Community pharmacy in 2016/17 and beyond – final package

Community pharmacy in 2016/17 and beyond – final package
Alastair Buxton FRPharmS Director of NHS Services PSNC @ABuxtonPSNC psnc.org.uk/fundingchanges #pharmacychanges @PSNCNews

Overview Changes to funding Pharmacy Access Scheme
Pharmacy Integration Fund Other contract changes Judicial Review NUMSAS Quality Payment scheme and support available from your LPC

Funding imposition 2016/17 £2.687 billion (£113 million reduction)
4% reduction in funding (cf. 2015/16) 12% reduction from Dec Mar 2017 cf. Nov 2016 levels Original plan was for £170 million reduction So eventual imposition was £57 million less than originally planned

Funding imposition 2017/18 £2.592 billion £95 million reduction cf. 2016/17 £208 million reduction = a further 3.4% reduction cf. 2015/16 7.4% reduction cf. Nov 2016 levels Beyond 2018 – Subject to future consultation

Single Activity Fee Incorporates the:
professional fee Practice Payment Repeat Dispensing payment monthly EPS payment Other fees (unlicensed medicines, appliances, CDs, etc) are not included One-off set up payment for EPS release 2 will cease at end of March £1.13/item Expected to rise in 2017/18 to £1.24/item

Establishment Payments
Will be phased out over a number of years 1st December 2016 – reduced by 20% compared to 2015/16 (equivalent to 6.7% reduction overall in 2016/17) 1st April 2017 – further reduced by 40% compared to 2015/16 levels Proposed to cease by end of 2019/20

PSNC website: indicative income calculator
Quality Payment

Summary of funding changes & pharmacy cashflow impact
Funding cut £113m Reduction in Establishment Payment by 20% Introduction of Single Activity rate of £1.13 per item Introduction of Pharmacy Access Scheme Ongoing margin recovery of £12m pcm Funding cut £95m Further reduction in Establishment Payment by 40% Slight increase in Single Activity rate of £1.24 per item Reduction in average Pharmacy Access Scheme Introduction of Quality Payments Margin recovery of £12m pcm ends 1st Dec 16 Jan 17 1st Feb 17 1st Mar 17 1st Apr 17 May 17 Jun 17 1st Jul 17 Aug 17 Dec 16 advance payment Nov 16 balancing payment Jan 17 advance payment Dec 16 balancing payment Oct 16 advance payment Sept 16 balancing payment Big Impact Month For eligible pharmacies the first Quality Payment will be made in July 2017 Note: this payment is only made twice a year with April and Novembers balancing payments No changes to payments for contractors apart from usual fluctuations in AIV. Dec 16 advance payment will be inflated as based on November’s AIV Jan 17 advance payment will be lower as the AIV calculation will take into consideration the reduction in fees. Dec 16 balance payment will be less than the value of the advance payment Try the PSNC’s Cashflow & Indicative Income Calculator to see how these changes will impact your pharmacy by visiting psnc.org.uk/fundingchanges and clicking on the ‘Impact on contractor income’ dropdown. 8

Pharmacy Access Scheme (PhAS)
Aim – ensure that a baseline level of patient access to NHS community pharmacy services is protected Funded from overall CPCF funding (bar near-miss review category) PhAS pharmacies will receive an additional payment – will be protected from full effect of the reduction in funding Payment will be based on the funding the pharmacy received in 2015/16 On average, roughly £11,600 in 2016/17 and £17,600 in 2017/18 This is roughly £2,900 per month in 2016/17 and £1,500 per month in 2017/18

If eligible on the list, no need to apply to ‘join’ the scheme A pharmacy is eligible if it meets three criteria: Is more than a mile away from its nearest pharmacy by road walking distance Was on the Pharmaceutical List on 1st September 2016 Not in the top 25% of pharmacies by dispensing volume (prof fees) According to DH’s original list, 1,356 pharmacies would receive funding based on criteria The list has subsequently been revised

Distance-selling pharmacies are not included LPS pharmacies are not included - although they may receive similar payments depending on the terms of their contract Eligibility is fixed to pharmacies on the published list (subject to review cases) Commenced on 1st December 2016 and runs to 31st March 2018 – unknown what will happen after this time period A review process has been included in the scheme to deal with any inaccuracies in DH’s calculations, or any unforeseen circumstances affecting access; like a road closure. Review will also be possible for cases where there may be a high level of deprivation, and pharmacies are slightly less than a mile from another pharmacy, but are critical to patient access. The DH guidance on PhAS confirms applications for reviews will need to be made within three months of the start of the scheme (1st December 2016) and reviews will be administered by NHS England. Details of where to send requests for reviews to be released shortly. Applications for review will be accepted from 1st November 2016 and NHS England will aim to complete a review within six weeks of receiving a request.

A review mechanism (administered by NHS England) is in place Aim - to allow for consideration of extenuating circumstances which may mean that access is not being protected in the way intended by the scheme Full details via psnc.org.uk/phas Grounds for review: Inaccuracy, e.g. if the pharmacy postcode is incorrect or the distance from the next pharmacy is calculated incorrectly A review process has been included in the scheme to deal with any inaccuracies in DH’s calculations, or any unforeseen circumstances affecting access; like a road closure. Review will also be possible for cases where there may be a high level of deprivation, and pharmacies are slightly less than a mile from another pharmacy, but are critical to patient access. The DH guidance on PhAS confirms applications for reviews will need to be made within three months of the start of the scheme (1st December 2016) and reviews will be administered by NHS England. Details of where to send requests for reviews to be released shortly. Applications for review will be accepted from 1st November 2016 and NHS England will aim to complete a review within six weeks of receiving a request.

Physical feature anomalies, e.g. a semi-permanent roadblock meaning two pharmacies are then more than 1 mile from each other Can be requested beyond the initial 3 month review period, but within 3 months of the change in circumstances Evidence of the anomaly must be submitted and will need to demonstrate, on a balance of probabilities, that the normal “1-mile rule” produces an unreasonable outcome in the particular circumstances of the case A review process has been included in the scheme to deal with any inaccuracies in DH’s calculations, or any unforeseen circumstances affecting access; like a road closure. Review will also be possible for cases where there may be a high level of deprivation, and pharmacies are slightly less than a mile from another pharmacy, but are critical to patient access. The DH guidance on PhAS confirms applications for reviews will need to be made within three months of the start of the scheme (1st December 2016) and reviews will be administered by NHS England. Details of where to send requests for reviews to be released shortly. Applications for review will be accepted from 1st November 2016 and NHS England will aim to complete a review within six weeks of receiving a request.

If a semi-permanent road or bridge closure means that the nearest pharmacy is in fact more than a mile away, the first stage of the review will be passed successfully If the problem is that the distance to the nearest pharmacy is in fact less than a mile but the journey is particularly difficult, NHS England will need evidence of the level of difficulty and the problems surmounting that difficulty If a pharmacy satisfies the first stage of the test, to then qualify for the PhAS payment, the pharmacy would also have to demonstrate on a balance of probabilities that they were critical for access A review process has been included in the scheme to deal with any inaccuracies in DH’s calculations, or any unforeseen circumstances affecting access; like a road closure. Review will also be possible for cases where there may be a high level of deprivation, and pharmacies are slightly less than a mile from another pharmacy, but are critical to patient access. The DH guidance on PhAS confirms applications for reviews will need to be made within three months of the start of the scheme (1st December 2016) and reviews will be administered by NHS England. Details of where to send requests for reviews to be released shortly. Applications for review will be accepted from 1st November 2016 and NHS England will aim to complete a review within six weeks of receiving a request.

In particular, it would need to demonstrate that a local population relies on that pharmacy and would be materially affected by its closing. The health needs of the population may be relevant to whether or not the local population is materially affected by the closure Near misses pharmacies between 0.8 and 1 miles from the next pharmacy; and in the top 20% of areas when ranked by Index of Multiple Deprivation the pharmacy will have to demonstrate on a balance of probabilities that they were critical for access A review process has been included in the scheme to deal with any inaccuracies in DH’s calculations, or any unforeseen circumstances affecting access; like a road closure. Review will also be possible for cases where there may be a high level of deprivation, and pharmacies are slightly less than a mile from another pharmacy, but are critical to patient access. The DH guidance on PhAS confirms applications for reviews will need to be made within three months of the start of the scheme (1st December 2016) and reviews will be administered by NHS England. Details of where to send requests for reviews to be released shortly. Applications for review will be accepted from 1st November 2016 and NHS England will aim to complete a review within six weeks of receiving a request.

The Pharmacy Integration Fund
5 year fund – £300m??? 2016/17 & 2017/18 value now £42m Urgent care workstream – emergency supply, DoS improvement work, NHS 111 integration, deploying pharmacists in urgent care settings (from April 2017) Care home workstream – deployment of pharmacists from April 2017 and workforce development HEE workforce plan for pharmacy professionals in primary care

Educational grants for community pharmacists to access postgraduate clinical pharmacy education and training courses up to diploma level (from April 2017) A programme of pharmacy technician clinical leadership development (from April 2017) Medicines Digital Strategy work (Domain E) – NHS Digital Transfer of care data from NHS 111 and hospitals to community pharmacies and post-event messaging

NHSmail 2 rollout to community pharmacy Murray Review will inform future decisions on how the fund is deployed Stakeholder reference group to be established in 2017

Spreading MAS… ‘NHS England will test the technical integration and clinical governance framework for referral to community pharmacy from NHS 111 for people who need immediate help with urgent minor ailments’ ‘Aim to develop an evidence-based, clinical and cost effective approach to how community pharmacists and their teams contribute to urgent care’ NHS England will encourage all CCGs to adopt this ‘joined-up approach’ by April 2018

Changes to market entry – consolidation of pharmacies
PSNC proposed changes to prevent a new pharmacy stepping in straight away if a chain closes a branch or two businesses merge Regulations laid in December 2016 which provide some protection for pharmacies that consolidate, where this does not create a gap in provision

Judicial Review PSNC is seeking a Judicial Review of the Secretary of State’s October decision What is a Judicial Review? Sought permission from the High Court to apply for the Judicial Review on the grounds that it believes the Secretary of State failed to carry out a lawful consultation PSNC’s application raises a number of concerns about the consultation, including: The DH’s failure to disclose the fact that it had carried out an indicative analysis of pharmacies’ profitability based on Companies House data as part of its Impact Assessment

Judicial Review The delay in providing this analysis to PSNC after the publication of the Impact Assessment The validity of the DH analysis including the sample size and the use of accounting returns, rather than economic returns, as the basis for the assessment of pharmacies’ economic viability and how they might be affected by the changes The DH’s failure to analyse what the levels of pharmacy closures may be The National Pharmacy Association is named as an interested party in PSNC’s application and has launched its own JR

Judicial Review The High Court granted PSNC permission for a Judicial Review (21st December 2016) The hearing was to be expedited and was due to be heard in the week commencing 6 February 2017 The Secretary of State has sought a later hearing date This matter was considered on 12th January 2017 – case now to be ‘rolled-up’ with the NPA case and heard week commencing 20th March

Judicial Review Likely outcomes? Implications for contractors…

Questions psnc.org.uk/pharmacychanges

Community pharmacy in 2016/17 and beyond
The NHS Urgent Medicine Supply Advanced Service (NUMSAS) Pilot

Introduction Service announced as part of DH imposition of changes to the CPCF (20th October 2016) National pilot service – commissioned as an Advanced Service Funded by the Pharmacy Integration Fund (PhIF) - £2m budget The service started to roll out from 1st December 2016 Will end on 31st March 2018 with a review point to consider progress in September 2017

Background PSNC proposed an emergency supply service as part of its service development and counter proposals to DH and NHS England Fully funded and with additional funding, not from within the CPCF funding envelope Covering all patients – walk-ins, referrals from other HCPs and NHS 111 NHS England proposed that the PhIF could fund a pilot scheme to test and evaluate a service to inform possible future commissioning The national Emergency Supply Audit conducted by community pharmacies in 2015 and existing locally commissioned services have informed the development and design of the service

Aims and intended outcomes of the service
To appropriately manage NHS 111 requests for urgent supply of medicines and appliances To reduce demand on the rest of the urgent care system, particularly GP Out of Hours (OOHs) providers To identify problems that lead to individual patients running out of their regular medicines or appliances and to recommend potential solutions that could prevent this happening in the future To increase patients’ awareness of the electronic Repeat Dispensing (eRD) Service To ensure equity of access to the emergency supply provision irrespective of the patient’s ability to pay for the cost of the medicines or appliances supplied

Training, premises and other requirements
The service specification sets out the requirements for the service (published on 29th November 2016) Pharmacies must have a consultation room that meets minimum requirements The pharmacy contractor must have a Standard Operating Procedure in place covering the provision of the service The pharmacy’s Business Continuity Plan should be updated to cover the service

Training, premises and other requirements
Training requirements Pharmacists’ core knowledge includes making emergency supplies Urgent care: a focus for pharmacy (CPPE, September 2016) may provide useful background knowledge Ensure other staff know how the service operates Make sure locums know how to operate the service Contractors must sign up to service delivery through the NHS BSA website

Roll out of the service The service is a fully integrated service that requires a number of key elements to be in place before it can go live To support the efficient roll-out of the service, particularly putting in place mechanisms for referral from NHS 111 to community pharmacy, a phased introduction will take place: Phase 1 – December 2016 – Brighton and Hove CCG; Guildford and Waverley CCG; Blackpool CCG and Fylde and Wyre CCG; Nottingham City CCG; Cambridgeshire and Peterborough CCG Phase 2 – January 2017 – East of England; North East; North West Phase 3 – February 2017 – South East Coast; West Midlands; East Midlands; South West Phase 4 – March 2017 – London; Yorkshire and Humber; South Central; Isle of Wight

IT requirements The pharmacy must be enabled to receive and dispense Electronic Prescription Service (EPS) Release 2 prescriptions Pharmacies must have a shared NHSmail inbox Access to the Directory of Services If available, pharmacists providing the service should have access to the NHS Summary Care Record (SCR) Locally commissioned IT support, e.g. PharmOutcomes, may be used to support referrals from NHS 111 and notifications to GPs This will not however be nationally commissioned by NHS England

How will the service work?

Referral of patients to the service
Patients contact NHS 111 to request access to urgently needed medicines or appliances (previously supplied on script) Referral to a pharmacy, chosen by the patient, that is providing the service - referral via NHSmail or other electronic solution NHS 111 provide the phone number of the selected pharmacy to the patient, advising them to call the pharmacy in the following 30 minutes The pharmacist will assess the need of the patient for an emergency supply

NHS 111 call handlers will not be assessing patients’ suitability for emergency supply If a patient calls the pharmacy but no referral has been received from NHS 111, contact the NHS 111 professionals line If a referral is received and no contact is made by the patient, the pharmacy should attempt to make contact; referrals can be closed if no contact is made before the next working day

This service will not be actively promoted directly to the public by either the pharmacy contractor or the NHS Pharmacy teams should regularly check for an or electronic message throughout the day to pick up referrals from NHS 111

Pharmacy consultation: Over the telephone
An initial telephone consultation will normally take place to: determine further information about the patient assess the need for an emergency supply (suitability and legality) decide whether or not to invite the patient to the pharmacy for a face-to-face consultation and/or supply If the patient indicates that they cannot visit the pharmacy, the pharmacist should use their professional judgement as to whether it is appropriate for a representative to collect the medication or appliance

Pharmacy consultation: face-to-face
If appropriate, the pharmacist can invite the patient or their representative to come into the pharmacy The pharmacist will then conduct a face-to-face consultation, to collect any additional information that was not obtained during the telephone conversation with the patient

If a supply is not possible…
If an emergency supply is not possible at any stage pharmacists should refer the patient: to their own general practice; or contact the local GP Out of Hours (OOH) provider to discuss a solution Do not refer the patient back to NHS 111

If stock is not available…
If the required medicine or appliance is not in stock, with the agreement of the patient, identify another convenient pharmacy (Pharmacy 2) that provides the service, call them to see if they have stock and if so, forward the electronic referral received from NHS 111 to them Pharmacy 2 will then contact the patient Inform NHS 111 of the onward referral to pharmacy 2 If Pharmacy 2 does not hold the stock, contact the local GP OOH provider to discuss a solution

Provision of advice and information
The pharmacist must advise the patient or their representative on the importance of ordering prescriptions in a timely manner from their GP practice and the benefits of the NHS eRepeat Dispensing Service If appropriate, the pharmacist can also raise the patient’s awareness of the Medicines Use Review or the Appliance Use Review services The patient or their representative should be asked to complete a patient questionnaire; an IT platform (like the flu vac platform) will be made available to record the results electronically

Records and documentation
A blank FP10DT EPS dispensing token will be used to document ALL referrals received from NHS 111, irrespective of whether or not a supply has been made Information will need to be printed or recorded in legible handwriting on the token – IT support may be available An NHS prescription charge per item should be collected, unless the patient is exempt from prescription charges

Records and documentation
The patient (or representative) must complete the relevant sections of the reverse of the token to claim any exemptions from NHS prescription charge payment and confirm supply when they receive the medicine or appliance at the pharmacy Make your usual records of the emergency supply in accordance with the HMR A Post Event Message notification to the patient’s general practice must be sent either electronically, via hardcopy or fax on the same day or the next working day

The claims and submissions process
Contractors who fail to notify NHS England that they intend to provide the service by completion of the NHS BSA form will not be paid if they submit any claims To claim payment, the contractor must complete the NHS Urgent Medicines Supply Advanced Service Pilot claim form and submit it to the NHS BSA along with the completed FP10DT EPS dispensing tokens This process will be separate to the submission of other FP10 forms and NHS BSA will advise contractors on this process as part of the registration process

Fees that will be paid For ANY referral received from NHS 111 for a request for an urgent medicine or appliance supply, whether or not a supply is made and irrespective of the reason for any non-supply: A Consultation fee of £10, and An Administration fee of £2.50 per consultation to reflect the additional work/documentation required to support evaluation of the service Where a medicine or appliance has been supplied, a Supply fee of £1.50 will be made for the first item and an additional £0.50 will be paid for each additional item supplied

Reimbursement for items supplied
The cost of medicines or appliances supplied under the service will be reimbursed using the basic price An allowance at the applicable VAT rate will be paid to cover the VAT incurred when purchasing the supplied medicine or appliance

PSNC’s general view on the service
PSNC supports, in principle, the commissioning of emergency supply services, as they drive value for NHS commissioners, reduce the burden on general practice and GP out of hours services and provide a timely and convenient service for patients Pleased to see, in the commissioning of the service, recognition of how community pharmacies can help patients and the NHS Disappointed that the scheme has only been commissioned as a pilot Disappointed that the service will not cover patients who have been referred by other health professionals or come to pharmacies in the first instance themselves

PSNC’s advice to contractors
The service is part of the DH imposition of changes to the CPCF As such the service, including the funding, has not been agreed by PSNC We have however sought to work with NHS England to ensure the service specification and requirements are, wherever possible, as manageable as possible for contractors

Lack of nationally commissioned IT support - this means that it may be more bureaucratic and hence costly to provide, in comparison to equivalent locally commissioned services which are supported by IT systems It is regrettable that it has not been possible for NHS England to procure specific IT support for the service, particularly when the Pharmacy Integration Fund is funding this pilot service

Funding – At PSNC’s November 2016 meeting, the Committee considered the costs of providing the service and they expressed concern that contractors would find that the likely costs of provision of the service would exceed the fees that NHS England will pay for its provision The volume of referrals from NHS 111 to contractors is likely to be relatively low The maximum number of all such potential referrals is in the region of 200,000 per annum

Questions psnc.org.uk/pharmacychanges psnc.org.uk/numsas
psnc.org.uk/numsasfaqs

Community pharmacy in 2016/17 and beyond
The Quality Payments Scheme

Introduction DH is introducing the Quality Payments scheme as part of the CPCF imposition Voluntary engagement – contractors don’t have to participate Derived from a PSNC proposal but the PSNC proposal was with full funding to recognise costs to tackle their move to even greater Rx volume focussed funding Payments will be made to community pharmacy contractors who meet certain quality criteria Payments will be made in 2017/18 Implementation commenced in December 2016

Eligibility to participate
All pharmacies on the pharmaceutical list in England including Distance Selling Pharmacies including pharmacies receiving a Pharmacy Access Scheme (PhAS) payment Does not include Local Pharmaceutical Services (LPS) contracts but NHS England local teams and LPS contractors can theoretically include a similar concept in LPS contracts when they are reviewed

Funding £75m value in 2017/18 (from the overall £2.592bn CPCF funding)
100 points maximum per contractor Value of each point set at £64 = ‘max’ of £6,400 But potentially a reconciliation payment in final payment for March 2018 to pharmacies that have participated in the scheme The reconciliation payment received will depend on the number of points the contractor has achieved £128 cap on points value

Claiming payment 2 review points during the year at which contractors assess which requirements they have met and how many points they have achieved: 28th April 2017 24th November 2017 Declarations will be made to the BSA in April and November – form still to be published payments made with the final payment for those months i.e. April claim paid in end June/early July payment

Gateway criteria Pharmacies must first meet four gateway criteria:
Offering MURs or the NMS or must be registered to provide the NHS Urgent Medicine Supply Advanced Service (NUMSAS) NHS Choices entry up to date Ability to send and receive via NHSmail Ongoing utilisation of EPS There is no payment for passing the gateway criteria

Quality criteria 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 Patient Safety Written safety report at premises level available for inspection at review point, covering analysis of incidents and incident patterns (taken from an ongoing log), evidence of sharing learning locally and nationally, and actions taken in response to national patient safety alerts One 20 On the day of the review 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status for children and vulnerable adults in the last two years Two 5 10 Patient Experience On the day of the review, the results of the Community Pharmacy Patient Questionnaire from the last 12 months is publicly available on the pharmacy’s NHS Choices page

Number of review points at which it can be claimed Points at any one review point Total points over the two review points Public Health On the day of the review, the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment) One 20 Digital On the day of the first review, the 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; and on the day of the second review, the pharmacy can demonstrate a total increase to access to Summary Care Records between 1 May 2017 and 24 November in comparison to the previous 7 months Two 5 10 On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date 2.5

Number of review points at which it can be claimed Points at any one review point Total points over the two review points Clinical Effectiveness On the day of the review, the 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 an appropriate health care professional for an asthma review. Two 10 20 Workforce On the day of the review, 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’ 5 Total number of points: 100

How to get going with meeting the requirements
If you are going to participate, get going as soon as possible Decide which QP criteria you plan to meet and by which review point consider the costs you are likely to incur to achieve each criterion some will take more time and staff resource to achieve (e.g. Healthy Living Pharmacy (HLP) level 1), and some are much more complex than others Develop a timed plan for achieving the gateway and quality criteria timing of meeting the gateway criteria – not all can be achieved now start with the easy ‘quick wins’, particularly those that have two review points consider which gateway and quality criteria you will initially find easiest to achieve during late 2016 and early 2017

Our suggested plan for contractors
NHSmail Clin effectiveness – asthma Provision of Advanced service NHS Choices entry Use of EPS NHS 111 DoS Use of SCR HLP Dementia Friends CPPQ publication Safeguarding Patient safety report

1. NHSmail On the day of the review, Pharmacy staff at the pharmacy must be able to send and receive NHS mail (Note: For the April 2017 Review, evidence of application for an NHS Mail account by 1 February 2017 will be acceptable). Gateway criterion Shared mailboxes – what are they? Access to shared mailboxes – individual NHSmail accounts Standard pharmacy address format

1. NHSmail Special approach taken in December 2016
Area by area rollout linked to the NUMSAS roll out programme New centralised process – submit request by 1st February – see psnc.org.uk/nhsmail Accenture developing a portal to collect additional information Details of staff needing individual NHSmail accounts and access to the pharmacy shared mailbox Pharmacies with existing NHSmail accounts…

As the first thing you do when you are next in work, please ensure that this is sent on behalf of your pharmacy. The deadline is the 1st of February and you need to have completed this to be eligible to claim for any of the other payments From January 1st our area is eligible to provide NUMSAS so NHS Mail requests should be prioritised. Please ensure you safely store a copy, either electronic or paper, of the you have sent with the date and time stamp and any responses you received on submission. This will be critical if any s “ go astray” to prove that you complied with the requirement

2. Provision of one specified Advanced Service
On the day of the review, the contractor must be offering at the pharmacy Medicines Use Review (MUR) or New Medicine Service (NMS); or must be registered for NHS Urgent Medicine Supply Advanced Service Pilot. Gateway criterion Consider provision of MUR or NMS if not doing so already, or signing up for NUMSAS

Contractors will be asked to report figures on MURs and NMS provided from April 2017 via the BSA website Contractors should look to regularly provide and claim for these services to prevent the need to show additional evidence that the service is being “offered”. Contractors in Suffolk can now sign up to provide NUMSAS if they have a premises NHSMail account

3. Ongoing utilisation of the EPS
On the day of the review, the pharmacy contractor must be able to demonstrate ongoing utilisation of the Electronic Prescription Service at the pharmacy premises. Gateway criterion If your pharmacy is not enabled to provide EPS, speak to your PMR system supplier about how to get enabled as soon as possible

EPS roll out is continuing across Suffolk and the “go-live” dates for surgeries are on the LPC website. Nomination is an important part of the gateway requirements so please ensure you are collecting nominations in preparation for surgeries going live.

4. Use of the NHS Summary Care Record (SCR)
On the day of the first review, the 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; and on the day of the second review, the pharmacy can demonstrate a total increase to access to Summary Care Records between 1 May 2017 and 24 November in comparison to the previous 7 months. Claim at both review points - 10 points (£640) PSNC is seeking to publish details of SCR access for each pharmacy or ‘Privacy Officer’ should be able to obtain the number of records accessed

4. Use of the NHS Summary Care Record (SCR)
Consider how to make use of SCR part of ‘business as usual’ Lots of resources available via psnc.org.uk/scr If you haven’t got SCR access yet – start that process ASAP

11 pharmacies in Suffolk have not yet attended face to face training which is essential for SCR accreditation. They have been contacted. There is one final local training session available to those pharmacies here on the 9th of February 2017 All other pharmacies can check with the SCR Helpdesk to find out what they need to do to complete accreditation and begin accessing SCR

5. Dementia Friends On the day of the review, 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’ Claim at both review points - 10 points (£640) Two routes by which to become Dementia Friends: attending a face-to-face Dementia Friends Information Session watching a set of short online videos or local Dementia Action Alliance All staff – including locums Record sheet on the PSNC website / keep copies of webpage

The LPC would recommend that training be completed online where possible to facilitate access for all staff members All staff accessing LPC-led HLP Health Champion training will receive dementia friends training as part of the MECC training dates and completion will be certificated. The dementia friends training takes place at 2 pm on all the MECC days currently advertised on the website and other staff members from any pharmacy are welcome to attend that session only to receive face to face certificated training.

6. Safeguarding On the day of the review 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status for children and vulnerable adults in the last two years Claim at both review points - 10 points (£640) Pharmacy professionals = Pharmacists and pharmacy technicians Local face-to-face training or CPPE e-learning and assessment All pharmacy professionals – including locums Record sheet on the PSNC website / keep copies of certificate/webpage print out

The LPC would recommend that pharmacists and technicians complete the online CPPE package
The LPC is working with CPPE to plan a face to face event as soon as possible We have looked at providing face to face training events using an external commercial provider but the cost is prohibitive and this could only be considered if there was a significant demand and may incur a cost to the contractor

7. Clinical effectiveness - over use of asthma treatments
On the day of the review, the 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 an appropriate health care professional for an asthma review. Claim at both review points - 20 points (£1,280) PSNC Briefing on this subject – record sheet/referral form & PharmOutcomes module Talk to local GP practices about this Inhaler technique checks and MURs…

The LPC will be working with NHSE locally and the LMCs to ensure that GPs are aware of the referral requirement for these patients Contacting your main local surgeries to ensure they are aware that this will be happening is strongly recommended Please ensure you have a robust process in your pharmacy to record this information in a way that can be easily retrieved should you be asked to produce evidence of compliance to NHSE

8. NHS Choices entry On the day of the review, the NHS Choices entry for the pharmacy must be up to date. Gateway criterion Changes needed to NHS Choices to allow a record to be made of when a contractor updates / verifies their details Register for self-management rights and check content, but a ‘formal’ review will need to be undertaken once the changes to NHS Choices have been made

Please ensure your pharmacy has the ability to edit your entry and check that your opening times, address and contact details are correct Do not free type information onto the site as it is unlikely that this content will transfer to the new format leading to additional workload

9. NHS 111 Directory of Services
On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date. Claim at both review points - 5 points (£320) What is DoS? Pharmacy access to DoS information Currently no action can be taken by contractors to comply with this QP criterion

We are in touch with the DoS leads for Suffolk and they are aware of the requirement. We will work with them going forward when we have further implementation details Watch out for further information on this requirement on our website and in LPC Links

10. Health Living Pharmacy level 1
On the day of the review, the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment). Claim at ONE review point - 20 points (£1,280) Self-assessment process and the RSPH Grandparenting of existing HLPs? Hardest to achieve if starting from scratch Links to resources at psnc.org.uk/hlp

Suffolk already has 25 accredited HLP Level 1 pharmacies to date due to funding from the County Council and support from the LPC We have funding to support the training of ONE FTE Health Champion in every pharmacy and a leader in every HLP pharmacy We can provide every pharmacy in Suffolk with a Healthy Living Pharmacy Evidence folder to ensure self accreditation standards are met We can provide help and support with the self-accreditation process but the ownership of the programme lies with the pharmacy team

Website details psnc.org.uk/suffolk-lpc/hlp/ Service Support Officer/HLP Lead Myra Battle

11. Community Pharmacy Patient Questionnaire (CPPQ) results
On the day of the review, the results of the Community Pharmacy Patient Questionnaire from the last 12 months is publicly available on the pharmacy’s NHS Choices page. Claim at ONE review point - 5 points (£320) Discussing with NHS England and the NHS Choices team about how this is to be undertaken by contractors Upload a PDF – probably using a standard template

All contractors should complete the CPPQ for this financial year if they have not already done so by the end of March 2017 The specific process for uploading the information to NHS Choices will be sent out via LPC Links as soon as it is confirmed.

12. Patient safety report Written safety report at premises level available for inspection at review point, covering analysis of incidents and incident patterns (taken from an ongoing log), evidence of sharing learning locally and nationally, and actions taken in response to national patient safety alerts. Claim at ONE review point - 20 points (£1,280) Discussing with NHS England what needs to be included in the report A template will be made available to assist completion

Pharmacy Teams should continue to use existing logs and reporting tools and ensure all staff are aware of the requirement to record incidents Further information on specific requirements will be sent out via LPC Links once the details are confirmed.

Next steps Initial guidance on Gateway criteria was published by NHS England in December Further guidance being developed by NHS England PSNC Briefings and associated resources available at psnc.org.uk/quality PharmOutcomes modules available to help track progress and make referrals/records for the asthma criterion

Visit our website Sign up for our weekly e-newsletter- LPC Links Complete the sign up form on our website Contact Nicky Betts, LPC Communications Officer

Questions psnc.org.uk/pharmacychanges psnc.org.uk/quality

Community pharmacy in 2016/17 and beyond – final package

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Community pharmacy in 2016/17 and beyond – final package

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Presentation on theme: "Community pharmacy in 2016/17 and beyond – final package"— Presentation transcript:

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