Quality Criteria

Contractors passing all of the gateway criteria on the day of the declaration (which must be done between 3rd February 2020 and 28th February 2020) will receive a PQS payment if they meet one or more of the domains listed below (please note, contractors must meet all of the quality criteria in each domain to be eligible for a PQS payment). The PQS payment will depend on how many of the domains the pharmacy meets.

For further information on each quality criterion, click on the links below. If a link is not available for a quality criterion, this will be made available soon.

Risk management and safety domain

Contractors must meet all five of the quality criteria listed below in the Risk management and safety domain to be able to claim payment for this domain. Meeting this domain is worth 30 points and has a value of between £1,920 – £3,840 (funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments
will be made to eligible contractors depending on how many domains they have met and hence points claimed).

1.	On the day of the declaration, 80% of all registered pharmacy professionals working at the pharmacy to have satisfactorily completed the CPPE risk management training and assessment. AND
2.	On the day of the declaration, 80% of all registered pharmacy professionals working in the pharmacy have satisfactorily completed the CPPE sepsis online training and assessment, can demonstrate that they can apply the learning to respond in a safe and appropriate way when it is suspected that someone has sepsis, and demonstrably ensure all patient facing staff have understood alert symptoms to ensure referral of suspected sepsis to a pharmacist. AND
3.	On the day of the declaration, the pharmacy has available, at premises level, an update of the previous risk review undertaken as part of the 2018/19 Quality Payments Scheme (QPS), i.e. updated since the last review date of 15 February 2019, that the pharmacy team at the premises had drawn up for a risk in that pharmacy. This update must include a recorded reflection on the identified risk and the risk minimisation actions that the pharmacy team has been taking and any subsequent actions identified as a result of the reflection. The risk review should include the risk of missing sepsis identification as a new risk as part of the review and record demonstrable risk minimisation actions that have been undertaken to mitigate the risk. Note: Pharmacies that did not claim for the risk management quality criterion previously, who wish to claim for the PQS 2019/20, must have a risk review containing two identified risks, including the risk of missing sepsis as above, as part of completion and claiming for this domain. AND
4.	On the day of the declaration, 80% of all registered pharmacy professionals working at the pharmacy to have satisfactorily completed the CPPE reducing look-alike, sound-alike (LASA) errors e-learning and assessment. AND
5.	On the day of the declaration, pharmacies must have a new written safety report (i.e. new since 15th February 2019 (the last review date) or covering the last year if not previously claimed) at premises level available for inspection from the day of the declaration 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. Demonstrable learnings from the CPPE LASA e-learning should also be incorporated into the safety report. This should include a review of, and subsequent actions, where mitigation taken has failed to prevent a LASA incident or LASA near miss from occurring. Demonstrably, the pharmacy contractor actively identifies and manages the risks at premises level associated with the specified LASA medicines identified from the National Reporting and Learning System (NRLS). Demonstrably, the pharmacy contractor has put in place actions to prevent these risks, for example, physical separation, staff awareness raising, visual warnings, tags or labels on shelving, fatigue reduction strategies or enhanced checking procedures for these medicines. There must be demonstrable evidence of all actions identified in the patient safety report having been implemented. Demonstrably, the pharmacy contractor uploads any LASA incident reports to the NRLS and keeps a record for confirmation of this activity at the pharmacy premises or within any electronic reporting system used by the contractor. In the description of what happened in the NRLS report, the contractor must include the text ‘LASA’ as a unique identifier to facilitate future national learning. NHS Improvement top combinations by likelihood and harm caused – propranolol and prednisolone, amlodipine and amitriptyline, carbamazepine and carbimazole, rivaroxaban and rosuvastatin, atenolol and allopurinol.

Medicines safety audits complementing Quality Outcomes Framework (QOF) Quality Improvement (QI) domain

Contractors must meet all three of the quality criteria listed below in the Medicines safety audits complementing QOF QI domain to be able to claim payment for this domain. Meeting this domain is worth 25 points and has a value of between £1,600 – £3,200 (funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments will be made to eligible contractors depending on how many domains they have met and hence points claimed).

On the day of the declaration the pharmacy must have completed a lithium audit, over three consecutive months, aligned with requirements of the NPSA alert on lithium for all patients prescribed lithium. A link to the NPSA alert will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance. Further details of the required questions to be asked and the details to be recorded will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance.

Before starting the audit, the contractor must check their PMR prior to choosing the consecutive three-month period for the audit to verify whether they have had any ongoing patients to whom they have dispensed lithium in the preceding three months. If the pharmacy has no patients who have had lithium dispensed from the pharmacy in the previous three months, the contractor must complete a safety audit of patients prescribed one of the following medicines instead, in the following order of preference: either methotrexate; amiodarone; or phenobarbital, which are in line with alternatives suggested in the GP QOF QI Prescribing Safety Module (please note that the same process for identifying if the pharmacy has any patients on lithium should be applied for identifying if the pharmacy has any patients on methotrexate, amiodarone or phenobarbital).

AND

On the day of the declaration, the pharmacy must have completed a valproate safety audit, over three consecutive months for all girls and women of childbearing potential who have had valproate dispensed from the pharmacy. Further details of the audit and the details to be recorded will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance.

AND

On the day of the declaration, contractors should have implemented, into their day-to-day practice, the findings and recommendations from the previous clinical audit on NSAIDs prescribed for those aged 65 years and above without gastroprotection, undertaken as part of the QPS for the February 2019 review point; the link for the report will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance. The pharmacy must then repeat the updated audit of NSAIDs and gastroprotection for all patients 65 years and over (the link for the updated audit will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance, including notifying the patient’s GP where concerns are identified, sharing their anonymised data with NHS England & NHS Improvement, and incorporating any learning from the re-audit into future practice.

Note: Pharmacies that did not claim for the NSAID audit quality criterion previously, i.e. at the last review date of 15th February 2019, and wish to claim for this criterion for the PQS 2019/20 as part of claiming for this domain, must complete the NSAID audit for the first time and complete the other elements as described above.

Submission of information to NHS England & NHS Improvement should be reported on the Manage Your Service (MYS) application for all of the above audits.

Prevention domain

Contractors must meet all five of the quality criteria listed below in the Prevention domain to be able to claim payment for this domain. Meeting this domain is worth 25 points and has a value of between £1,600 – £3,200 (funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments will be made to eligible contractors depending on how many domains they have met and hence points claimed).

1.	On the day of the declaration, the pharmacy is a Healthy Living Pharmacy level 1 (self-assessment). AND
2.	On the day of the declaration, all patient-facing staff are Dementia Friends (Alzheimer’s Society). AND
3.	On the day of the declaration, the pharmacy has completed a specified dementia-friendly environment checklist which will be available in the NHS England & NHS Improvement Pharmacy Quality Scheme 2019/20 guidance in relation to the registered pharmacy premises and created an action plan which includes making some demonstrable recorded changes to the environment in line with the checklist, as appropriate. AND
4.	On the day of the declaration, the pharmacy must confirm that the pharmacy checked that all patients with diabetes aged 12 years or over, who presented from 1st October 2019 to 31st January 2020, have had foot and eye checks (retinopathy) in the last 12 months. The pharmacy must have recorded the patient’s response on the PMR or appropriate form/patient record and signposted/referred patients as appropriate. This record should set out the total number of patients who have had this intervention, the number that have not had one or either check in the last 12 months, and it should be recorded where they have been appropriately signposted/referred and reported as part of this criterion. AND
5.	On the day of the declaration, pharmacies (the registered pharmacy premises) must have either achieved that the sales by the pharmacy of Sugar Sweetened Beverages (SSB) account for no more than 10% by volume in litres of all beverages sold or must declare that they will be meeting this criterion by 31 March 2020. For the definition of added sugar see Annex B in the following link: https://www.england.nhs.uk/wp-content/uploads/2017/04/sugar-action-doc.pdf.

Primary Care Networks (PCNs) domain

Contractors must meet the one quality criterion listed below in the PCN domain to be able to claim payment for this domain. Meeting this domain is worth:

22.5 points and has a value of between £1,440 – £2,880 for a Pharmacy PCN lead; or
12.5 points and has a value of between £800 – £1,600 for a non-Pharmacy PCN lead.

Funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments will be made to eligible contractors depending on how many domains they have met and hence points claimed.

On the day of the declaration, the pharmacy must be able to demonstrate that their pharmacy, and all of the other pharmacies within the PCN footprint who wish to engage with a PCN, have agreed a collaborative approach to engaging with their PCN. This approach must include agreement on a single channel of communication by appointing a named lead representative for all of the community pharmacies who wish to engage with their PCN in the PCN footprint. The Pharmacy PCN Lead must have provided their name to the Local Pharmaceutical Committee (LPC) in which the PCN lies and must have demonstrable evidence that they have started the engagement process with the PCN, i.e. they have made initial contact with the Clinical Director for the PCN either by contacting them through correspondence (post/email) or by arranging a meeting with them or by meeting them.

All pharmacies claiming for this domain must submit the name of their appointed Pharmacy PCN Lead and the pharmacy name and ODS code for the Pharmacy PCN Lead as will be described in the NHS England and NHS Improvement Pharmacy Quality Scheme 2019/20 Guidance.

The Pharmacy PCN Lead must declare:

Local PCN information can be found on our PCN webpage here

Asthma domain

Contractors must meet the one quality criterion listed below in the Asthma domain to be able to claim payment for this domain. Meeting this domain is worth 5 points and has a value of between £320 – £640 (funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments will be made to eligible contractors depending on how many domains they have met and hence points claimed).

On the day of the declaration, the pharmacy can show evidence that patients with asthma, for whom more than 6 short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period have, since the last QPS review point (i.e. 15th February 2019), been referred to an appropriate healthcare professional for an asthma review; and can evidence that they have ensured that all children aged 5-15 years old prescribed an inhaled corticosteroid for asthma have a spacer device where appropriate in line with NICE TA38 and have a personalised asthma action plan. The pharmacy must be able to show that they have referred patients with asthma to an appropriate healthcare professional where this is not the case.

Digital enablers domain

Contractors must meet the two quality criteria listed below in the Digital enablers domain to be able to claim payment for this domain. Meeting this domain is worth 2.5 points and has a value of between £160 – £320 (funding will be divided between qualifying pharmacies based on the number of points they have achieved. Payments will be made to eligible contractors depending on how many domains they have met and hence points claimed).

On the day of the declaration, the pharmacy must have updated its NHS 111 DoS profile via the DoS updater, including its opening hours for Easter Sunday 2020 and public and bank holidays including Christmas Day 2019, Boxing Day 2019, New Year’s Day 2020, Good Friday 2020, Easter Monday 2020, Early May Bank Holiday 2020 and Spring Bank Holiday 2020, and must promptly update its profile as information changes, to ensure information is accurate for real time referrals, e.g. from NHS 111 providers. The update window for the February 2020 declaration is between 00:00 on 1st October 2019 and 23:59 on 30th November 2019.

AND

On the day of the declaration, the pharmacy can demonstrate access to SCR by having accessed the SCR between 00:00 on 1st October 2019 and the day of the declaration.

Quality Criteria