user guide, which provides step-by-step instructions on how to use this tool.

Contractors must ensure the information about their pharmacy on DoS is accurate for real time referrals (eg from NHS 111 providers) and must update their opening hours for Easter Sunday 2020 and public and bank holiday dates until spring bank holiday 2020, as per their NHS website entry.

A single pharmacy may have multiple DoS services listed on the profile updater and you’ll need to update all of them. However, you can ignore the NHS Urgent Medicine Supply Advanced Service (NUMSAS) and the Digital Minor Illness Referral Service (DMIRS) DoS services (if still displayed) now that these services have finished.

The DoS profile is one of two quality criteria that form the digital enablers domain: pharmacies must meet both criteria to claim payment for this domain. The other criteria, accessing the Summary Care Record (SCR), must be met by the day that the contractor makes their PQS declaration.

PSNC’s top tip: Once you’ve submitted the details on the DoS profile updater, an email will be sent to your NHSmail address confirming this. We recommend keeping these emails as evidence of meeting this quality criterion.

 

3. Checking the NHSBSA report

A report from the NHSBSA details pharmacies that have been assessed, using national datasets, as meeting three out of the four gateway criteria (there is no national dataset for the safeguarding gateway criteria as there are different routes for achieving level 2 safeguarding). An updated version of the gateway dataset report will be published every Friday (under ‘PQS datasets’), so contractors can search to see if their pharmacy meets the three criteria.

The report displays a green tick or a red cross depending on whether the pharmacy has been assessed as meeting the gateway criteria in the advanced services, NHSmail and NHS website columns of the spreadsheet. It also shows a green or red box for opening times, services and facilities columns, where the dates denote when these sections of a pharmacy’s NHS website profile were last edited or validated.

If you are not currently meeting all three of the criteria, act as soon as possible to ensure you have time to rectify this before the 30th November 2019 deadline for the NHS website gateway criterion and by the February 2020 declaration period for the other two gateway criteria. Corrective action will not show on the report until it has been updated on the following Friday.

The report can change. For example, if there are only two personal NHSmail accounts linked to the shared NHSmail account and one of these becomes inactive, ahead of the PQS declaration date, the contractor may then show as not meeting the NHSmail gateway criteria. We therefore recommend checking the report again in early 2020 to check that you still meet all three of the reported gateway criteria.

PSNC’s top tip: Use the NHSBSA report to double check that you have completed the NHS website criterion correctly. There is also an additional column you can check to see if your pharmacy is meeting the DoS quality criterion.

 

*All figures and information regarding achievement of PQS criteria by community pharmacies in England were correct as of 12th November 2019.


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