The direction of travel indicated by the NHS Five Year Forward View, government policies and consumer expectations is clear – it’s based on high quality, efficient and effective clinical care in health and wellbeing.
As part of the imposed community pharmacy funding arrangements the government included a Quality Payments Scheme consisting of 4 Gateway Criteria and 8 Quality Criteria. The scheme, which aims to drive up consistency of quality and value of pharmacy services comes with a £75million budget taken out of current funding so would be a further loss to contractors beyond the existing cuts if not achieved.
Initial information indicates that the majority of contractors in England claimed at least some of the quality criteria thus presuming that the Gateway Criteria were also met. As yet, no detail is available on who and which criteria were claimed for.
What to do now?
Having worked hard to achieve some or all of the criteria, it is now about leveraging that and understanding local needs and priorities is a great place to start. The Joint Strategic Needs Assessment (JSNA) and Pharmaceutical Needs Assessment (PNA) highlight these for you and will be hosted on most CCG and Local Authority websites. Another place to look is the Health Profiles website, these provide a snapshot of local needs and hence opportunities for pharmacy campaigns, interventions and services.
Opening dialogue with local CCGs and Local Authority Public Health commissioners is also important, particularly for LPCs who have a key role in driving new services for their contractors.
All of the Quality Criteria are important but perhaps some more than others on which to build a healthier future for your pharmacy and your community. Achieving Healthy Living Pharmacy (HLP) status is but the beginning and should be the platform for the development of a future professional business model based on an effective workforce, community engagement and a professional pharmacy environment. The Dementia Friend criterion also adds to team skills.
Patient Safety is also a critical element of the criteria with safeguarding, clinical effectiveness (asthma management) and effective use of the Summary Care Record.
Ensure that your local population, other health and wellbeing providers and local commissioners understand what you do by keeping NHS Choices and NHS111directory of services up-to-date.
Most people believe that the QPS is here to stay but, given the drivers in the landscape, there is a natural evolutionary pathway. Once some of the criteria are bedded down one could imagine them transferring into the Essential Services specifications and being replaced with others. Workforce capabilities may include making every contact count, behavioural change or mental wellbeing; clinical effectiveness may focus on T2 diabetes, hypertension or high-risks medicines; prevention criteria maybe introduce on lifestyle-related health risks such as smoking, healthy diet and healthy weight, alcohol, physical activity or hypertension and AF-related stroke risks.
Whilst this is a very challenging time for community pharmacy, particularly in England, the landscape will continue to change and the pace will only accelerate so the sooner we embrace it and adapt to it the more likely we are to achieve a healthier future.
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