Fin Mc Caul Contractor Engagement & IT IT Le Lead, , GM LP - - PowerPoint PPT Presentation

Fin Mc Caul

Contractor Engagement & IT IT Le Lead, , GM LP LPC

GM LPC Member Workshop, Worsley Park Marriott Sunday 27th November 2016

C.I.A.

Affect Influence Control

4 critical success factors

• 1. There MUST be a ‘why’
• 2. The service MUST be owned by someone in

the pharmacy

• 3. The service MUST be ‘set up’ to succeed
• 4. The service MUST be tracked and rewarded

If these conditions are not met – don’t waste your time.

The Pareto Principle

The Pareto Principle referred to the observation that 80% of Italy’s wealth belonged to only 20% of the population. More generally, the Pareto Principle is the observation (not law) that most things in life are not distributed evenly. It can mean all

• f the following things:
• 20% of the input creates 80% of the result
• 20% of the workers produce 80% of the result
• 20% of the customers create 80% of the revenue
• 20% of the bugs cause 80% of the crashes
• 20% of the features cause 80% of the usage

And on and on…

Pharmacy 2016 and beyond

For contractors in GM LPC: Dec 2016 to Mar 2017 = -£7,900,000 Apr 2017 to Mar 2018 = -£13,700,000*

* Assuming no one does the Quality Payments scheme

Pharmacy 2016 and beyond

For the average contractor in GM LPC: Dec 2016 to Mar 2017 = -£11,600 Apr 2017 to Mar 2018 = -£19,300*

* Assuming no one does the Quality Payments scheme

Cash flow

• Text to go here

Planning tool

OPPORTUNITY FOCUS DO DIFFERENTLY REVIEW

SUBJECT

Quality Payments

• 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

• Up to £75million available in 2017/18 from the
• verall funding

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

To qualify for payments, pharmacies will have to first meet all four gateway criteria:

• Provision of at least one specified advanced

service (MURs, NMS or NUMSAS)

• NHS Choices entry up to date
• Ability for staff to send and receive NHSMail

and

• Ongoing utilisation of the Electronic

Prescription Service

MUR in Gtr Manchester

LPC Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Total Ashton, Leigh & Wigan 1515 1612 1903 1983 1925 1799 1702 1727 1414 1939 2180 1839 21538 Bury & Rochdale 2060 2252 2466 2497 2224 2288 3049 2816 1943 2594 2688 2235 29112 Manchester 2692 2678 3153 3074 2764 2688 3178 3070 2812 2781 3251 2435 34576 Oldham, Tameside & Glossop 3014 2631 3039 2945 2683 2760 2769 2768 2546 3508 3379 2625 34667 Salford & Trafford 2933 2989 3352 3219 2933 2944 3031 3209 3006 3481 3839 2870 37806 Stockport 1460 1409 1494 1590 1385 1491 1682 1457 1236 1815 2006 1674 18699 GM LPC Area Total 13674 13571 15407 15308 13914 13970 15411 15047 12957 16118 17343 13678 176398 Bolton 1430 1586 1682 1853 1549 1644 1799 1905 1420 1963 2111 1724 20666 Greater Manchester Total 15104 15157 17089 17161 15463 15614 17210 16952 14377 18081 19454 15402 197064

MUR in Gtr Manchester

• 700 pharmacies @400 MURs per pharmacy
• 280,000 patient interventions to asses

understanding and compliance

• In 2015/16 we only did 70% of these
• Potentially let 83,000 patients down
• Fees £2,000,000+

NMS in Gtr Manchester

LPC Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Total Ashton, Leigh & Wigan 405 405 325 358 370 387 408 435 354 360 373 425 4605 Bury & Rochdale 584 584 583 646 717 732 628 692 753 539 796 708 7962 Manchester 626 626 785 685 636 552 677 716 660 567 658 583 7771 Oldham, Tameside & Glossop 923 923 873 919 818 743 832 858 894 772 815 845 10215 Salford & Trafford 863 863 820 823 758 769 762 725 873 733 818 873 9680 Stockport 394 394 398 360 395 320 426 386 401 345 434 447 4700 GM LPC Area Total 3795 3795 3784 3791 3694 3503 3733 3812 3935 3316 3894 3881 44933 Bolton 349 349 304 366 287 284 375 341 357 357 483 458 4310 Greater Manchester Total 4144 4144 4088 4157 3981 3787 4108 4153 4292 3673 4377 4339 49243

NMS in Gtr Manchester

• 700 pharmacies @400+ NMS per pharmacy
• 280,000+ patient interventions to impact on

beliefs, understanding, compliance & self care support

• In 15/16 we did less than 20% of these
• Potentially let 230,000+ patients down
• Fees £4,000,000+

Provision of one specified Advanced Service

On the day of the review, the contractor must be

• ffering at the pharmacy Medicines Use Review

(MUR) or New Medicine Service (NMS); or must be registered for NHS Urgent Medicine Supply Advanced Service Pilot.

• PSNC Site
• CPPE packs, NPA resources
• Pfizer, Teva, Activas

NHS Choices entry

On the day of the review, the NHS Choices entry for the pharmacy must be up to date.

• Entry must be up-to-date for gateway criteria
• Contact NHS Choices Service Desk to register

& for training and support: 0845 4023089 nhschoicesservicedesk@nhschoices.nhs.uk

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 NHSMail account by 1 February 2017 will be acceptable)

• Guidance & all forms on our website at

http://psnc.org.uk/greater-manchester- lpc/resources/nhsmail-nhs-net-email-accounts/

Ongoing utilisation of 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.

• If your pharmacy is not enabled to provide EPS,

speak to your PMR system supplier about how to get enabled as soon as possible

PSNC’s view on the scheme

• Direction of travel is right and some useful enablers for the

future

• Lack of specific funding is an issue, particularly for HLP
• Advise contractors to carefully consider which elements of

the scheme they engage with and the costs that they will incur in comparison to the funding available for each element

• But we expect that most contractors will want to

participate

• Longevity of the scheme is unclear and will be influenced

by the Murray Review

• We still need to do some work with NHS England to sort
• ut some details related to implementation – this should

have been finalised by DH/NHS England before imposition

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

• thers
• 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

• No ‘one size fits all’ approach
• But the following approach is ordered based on

the criteria on the previous slide

• All the criteria are included – both gateway and

quality criteria

Our suggested plan for contractors

• Get the Gateway Criteria sorted – URGENT
• Focus on the ‘split points’ criteria first – if you

miss April, you lose the points

• Plan the work in advance
• Involve the whole team

NHS Summary Care Record (SCR) – 10pts (£640), April & Nov

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.

• PSNC will publish details of SCR access for each pharmacy or

‘Privacy Officer’ should be able to obtain the number of records accessed

• Make part of business as usual

Dementia Friends – 10pts (£640), April & Nov

On the day of the review, 80% of all pharmacy staff working in patient facing roles are trained ‘Dementia Friends’.

• Two routes by which people can become a Dementia Friend:
• attending a face-to-face Dementia Friends info session
• watching a short online video
• www.dementiafriends.org.uk or local Dementia Action Alliance
• Training today (and more to follow)
• All staff – including locums
• Record sheet on the GM LPC website / keep copies of

certificate/webpage print out

Safeguarding – 10pts (£640), April & Nov

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.

• Pharmacy professionals = Pharmacists and pharmacy

technicians – including locums

• Local face-to-face training or CPPE e-learning and

assessment

• https://www.cppe.ac.uk/services/safeguarding
• Record sheet on the GM LPC website / keep copies of

certificate/webpage print out

Clinical Effectiveness – 20pts (£1,280), April & Nov

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 healthcare professional for an asthma review.

• PSNC Briefing on this subject – record sheet/referral

form & PharmOutcomes module (to be developed)

• Talk to local GP practices about this
• Inhaler technique checks and MURs…

NHS 111 DoS – 5pts (£320), April & Nov

On the day of the review, the pharmacy’s NHS 111 Directory of Services entry is up to date.

• What is DoS?
• Pharmacy access to DoS information
• Currently no action can be taken by

contractors to comply with this QP criterion

HLP Level 1 – 20pts (£1,280) – Claim once

On the day of the review, the pharmacy is a Healthy Living Pharmacy level 1 (self- assessment).

• 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
• GM LPC focus to support contractors

Patient safety report – 20pts (£1,280) – Claim once

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.

• Discussing with NHS England what needs to be included in the

report

• Likely to be a template made available to assist completion
• NPA MSO report – sign up
• NPA Superintendents emails – sign up

CPPQ results – 20pts (£1,280) – Claim once

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.

• 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

Quality Payments

Payments will be made to eligible contractors depending on how many how many ‘points’ they achieved. We expect the value of each point to be set at £64. This is set at a level that would deliver £75m assuming 100% of pharmacies achieved all 100 points.

Quality Payments

However, in reality it is unlikely that all pharmacies will achieve all of the quality criteria across the two review points.

Quality Payments

Therefore, after the two review points, there will be a reconciliation process, at which the remaining funding will be divided between qualifying pharmacies based on the number of points they have achieved over the two review points.

Quality Payments

• To ensure the overall amount earned by one

contractor for quality payments remains proportionate, a cap of £128 per point will be allowed in totality, including the reconciliation payment

• To reach the cap would require less than 50%
• f pharmacies achieving less than 50% of the

quality criteria

Quality Payments

For GM contractors… Quality Payments are worth £4,500,000 to £9,000,000

Pharmacy 2016 & beyond

Once a year (at either review):

• Results of patient experience survey from the last 12 months

published on the pharmacy’s NHS Choices page (5)

• Production of a written report that demonstrates evidence of

analysis, learning and action taken in response to near misses and patient safety incidents, including implementation

• f national patient safety alerts and having shared learning

(20)

• Healthy Living Pharmacy level 1 (self-assessment) (20)

= 45 total points worth £2,880

Pharmacy 2016 & beyond

Summary:

• Satisfy the Gateway Criteria
• Submit claim for first review (Apr 2017)
• Submit claim for second review (Nov 2017)
• Payment of at least £64 per point, up to a max 100

points (£6,400)

• If all pharmacies do not achieve 100 points, payment

could increase to a maximum of £128 per point (£12,800)

• Three of the quality criteria account for 45 points

(£2,880) and only need to be met once a year

Pharmacy 2016 & beyond

• What is the LPC doing to help contractors with the

changes ?

• Where can contractors get information about the

changes?