Jeff Blankley MRPharmS Chair Birmingham Local Pharmaceutical Committee Value-based Decision Making in Community Pharmacy Funding Cuts and Quality Payments – Session 4 Jeff Blankley MRPharmS Chair Birmingham Local Pharmaceutical Committee Wolverhampton Local Pharmaceutical Committee February 2017 Intro Seen the style of slides before Thank to previous presenter For contractors there are decisions to be made as the business’s profit will come under pressure And this starts from Dec 16

Value-based Decision Making in Community Pharmacy Objectives Recap of cuts and changes to the funding structure Share impact on income Updates for Quality Points – gateway and payments PharmOutcomes data capture x 3 Highlight the submissions needed for March 31st 2017 Provide some handouts to support compliance CPWM Website: http://psnc.org.uk/cp-west-midlands/ Gather some feedback

Value-based Decision Making in Community Pharmacy Contractor Evening Supporting YOU to be ready: for 31st March 2017 and for 28th April 2017 Session 4: Agenda 18.45 Arrival, Registration & Buffet 19.15 Welcome & Introductions 19.30 Main event QP Update for April Jin PharmOutcomes inputs for April Jin Contract Deadlines for march 31st 2017 Jeff 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 Funding Cuts and Quality Payments

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 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

Quality Payments Scheme Updates Jin Samra Senior Prescribing Adviser Midlands & Lancashire Commissioning Support Unit Gurjinder.samra@nhs.net Wednesday 1st March 2017

Overview Objectives Ensure contractors know what is required of them to pass the gateway criteria for the QPS scheme at the first review date. Ensure contractors know what is required of them to claim QPS quality points and how to do so. Ensure contractors know how to track and record their progress towards achievement of QPS Criteria via the assessment framework on PharmOutcomes. *Updates based on newly released NHSE guidance, available from: https://www.england.nhs.uk/commissioning/primary-care-comm/pharmacy/framework-1618/pqp/ Plan Gateway Criteria Updates Quality Criteria Updates Quality payments PharmOutcomes assessment framework IG (Jeff Blankley) Close 3 Objectives The original presentation I had prepared for today has been scrapped and new slides developed following yesterdays newly released QPS guidance from NHSE. I strongly recommend all contractors view this guidance to help them meet the QPS criteria. Plan

How to Claim Quality Payments via the NHS BSA online declaration website Pharmacies to complete the online declaration on the NHS BSA website at www.nhsbsa.nhs.uk/QualityPaymentscheme Review Point One, 28th April 2017: Website open for declarations between Monday 10th April 2017 to Friday 12th May 2017. Payments to contractors made at end of June 2017 Review Point Two, 24th November 2017: Website open for declarations between Monday 13th November 2017 to Friday 8th December 2017. Payments to contractors made at end of Feb 2018 The BSA online declaration tool is currently unavailable to view and is NOT YET linked to the PharmOutcomes Assessment Framework (POAF) support tool. The POAF support tool should be used as a portfolio to gather evidence prior to completing the BSA online declaration. Before I begin talking about QPS specifics, I’d like to explain the process for claiming quality points. The assumption is the tool will be similar to that used for CPAF. Once contractors have submitted their declaration on the BSA website, they will receive a confirmation e-mail. BSA are intending provide additional support to contractors via WebEx sessions – for which there is no further info currently.

Introduction to the Quality Payments Scheme (QPS) The QPS Scheme From 1st December 2016, DH has introduced a new QPS scheme on community pharmacies. Focus on recognising and rewarding quality rather than dispensing volume within the CPCF. 2 review dates for payments: April 28th and 24th November. Gateway Criteria must be fulfilled for eligibility to QPS payments. Gateway Criteria Updates 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 from: NMS, MUR or NUMSAS. *Contractors declaring on the BSA website that they are offering NMS or MUR must have the service visible in the services section of their NHS choices profile by the first review date. Just to recap, a brief re-introduction to QPS NHS Mail: For April review date evidence of an application for an NHS mail account by the 1st Feb is sufficient. Not to be confused with the RQMTS for NUMSAS which is contractors need to have a shared pharmacy mailbox NHS mail account to be able to register to provide the NUMSAS service. More detail on NHS Choices in the next slide

NHS Choices Gateway Criteria Update To meet the first review point GW criteria; contractors must amend/validate their NHS Choices profile by 28th April. Specifically: Opening hours Pharmacy facilities Pharmacy services. Pharmacies that don’t currently have profile editing rights can register for web editor rights at: https://www.nhs.uk/web-editor Existing web editor passwords can be reset at: https://www.nhs.uk/Personalisation/ResetPassw ord.aspx User guides for managing the NHS choices profile are available from http://www.nhs.uk/aboutNHSChoices/profession als/Pages/manage-profiles-faq.aspx Slide first then…. Please note: One Web editor account will be issued per pharmacy. Pharmacies not listed on NHS Choices need to contact NHSE local team to do so NHS Choices will also maintain a record of when each contractor last updated its NHS Choices profile

NHS Choices and Distance Selling Pharmacies (DSP’s) Gateway Criteria by 28th April 2017: DSP’s to review their NHS Choices entry and e-mail the NHS Choices service desk : If DSP is NOT listed on NHS Choices will need to e-mail the service desk nhschoicesservicedesk@nhs.net with subject: No DSP profile and provide info as per table. DSP’s that are listed on NHS Choices, will need to e-mail the service desk with subject: distance selling pharmacy to confirm the accuracy of their profile and provide info as per table. DSPs to complete their online declaration on the BSA website to confirm the service desk has been e-mailed accordingly. NHS Choices will further engage with & survey DSP’s to collect info to be added to their NHS Choices profiles. Gateway Criteria by 24th November: DSPs to complete survey and e-mail the service desk with subject : DSP survey DSPs to complete their online declaration on the BSA website that the DSP survey has been sent. Show of hands if any contractors are present with Distance selling pharmacies? This slide is specific to DSPs. DSPs do not currently have full NHS Choices entries, instead there is an A to Z list including name/web address/telephone and EPS status. Slide: To meet Gateway criteria by 28th April 2017……

QPS Quality Criteria 6 DOMAINS. 8 CRITERIA. 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. 2 of the quality criteria , account for 40 points and can only be claimed at ONE of the TWO review dates i.e. HLP & Safety reports

Safety Criteria: Safety Report “Production of a written report that demonstrates evidence of analysis, learning and action taken in response to near misses and patient safety incidents, including implementation of national patient safety alerts and having shared learning.” Claim at one review point only: worth 20 points. In order to meet this quality criterion, contractors should: Include evidence of actions in response to CAS alerts. collate incidents and near misses from an ongoing log; analyse these and look for patterns; reflect on the learning from these; take actions to minimise future risk from repeated errors; and share their learning e.g. via LPC/LPN. Already requirement of the CPCF essential services to report patient safety incidents. SLIDE Contractors can use the template Annex 1 (from the updated guidance) to collate and review patient safety incidents each month. Contractors can use the outputs of these forms to complete their annual written patient safety report. Annual report looks identical to Annex 1 except has an additional section to record monthly summaries of incidents.

Safety Criteria: Safeguarding “80% of registered pharmacy professionals (pharmacists, locums and technicians) have achieved level 2 safeguarding status for children and vulnerable adults within the last 2 years.” Can be claimed at two review points: worth 10 points. 80% of all registered Pharmacy professionals working in Pharmacy on 28th April will have needed to complete a level 2 safeguarding course within the last 2 years and have certification to prove this. Training is available from: CPPE safeguarding children and vulnerable adults eLearning 2017 and the associated… CPPE safeguarding e-assessment level 1 & 2 (2017). Local Safeguarding children and vulnerable adults workshop Once completed a certification of completion can be downloaded from CPPE and saved as evidence.

Patient Experience Criteria “Results of patient experience survey from the last 12 months published on the pharmacy’s NHS Choices page.” Claim at one review point only, worth 5 points. All Pharmacies are required to conduct an annual community pharmacy patient questionnaire (CPPQ) for valuable patient feedback. For further information on how to complete your CPPQ go to http://psnc.org.uk/contract- it/essential-serviceclinical-governance/cppq/ PSNC website contains an adaptable Standard national survey template developed to collate and analyse CPPQ responses. Standard national survey template visual. Results of the CPPQ must be uploaded to the Pharmacy’s NHS choices profile. User guide available via http://www.nhs.uk/aboutNHSChoices/professionals/Documents/how-to- upload-the-community-pharmacy-patient-questionaire.pdf CPPQ results upload user guide visual. DSPs may display results of their CPPQ on their website & notify NHS Choices service desk.

Public Health Criteria “Health Living Pharmacy (HLP) Framework for self-assessment.” Can be claimed at one review point: worth 20 points. Pre-requisites necessary to achieve HLP Level 1: Pharmacy has a consultation room, compliant with the Advanced Services standards. In the past year, the pharmacy has provided both MURs and NMS, and has proactively engaged in health promoting conversations. In the past year, the pharmacy has participated in the provision of the NHS Community Pharmacy Seasonal Influenza Vaccination Advanced Service or has actively referred patients to other NHS providers of vaccinations. Contractors will only be able to complete the HLP declaration assessment of compliance when they have met the General Pharmaceutical Council’s Standards for Registered Premises and Standards of Conduct, Ethics and Performance and comply with the NHS Community Pharmacy Contractual Framework (CPCF) requirements.

Public Health Criteria “Health Living Pharmacy (HLP) Framework for self-assessment.” HLP Level 1 – Quality Criteria Self Assessment on PharmOutcomes Contractors are required to complete the self assessment Evidence Portfolio which corresponds with PHE HLP Level 1 Quality Criteria. Criteria for HLP Level 1 status are split into: Workforce development Engagement Environment: HLP Quality Criteria Self Assessment visual HLP Level 1 – Assessment of Compliance PharmOutcomes Framework Part 1: Contractors to indicate compliance with statements via Y or N Part 2: Contractors to provide evidence of compliance Part 3: Declaration of compliance made Part 4: Once declaration is complete, RSPH will provide HLP certificate. HLP Assessment of Compliance visual SLIDE Self Assessment visual: go through each area with first point from first section only Clicking reveal plans: reveals a section of the screen where contractors can record an action plan or detail any evidence to support their claim. JSNA (Joint strategic needs assessment) pulls together info about local health and social care needs, PNAs relate this to provision of pharmacy services. Available via local authority websites. Assessment of compliance visual

Digital Criteria: Summary Care Records (SCR) “Demonstration of having accessed the summary care record and increase in access since the last review point.” Can be claimed at two review points: worth 10 points. If you don’t have SCR access: Attend a face to face learning event Complete current CPPE eLearning package Submit the acceptable user agreement form For the first Review date: The Pharmacy needs to demonstrate a total increase in access to SCR from Monday 27th June 2016 to Sunday 27th November 2016 compared to Monday 28 November 2016 to Sunday 30 April 2017. Contractors are advised to review and maximise their approach to the use of the SCR NHS Digital will publish the number of times a Pharmacy has accessed SCR, on a weekly basis. Contractors can check their SCR figures via QPS SCR Viewing calculator. Contractors to confirm via the NHS BSA online declaration page that their use of SCR has increased. Complete CPPE e-assessment Attend training. Complete AUA form Share CPPE certificate with RA’s SCR access granted via NHS smartcard

Digital Criteria: NHS 111 Directory of Services “On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date.” Can be claimed at two review points: worth 5 points. The Directory of Services (DoS) is a central directory (NOT in the public domain), which provides NHS 111 call handlers with real time information about services available. To access DoS for the first time: Create a new user account via www.pathwaysdos.nhs.uk Complete the online User Request Form and submit. Contractors will receive an automatic e-mail with a link to be validated. Further confirmation will be sent once the account has been approved by a RA. At the first review point the Pharmacy must confirm their DoS entry is up to date via the NHS BSA online declaration page. Contractors can check their DoS entry and request changes via an online form available at: https://www.england.nhs.uk/commissioning/primary-care-comm/pharmacy/framework- 1618/pqp/

Clinical Effectiveness Criteria: Over use of Asthma Treatments “Asthma patients dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6 month period are referred to an appropriate health care professional for an asthma review.” Can be claimed at two review points: worth 20 points. The Asthma quality criterion reporting tool is available via the services tab. The tool allows the secure referral of appropriate patients to their GP in a similar manner to GP notifications for the national FLU service. Contractors are advised to download reports for this service platform to act as evidence when completing the POAF. Asthma Referrals service platform visual

Workforce Criteria “80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends.” Can be claimed at two review points: worth 10 points. The Dementia Friends initiative was developed by the Alzheimer's society in 2012 and is supported by Public Health England. How to register as a dementia friend for organisations: Register your pharmacy on the Dementia Friends website at https://www.dementiafriends.org.uk/ A unique code will be sent which allows access to the Pharmacy dashboard and videos. Each staff member should watch a minimum of 2 from 5 short online videos Contractors should order Dementia Friend badges by e-mailing programmepartnerships@alzheimers.org.uk Contractors will need to declare via the NHS BSA online declaration tool that this criterion has been met. The above e-mail can be used as evidence.

QPS Assessment Framework on PharmOutcomes The PSNC have developed a quality framework on PharmOutcomes. The framework allows monitoring of compliance and progress with the Quality Criteria by the contractor and the LPC. Payment will be made at each review point (28th April 2017 & 24th November 2017) once contractors have made their declaration to the NHS BSA. Access the framework at https:///pharmoutcomes.org The framework can be accessed using your existing log in details. If you do not have a log in contact Pinnacle Support at helpdesk@phpartnership.com From the home page click on the “Assessments” tab to access the framework. Framework Visual Saving details on the framework will automatically update the summary of quality payments report. POAF designed for contractors to track & record progress with regards to achieving QPS criteria. LPC are able to log in and direct support to contractors via the POAF. The POAF contains links to further information on PSNC website and allows contractors to hold their evidence

Thank you for your time…

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