The NHS Business Services Authority (NHSBSA) will start carrying out post-payment verifications of medicines use reviews (MURs) from October 2017.
The new approach was agreed by the NHBSA, NHS England and the Pharmaceutical Services Negotiating Committee (PSNC) and came after internal audits were conducted within NHS England’s operations.
The inspections revealed that resource constraints in several areas led to a lack of consistency in the way post-payment verifications were conducted.
Help to claim payments
Until now, NHS England was the only body keeping track of the provision of Essential and Advanced Services within the Community Pharmacy Contractual Framework (CPCF).
The move is hoped to uncover any issues linked to the claiming of payments for advanced services and ease their resolution with pharmacy contractors.
The process will begin with payment claims for MURs and last for six months before being reviewed. In the future, more advanced services will be covered.
How will it work?
In order to verify any payment claims, selected contractors will have to provide agreement forms signed by their patients to use as evidence supporting their claims, over a period of three months.
If any issues occurred, the NHSBSA would be available to assist contractors and give them advice on how problems could be prevented in the future.
Should there be a mismatch between the provided evidence and the payment claims requested by a contractor, an adjustment would be made. If no solutions could be found, the case would go to NHS England, which would start a dispute resolution process.
The NHBSA recommends contractors to reorganise their signed patient consent forms in chronological order, in case they were to be selected for participation in the verification process.
The verification only concerns pharmacy contractors who are contacted by the NHSBSA.