Value-based Decision Making in Community Pharmacy Contractor Evening Supporting YOU to be ready: for 31st March 2017 and for 30th April 2017 Session 3: Agenda 18.45 Arrival, Registration & Buffet 19.15 Welcome & Introductions 19.30 Main event NHS Mail NHS Choices SCR DoS 21.00 Close

Value-based Decision Making in Community Pharmacy Supporting YOU to be ready. Usual disclaimer/conditions apply Summary of Changes 2-year package -£113m in 16/17 (4 months) 17/18 squeeze to make up the lower reduction in 16/17 (late implementation) Single Activity Fee (SAF) £1.13 from Dec 16 increasing to £1.24 in April 17 Reduction in Establishment Payment (-20%) in Dec 16 and a further -20% from Apr 17 Introduction of Quality Payments from Apr 17 (£75m) (from existing funding) Gateway criteria to become eligible for Quality Payments Introduction of Pharmacy Access Scheme (PhAS) (4 in Birmingham, 1 in Wolverhampton) Introduction of ERMS linked to NHS 111 (Pilot) (£2m in 16/17) (WIGIG) (PhIF) Changes to market entry regulations. Mergers, PNAs

Value-based Decision Making in Community Pharmacy Supporting YOU to be ready Impact first month December 2016   Indicative monthly income for national contract Essential Services by item band as at December 2016 (may decrease if a further reduction is made to Cat M) Items per month Total income from fees and allowances pcm Estimated average buying profit Indicative total income pcm £ per item % Change v Nov 1,000 £1,230 £635 £1,865 £1.87 -7.2 2,000 £2,460 £1,270 £3,730 -11.6 2,500 £4,626 £1,588 £6,215 £2.49 -18.8 2,830 £5,093 £1,798 £6,891 £2.43 -18.4 3,150 £5,547 £2,001 £7,548 £2.40 -18.1 4,000 £6,593 £2,541 £9,134 £2.28 -17.3 5,000 £7,822 £3,176 £10,999 £2.20 -16.7 6,000 £9,052 £3,811 £12,864 £2.14 -16.2 7,000 £10,282 £4,447 £14,729 £2.10 -15.9 8,000 £11,512 £5,082 £16,594 £2.07 -15.7 9,000 £12,742 £5,717 £18,459 £2.05 -15.4 10,000 £13,972 £6,352 £20,324 £2.03 -15.3 11,000 £15,201 £6,988 £22,189 £2.02 -15.1 13,000 £17,661 £8,258 £25,919 £1.99 -14.9 15,000 £20,121 £9,529 £29,649 £1.98 -14.7

Value-based Decision Making in Community Pharmacy Funding Cuts and Quality Payments

Value-based Decision Making in Community Pharmacy Gateway Criteria for Quality Payments in 17/18 EPS is active and used NHS Choices is up to date and maintained Active NHS Mail address and active Delivery of at least ONE specified Advanced service

Value-based Decision Making in Community Pharmacy Gateway Criteria and Quality Payments in 17/18 Domain Criteria Number of review points at which it can be claimed Points at any one review point Total points over the two review points   Digital Demonstration of having accessed the Summary Care Record and increase in access since the last review point Two 5 10 Session 3 NHS111 Directory of Services entry up to date at review point 2.5

Value-based Decision Making in Community Pharmacy Quality Payments in 17/18 Total of 100 points £64 per point = £6,400 per contract Size of the prize Birmingham = £1.862m Size of the prize Wolverhampton = £448k Could increase as additional allocation if less than 100% uptake To a max of £128 per point

Value-based Decision Making in Community Pharmacy Quality Payments in 17/18 Introductions Experts Jin Samra CSU David Murphy, National DoS Lead for NHS111

Quality Payments Scheme and Community Pharmacy Jin Samra Senior Prescribing Adviser NHS Midlands & Lancashire Commissioning Support Unit 1st February 2017

Objectives & Plan Objectives Contractors understand and can meet Gateway Criteria for the Quality Payments scheme Contractors know how to fulfil Digital Quality Criteria relating to SCR and DoS. Plan Introduction to QPS: Gateway and Quality Criteria NHS Mail (GC): New Accounts and Shared Mailboxes NHS Choices (GC). Summary Care Records (QC). NHS Pathways (QC) – National Directory of Services Lead, David Murphy. Close – LPC. *Important to stress that the INFO provided today is correct at the time of writing. Any updates will be shared with you via the LPC & NHSE. NHS Digital and the PSNC websites have further resources and guidance. During the presentation, Take time out to interact and actually submit information via e-mail to fulfil Quality Payments Criteria If any QUESTIONS, try to Capture your Questions for the benefit of all. Please WRITE Q’s on POST-ITS provided & add your e-mail address. Tom will receive your Q’s & evaluation form and give a HANDOUT of todays slides.

Introduction to the Quality Payments Scheme (QPS) The QPS Scheme Initiated at the end of 2016, DH imposed a two year funding package on community pharmacies. Recognise and reward quality rather than dispensing volume within the CPCF. Payments taken from £75 million budget, taken from the overall global sum. 2 review dates for payments: April 28th and 24th November. Gateway Criteria MUST be fulfilled for eligibility to QPS payments. Gateway Criteria To qualify for payments on the first review date, contractors must first meet the following gateway criteria: NHS Mail set up and active Up to date NHS Choices entry. EPS set up and active Delivery of at least one specified advanced service: NMS, MUR or NUMSAS. CONTRACTORS MUST MEET THE GATEWAY CRITERIA BY THE FIRST REVIEW DATE TO BE ELIGIBLE FOR PAYMENTS!!!!!!

QPS Quality Criteria Domain Criteria, On the day of the review: # of Points obtainable per review point # of Review points at which can be claimed   Patient Safety Written safety report at premises level available for inspection at review point 20 One 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status 5 Two Patient Experience Results of the Community Pharmacy Patient Questionnaire from the last 12 months is publicly available on the pharmacy’s NHS Choices page Public Health Pharmacy is a Healthy Living Pharmacy level 1 (self-assessment) Digital Pharmacy can demonstrate a total increase in access to Summary Care Records between 1 December 2016 and 28 April 2017 in comparison to the previous 5 months; Pharmacy’s NHS 111 Directory of Services entry is up to date. 2.5 Clinical Effectiveness Pharmacy can show evidence of asthma patients, for whom more than 6 short acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, are referred to HCP 10 Workforce 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’. 6 DOMAINS. 8 CRITERIA. Potential 100 points available across the 2 review dates. Points rewarded at between £64 to £128 depending on service uptake. Potentially 15 points over the 2 dates.

NHS Mail and the NHS Urgent Medicine Supply Advanced Service (NUMSAS) NUMSAS is a new advanced service that goes live in Feb 2017. Purpose is to reduce demand on the Urgent care system. Pharmacies will receive direct referrals from NHS 111 via their NHS mail pharmacy mailboxes. A pharmacy will only be able to provide the NUMSAS service i.e. receive referrals from NHS111, once the pharmacy mailbox is modified to a shared generic mailbox. Guidance from the NHSBSA is NOT to proceed to register to provide the service until you have such a mailbox. A personal NHS mail account CANNOT be used for the service. Further info on NUMSAS is available from: https://www.england.nhs.uk/wp- content/uploads/2016/11/numsas-service-specification.pdf and http://psnc.org.uk/services- commissioning/urgent-medicine-supply-service/ and the LPC website. Once compliant contractors can sign up and provide the service using the NHSBSA form available from https://www.snapsurveys.com/wh/s.asp?k=147810384073 . Before I talk about how an NHS mail account being set up and active is imperative to meet the gateway criteria of the new QPS scheme; we need to first understand its importance to the new advanced service NUMSAS. SLIDE POINTS The priority today in order to meet the gateway criteria is that Pharmacies must have applied for their NHS mail account by the 1st February, 2017.

NHS Mail & Shared Mailboxes NHS mail account is necessary for Pharmacies to provide NUMSAS. The Pharmacy premises mailbox needs to be set-up as a shared generic pharmacy mailbox. Why? To prevent any IG breaches that could occur e.g. when receiving NHS 111 referrals. New centralised approach to allocation of NHS mail account from a local admin approach. All new and existing pharmacy mailboxes must be set up or modified, to have a shared generic pharmacy mailbox. A shared generic pharmacy mailbox is one that cannot be logged into directly i.e. it doesn’t have a password. Individual users within the pharmacy must log into the shared pharmacy mailbox via their personal NHS mail log-ins. NHS Digital will modify existing shared pharmacy generic mailbox accounts so that individual users within the pharmacy have membership access. If a pharmacy has a individual user level NHS mail account set-up for the pharmacy e.g. pharmacyname@nhs.net or Pharmacistname@nhs.net. NHS Digital will modify these accounts to make them shared pharmacy generic mailbox accounts. Further information on how this process will take place will be shared when available. Phased roll out of allocated NHS mail accounts will be completed by the end of March 2017. Now we understand why a NHS mail account is necessary for Pharmacies to be able to provide the NUMSAS service, we can perhaps better understand why it has been positioned as a gateway criteria for the new quality payments scheme. The requirements of NHS mail for the QPS scheme do not stop at having an active account. It also needs to be set up correctly. In terms of shared mailboxes no action needs to be taken by contractors at this time. When additional guidance is available from NHS Digital, NHSE, and LPC will update contractors immediately.

Applying for a new NHS Mail account? E-mail nhspharmacy.registration@nhs.net with the following information: Contractors must have applied for an NHS mail account by 1st Feb 2017 to meet the gateway criteria for QPS. SLIDE FIRST FIRST INTERACTIVE PHASE OF THE EVENING. Will take 10 minutes for anybody who needs to apply for a NHS mail account and any Q’s you may have regarding the information available so far. Show of hands anybody: Who has an NHS mail account for their premises? Who has an NHS mail account for their premises set up with a shared mailbox? Who has an NHS mail account for their premises set up without a shared mailbox? Who needs to set up a new account for their premises? For the benefit of those that need to sign up, we will work through the process now as per the slide. If you could have your portable devices ready to send an e-mail…. Previously once the info was submitted to the regional team, it would take 28 days to create an account. Individual user level accounts would then need to respond to request a PW. Shared mailbox accounts would be good to go. Has anyone applied for a NHS mail account via the new centralised system and can they share what happens next? For the rest of you if you have any questions you’d like to ask about the presentation content so far go ahead…..If we can’t answer them we will make a note and get back to you.

NHS Choices Primary public facing website of the NHS in England since 2007 Can be accessed via http://www.nhs.uk Contains a directory of services, info on conditions & treatments available to patients. Having an up to date NHS choices entry is one of the QPS Gateway Criteria. From the 7th February NHS choices will provide contractors with an option to: Validate their entry as accurate or Amend their profile for opening hours, facilities, and services provided or In a manner which will create a record that will act as evidence to NHSE that this action has been undertaken. From a contractor perspective setting up an NHS choices profile offers a marketing opportunity to promote their premises and allows you to meet the gateway criteria - on the day of the review contractors must have their NHS choices entry up to date. An inaccurate NHS Choices profile may jeopardise the entire payment claimed for under QPS.

Setting up a NHS Choices Pharmacy Account Email the NHS Choices helpdesk (thechoicesteam@nhschoices.nhs.uk) In the e-mail provide the following information: Pharmacy’s name & address Pharmacy ODS code (F code) Name & e-mail address of staff member(s) to be given management rights. Request to activate either or both of your Management rights: Web Editor: can update info on the profile. Comment Administrator: can respond to patient feedback on NHS choices. SECOND INTERACTIVE PHASE OF THE EVENING. Will take 10 minutes for anybody who needs to set up their NHS choices account and any Q’s you may have regarding the information available so far. GO THROUGH SLIDE Show of hands anybody: Who has an NHS choices account set up for their premises? For the rest of you if you have any questions you’d like to ask about the presentation content so far go ahead…..

Updating your Pharmacy profile information on NHS Choices Successfully Log in via www.nhs.uk Presented with an administrative screen, listing pharmacy profiles that can be edited. Where you have the ability to edit a module, it will have a clearly marked ‘edit’ button for you to click as per the screenshot. Using Pharmacy opening hours as an example: Upon clicking the edit button, the fields within the module will become editable. Pharmacies can make amendments to other editable fields within other modules such as services provided. To re-iterate from the 7th February onwards NHS choices will give contractors the option to update/amend their profile or validate it as being accurate. Again the process for this is unclear currently but we will share this with you when we know more. So if you do need to update/amend your profile, this is what you need to do: GO TO SLIDE

Summary Care Records (SCR) SCR is an electronic patient summary holding key clinical info about a patients current/discontinued medication, allergies… SCRs can be viewed on the Spine portal. You will need a smartcard with the correct access. If you don’t have SCR access by 31st March: You will be ineligible to receive the £200 activation payment. If you don’t have SCR access by 28th April: You will be ineligible to receive the 5 QPS points Complete the following mandatory requirements, to get access: Attend a face to face learning event: google eventbrite SCR for national events. Complete current CPPE eLearning package Submit the acceptable user agreement form If you do have SCR access: To meet the QPS quality criteria for SCR at the first review date; the Pharmacy needs to demonstrate a total increase in access to SCR between 1st December 2016 and 28th April 2017 in comparison to the previous 5 months. Contractors are advised to review and maximise their approach to the use of the SCR and monitor their ongoing use to ensure they are on target to increase the overall use of Summary Care Records. PSNC will publish each month the cumulative number of SCR records accessed by each pharmacy during the period from NHS Digital data. Further guidance is available from psnc.org.uk/scr After 31st March, you will still be able to go live with SCR but will miss out on the activation payment and QPS payment and will likely have to complete the longer e-Learning module (guidance is not available currently)

Thank you for your time…

A little about me… National DoS Lead at NHS England Supported by network of local and regional leads Focus on maintaining and improving quality of data

What’s coming up… NHS Pathways and NHS111 The importance of DoS data DoS and the Quality Payment scheme

NHS Pathways and NHS111… NHS111 receives 15 million calls each year NHS Pathways is the clinical decision support software which identifies the skillset and timeframe required for a patient’s symptoms (or non-symptomatic needs) using a process of ruling out Let’s see it in action…

The importance of DoS data… Potential to relieve pressure on GP services Separate entries for prescriptions and minor ailments What data is included and who updates it?

DoS and the Quality Payments… Ability to view your data Requesting changes Mobile Directory…

Any questions…

Who to contact… dosleads@wmas.nhs.uk england.dos@nhs.net david.dos@nhs.net

Value-based Decision Making in Community Pharmacy Quality Payments in 17/18 – Planned Events   Nov Dec Jan-17 Feb-17 Mar-17 Session 1 7th or 8th Session 2 8th All Day Session 3 1st Feb Bham 2nd Feb W Session 4 1st Mar Bham 2nd Mar W

Role of the Contractors Value-based Decision Making in Community Pharmacy Quality Payments in 17/18 Role LPC Committed to enabling 100% of contractors to claim maximum points Providing own sessions F2F and sequential written updates Providing online links and all F2F materials CPWM Website http://psnc.org.uk/cp-west-midlands/ Signposting local alternatives Signposting essential allied events Role of the Contractors Committed to claiming maximum points

Value-based Decision Making in Community Pharmacy Objectives - Recap Recap of cuts and changes to the funding structure Share impact on income Understand the DIGITAL aspects of Quality Payments Link NHS Mail to NUMSAS Sharing the plan for remainder of 16/17 Provide handouts to support compliance Gather some feedback

Quality Payment Qualification and Bringing It All Together Value-based Decision Making in Community Pharmacy March 2017 1st St Chads B’ham, 2nd Village, Holiday Inn J10 M6 Book please - Eventbrite Quality Payment Qualification and Bringing It All Together Getting the basics RIGHT and ON TIME PharmOutcomes inputs BSA inputs Updates Latest Changes New News

Value-based Decision Making in Community Pharmacy Close Request feedback form Don’t forget CPWM Website Thank you Safe journey home Good night