A few weeks ago we covered the first part of the 2020/2021 Pharmacy Quality Scheme (PQS) which they announced on 13 July 2020. Whilst the primary focus of part one was preparing for and protection against Covid-19, the Pharmacy Quality Scheme part two also looks at the response and recovery from the pandemic.
Commencement Of The Pharmacy Quality Scheme Part Two
The Pharmacy Quality Scheme part two formally commenced on the 1st of October 2020. However, pharmacy contractors may start on the domains they would like to undertake as soon as they wish.
Covid-19 has created a “new normal” where the virus remains in circulation which prompted the Pharmacy Quality Scheme to take further action. In response to the coronavirus pandemic, the PQS aims to incentivise contractors who show quality improvement in areas that support the Covid-19 response.
The criteria to qualify for the incentive is focusing on the improvement of patient safety and outcomes. Contractors must complete all actions in the checklist to receive any payments. We included a summary of these actions in Part One of the PQS blog but you can also download a detailed list here.
Recap Of The Pharmacy Quality Scheme
As a recap, the Pharmacy Quality Scheme consists of two parts with funding of £18.75m. Contractors who meet the criteria can claim payment of £1,630 via the NHSBSA’s Manage Your Service (MYS) portal between 14 July 2020 and 23:59 on the 29th of January 2021.
If any funding from Part One remains unused and unclaimed before the declaration period for Part Two, it will be allocated to the funding for the second part of PQS 2020/21. This funding will be paid out to contractors who have completed and met all the requirements for Part One by the deadline.
Funding For The Pharmacy Quality Scheme Part Two
Total funding for the Pharmacy Quality Scheme is a minimum of £56.25m, with any unused funding from the Part 1 scheme also being added to the total. A new approach to allocating the funding is being introduced in this scheme to better reflect the varying workload of different sized pharmacies.
- Points allocated to Domains vary with contractor’s script volume in 2019/20
- The minimum value of a point is £48
- PCN Leads get an extra 15 points for each of the PCN Domains
- Declaration period is between 09:00 1 February 2021 and 23:59 26th February 2021
- The NHSBSA will make payments on 1 April 2021
Requirements For The Pharmacy Quality Scheme Part Two
Completing Part One of the PQS is only the gateway requirement for Part 2. Contractors may claim payment for one or more domains but only once they have completed the relevant elements. Here is a breakdown of the domains with some useful links to relevant government resources.
Domain 1: Infection Prevention and Control and Antimicrobial Stewardship
This domain aims to reduce the risk of transmitting Covid-19 and the potential harm within community pharmacies. They can achieve this through increasing awareness and by implementing actions following pharmacy training to improve infection prevention and control practices.
- All non-registered pharmacy staff must have satisfactorily completed the ‘HEE infection prevention and control Level 1 e-learning and assessment’
- All registered pharmacy professionals must have satisfactorily completed the ‘HEE Infection Prevention and Control Level 2 e-learning and assessment’ which includes pharmacists, provisionally registered pharmacists, pharmacy technicians and locum pharmacists
- After training, the entire pharmacy team must have completed a team review indicating the subsequent reflections and actions
- Submit amending SOPs and associated guidance, where necessary
More On Antimicrobial Stewardship
Antibiotic resistance is a real threat to our ability to fight off vicious infections and can be attributed to the oversubscription of antibiotics and misuse thereof. This criterion aims at reducing the potential harm caused by antimicrobial resistance (AMR) by promoting antimicrobial stewardship activity within community pharmacies.
- All patient-facing pharmacy staff that provide advice on medicines or healthcare must have satisfactorily completed the ‘PHE Antimicrobial Stewardship for Community Pharmacy e-learning and e-assessment’
- Contractors must have an antimicrobial stewardship action plan for the pharmacy available on-premises detailing how they will promote AMS
- The action plan must include how pharmacy staff will incorporate AMS principles into self-care advice, including the appropriate use of antibiotics, and the uptake of vaccinations
- All staff involved at this point should have become Antibiotic Guardians and know the local antibiotic formulary
Recommended: ‘The Importance of Becoming an Antibiotic Guardian’
Domain 2: Prevention
Covid-19 has identified certain risk factors and inequalities that have resulted in poorer patient outcomes for those who have contracted the coronavirus. As a result, there is a bigger focus on tackling modifiable risk factors which include obesity and mental health. Pharmacy teams must meet all three quality criteria in the Prevention Domain to be claim payment.
The aim here is to help contribute towards preventing suicide by enabling patient-facing community pharmacy staff. They must be able to appropriately discuss suicide with anyone who admits to having suicidal thoughts or those who display certain behaviours that prompt a conversation.
- All patient-facing staff must have completed training from the Zero Suicide Alliance (ZSA)
- Pharmacy contractors who already have an action plan in place before this year’s Pharmacy Quality Scheme must document any changes made to help support people who are having suicidal feelings and to retain a record of this as evidence of having met the requirement
This criterion ties in with training on children’s oral health and weight management as sugary beverages and sugar, in general, can have detrimental health effects. You can find the full definition and explanation of what sugary beverages entail on page 78 of the NHS Standard Contract 2020/21 General Conditions.
- Pharmacy contractors must declare whether they sell sugar-sweetened beverages
- If so, confirm that sales of sugar-sweetened beverages from the registered pharmacy premises did not account for more than 10% by volume in litres of all beverages sold
Obesity and poor diets are not only linked to diabetes but also high blood pressure, high cholesterol and increased risk of respiratory, musculoskeletal and liver disease. Now, the coronavirus pandemic has shown that obese individuals are more likely to have poorer outcomes when contracting Covid-19.
- All non-registered patient-facing pharmacy staff that provide health-promoting advice must have completed the PHEs All Our Health bitesize training and assessments on Adult Obesity and Childhood Obesity
- At least 80% of pharmacy professionals must complete sections 1 and 3 of ‘CPPE Weight management for adults’ training and assessment
- The team must create an action plan of how they would proactively engage with people to discuss weight and assist someone who requires support
- Record of a 4-week campaign detailing how the staff helped explain how to measure BMI and waist circumference, provide advice and signposting
Domain 3: Risk Management
This domain links to the NHS priorities to continuously improve patient safety as outlined in the NHS England & NHS Improvement Patient Safety Strategy. The requirements for the Risk Management domain are as follows:
- 80% of pharmacy professionals must complete the CPPE risk management training and e-assessment if not previously completed between 1st April 2018 and 31st March 2020
- A new or updated risk review – including the risk of missing signs of sepsis and the risk of overlooking red flag symptoms
- Contractors who did not complete this domain in the last scheme are required to do sepsis training
Domain 4: Primary Care Network – Prevention
As part of the NHS Long Term Plan, community pharmacy teams must be involved in the work of their PCN. This will enable them to achieve and deliver on the health programmes including the national flu immunisation plan.
- Teams must engage with the PCN Pharmacy Lead to discuss collaborative efforts with pharmacies and GPs regarding vaccinating individuals 65 years and older
- The PCN Pharmacy Lead must agree on a collaborative approach with the PCN Clinical Director to increase vaccination rates
- Points are earned if vaccination rates across the PCN practices reach or exceed 70.1% of eligible patients
Domain 5: Primary Care Network – Business Continuity
This domain aims at encouraging pharmacy teams to collaborate with other primary care providers to maintain business continuity across the PCN after the temporary closure of pharmacies or general practices. It also builds on the business continuity elements included in the Pharmacy Quality Scheme 2020/21 Part 1.
- Teams must engage with the PCN Pharmacy Lead to discuss business continuity plans with other pharmacies
- PCN Pharmacy Lead must share findings with the PCN Clinical Director and obtain similar information on practice plans for closures
- The collated information must then be shared with pharmacy contractors, PCN Clinical Director, practices, LPC and NHSE&I to help promote collaborative operation in the event of a closure
Recommended: ‘Covid-19 Business Resilience Training’
For the Pharmacy Quality Scheme Part 2 declaration, contractors must provide evidence that they meet any quality criteria they are claiming for. They should keep the evidence of meeting the criteria of each domain for two years as it may be required for post-payment verification. You can visit the MYS Website for FAQ on claiming payments for the Pharmacy Quality Scheme.
As always, VirtualOutcomes is here to help and support all pharmacy teams and will have relevant training materials available shortly. Visit our website for more information and follow our blog for all the latest updates.