The Government and PSNC have agreed an interim arrangement to extend the current funding arrangements, including the Quality Scheme, until October 2018. The scheme, which began in April 2017, is but the start of a process which aims to drive improved quality and value into the current contractual framework for the NHS and the public. It comes with a £37.5 million budget for the 6-month period and a June 29 review point with a claim period from June 11 – July 13.
The direction of travel indicated by the NHS Five Year Forward View, government policy and increasing consumer expectations is clear; its based on high quality, efficient and effective clinical health and wellbeing services. This is not just about pharmacy, but all providers of health and care to bridge the current gaps in quality, health inequalities and finances.
Initial information indicates that 11,410 pharmacies in England submitted a QPS claim to the NHS Business Services Authority for the April and November review dates. There was broad engagement across the Quality Criteria with 9,474 pharmacies declaring Healthy Living Pharmacy (HLP) Level 1 status. A great commitment and achievement by all and clearly demonstrates a desire to meet the quality criteria and a need to receive the payment in what are very challenging times. These are strong and important messages to send to the NHS, the Department of Health and Social Care and Ministers.
This excellent engagement with the Quality Payment Scheme needs to be maintained for the next review date on June 29 when all criteria must still be fully compliant in order to make the claim.
As before there are four Gateway Criteria (Advanced Services, NHS Choices, EPS and NHSmail) all of which must be met, and eight Quality Criteria. There are some minor amendments to the Gateway criteria for using NHSmail from a premises shared account and listing Bank Holiday opening times on NHS Choices; these are covered in the Pharmacy Complete QPS Quick guide with key requirements and solutions. More information is available on the PSNC website
Healthy Living Pharmacy
There are about 2000 pharmacies yet to declare HLP status and for some that may require more forward planning, work and evidence to achieve or maintain the criteria. For those who have yet to start or complete their HLP journey, we have developed our HLP Countdown initiative supported by a 6-week pathway and a series of short online videos.
We should recognise that becoming an HLP is not a tick-box exercise, it is the beginning of a new culture and business model based on quality people, premises, services and consumer experience which could and should form the foundation of a healthier future for pharmacies.
HLP is built on the basic business principles of organisational development and change management. The enablers are workforce development, engagement with the community and creating a health-promoting environment. These have never been more important.
What to do now?
You will need to regularly ensure you are meeting all the HLP quality criteria and have the evidence to show that. Please don’t wait until to last minute for the QPS claim or if there is a Quality Payment Scheme request or Assurance visit; HLP provides many benefits in addition to the payment. Once you are confident, start to build on the criteria utilising an empowered and engaged team:
1. Understand your market – Start with your local Joint Strategic Needs Assessment (JSNA) and Pharmaceutical Needs Assessment (PNA), both will be on your local authority website. Please note that many areas have recently updated both so download a summary and pop in your HLP portfolio folder. Your local Health Profile also provides a snapshot of needs and priorities. Work as a team to identify what you believe are the biggest health issues, based on what you see day-to-day.
2. Engage with others – be proactive by contacting local GP practices and other providers, NHS and public health commissioners. Use open discovery questions and active listening to understand their challenges and see what your pharmacy could offer to help with their issues. Speak to your LPC to understand what they are doing and how they can support you.
3. Develop the team – have a team meeting and ask them to write down their strengths and the areas they would like to develop. Some pharmacies have invested in the Health Champion qualification for all their team who have patient contact, including their pharmacists and home delivery colleagues. Many are now looking to develop knowledge and skills further, e.g. Flu Champions and Mental Health Champions.
This remains a very challenging time for pharmacy contractors, particularly with negative cash flow and rising costs of running a business. However, the landscape in which community pharmacy is operating will continue to change so the sector and the professions must adapt to these evolving needs to remain relevant and compelling to commissioners and consumers of our services. Achieving the quality scheme payment is but the start of that process; continual improvement and investment in quality will remain a critical success factor for a sustainable and healthier sector.