| Contractual Framework
for Community Pharmacy
Background
to the New Contractual Framework
Payment
for Essential Services
Establishment
Payment
Practice
Payment
Repeat
Dispensing Payment
Transitional
Payment
ETP Allowances
Payment
for Advanced Services
Medicines
Use Reviews
Payments
for Enhanced Services
Other
Payments
Essential
Small Pharmacies Scheme (ESPS)
The Pharmaceutical Contractual
Framework
There
are three tiers of services in the Pharmaceutical contractual framework: nationally set essential
and advanced services and enhanced services commissioned
locally by Primary Care Trusts (PCTs).
Essential
services are defined as those services that must
normally be provided by all community pharmacy contractors
under the new arrangements. Such services together with
advanced services form the ‘nationally agreed’
services and are not open to local negotiation.
Advanced
services are those services that require accreditation
of the pharmacist providing the service and/or specific
requirements to be met in regard to premises.
Enhanced
services are commissioned locally by PCTs. Local
Pharmaceutical Services (LPS) will continue to be an
option available to PCTs for delivery of local services.
Payment for Essential Services
There are currently five payments which are available
to contractors to support the provision of Essential
Services.
Establishment Payment
Contractors who submit at least 2,180 prescription items
per month receive an Establishment Payment. This payment
is based on the volume of prescription items submitted
by the pharmacy contractor and processed for payment
by the NHSBSA for that month. The number of ‘items’
is calculated from the number of fees payable plus the
number of oxygen items.
For
further details on this payment refer to Part VIA 1
of the Drug
Tariff.
Where
total monthly payments in relation to prescriptions
passed for pricing between 1st April and 31st March
in any financial year are less than the amount which
would have been paid had the payment been calculated
on an annual or six monthly basis for the period specified
in the Drug Tariff, pharmacy contractors may make a
claim for a top up payment to their PCT for England
and LHB for Wales. This should take account of any Protected
Professional Allowance Payments made, such that pharmacy
contractors do not receive both an Establishment Payment
and a Protected Professional Allowance Payment for the
same month.The contractor should submit copies of FP34
statements for the relevant period (April to March)
as evidence of the total number of prescription items
passed for pricing during this period. This claim needs
to be made by the 30th November following the March
cut off for the period.
This
payment is separately identifiable on the payment schedule
as an ‘Establishment Payment’. Top up facilities
are also available on this payment via the NHSBSA local
payment system.
Practice Payment
The Practice Payment is based on the volume of prescription items submitted and the staff declaration made on submission form FP34C. The number of 'items' are calculated from the number of fees payable plus the number of oxygen items.
In
order for a contractor to receive the full practice
payment to which they are entitled they must demonstrate
that they have sufficient dispensing staff levels to
support the number of items dispensed each month. Contractors
should declare the total number of hours that staff
members supporting the dispensing process work in an
average week. The total number of hours declared on
submission form FP34C
should be rounded to the nearest whole number. If the
number is 0.5 hours or less, the figure should be rounded
down and if the number is more than 0.5 hours the figure
should be rounded up. The declaration should include
all staff members involved in the dispensing process,
including the pharmacist. Where the number of staff
declared is identified as being less than the required
level for a given volume of prescription items the payment
will be adjusted, as detailed in Part VIA 2 of the Drug
Tariff.
This
payment is separately identifiable on the payment schedule
as a ‘Practice Payment’. An adjustment facility
is also available on this payment via the NHSBSA local
payment system.
Repeat Dispensing Payment
An
annual repeat dispensing payment is paid automatically on a
monthly basis to all existing and new pharmacy contractors who
submit prescriptions for payment, irrespective of the period
in that month the contractor was providing pharmaceutical services
The
amount is included on the payment schedule and shown
as ‘Repeat Dispensing Fee’.
Further details
on repeat dispensing can be found on the NHSBSA website
here.
Transitional Payment
A Transitional Payment is paid on a monthly basis to all pharmacy contractors. The payment is calculated based on the number
of prescription items submitted and reimbursed by the
NHSBSA, in the relevant month. This is detailed in the
Drug Tariff
Part VIA 5.
The
amount is shown on the payment schedule as ‘Pharmacy
Contract Transition Payment’.
Electronic Transfer of Prescriptions Allowances
In
order to be able to use the Electronic Prescription
Service pharmacy contractors need to have:
- an
ETP compliant pharmacy system accredited as such by
NHS Connecting for Health (either Release 1 or Release
2).
- appropriate
network connectivity to be able to operate the Electronic
Prescription Service (details of connectivity arrangements
for community pharmacies will be made available by
NHS Connecting for Health).
-
staff operating the service who are registered users
and have been issued with smart cards and PIN numbers
by their PCT’s Registration Authority.
Funding for this is linked to the pharmacy deploying
the Electronic Prescription Service, Release 1 allowances
of £1,300 were paid to pharmacy contractors who were
active on the appropriate dates.
If
the pharmacy does not deploy Release 1 of the service
(by a date as yet to be determined of which three months
notice will be given), the PCT can reclaim
these allowances from the pharmacy contractor via the
local payments application and this will be shown on
the Schedule of Payments.
A
further allowance of £1,000 has been paid for
the deployment of release 2 of the Electronic Prescription
Service. If the pharmacy does not deployed Release 2
of the service (by a date as yet to be determined of
which three months notice will be given), the PCT can
reclaim this allowance from the pharmacy contractor
through a deduction via the local payments application
and this will be shown on the Schedule of Payments.
When
the pharmacy contractor is able to operate the Electronic
Prescription Service if an appropriate prescription
is presented or requested, the pharmacy contractor can
claim £200/month by submitting form PPAETP1
to their PCT (Gateway reference PPA-05-007). This allowance
will show on the Payment schedule as ETP Allowance. If at a
later date the pharmacy contractor becomes unable to
operate the Electronic Prescription Service, they must
inform the PCT in writing immediately so that payment
of this ongoing allowance is stopped.
Any
queries regarding interpretation of the ETP payments
should be directed to the Department of Health.
Further details of service implementation and
deployment can be found at www.cfh.nhs.uk
PPAETP1
Payment for Advanced Services
Medicines
Use Reviews
A payment is available to pharmacy contractors who are
accredited and undertake medication use reviews (MURs).
In England and Wales payments will be made up to a maximum
of 400 MURs per pharmacy per financial year for the
period commencing 1 April and ending on 31 March in
any year. However, where a contractor enters into arrangements
with the PCT to provide MURs after 1st October, the
maximum number of MURs for the remainder of that year
will be 200. The payment for MURs is listed in Drug
Tariff Part VIC and is currently set at £28
per review.
The
pharmacy contractor should declare the number of reviews
carried out each month on submission form FP34C
submitted to the NHSBSA with the contractor batch. The
PPA will make payment based on the number of reviews
declared and will provide information to PCTs on the
number of reviews declared by each pharmacy contractor
for that month. The amount is included on the payment
schedule and shown as ‘Other Fees – Medicine
Use Reviews’
The
PCT may request the NHSBSA to make an adjustment for
payments already made. The NHSBSA provides a facility
to allow the PCT to recover money for overpayments via
the local payment system.
Payments for Enhanced Services
Enhanced
Services are commissioned locally by Primary Care Trusts and Local Health Boards in Wales.
As the commissioning body the PCT or LBH determine the payment arrangements for these
enhanced services. For further details see Part VID of the Drug Tariff.
Payments for these services are shown on the Payment schedule as Local Scheme 1- 10.
Essential
Small Pharmacies Scheme (ESPS)
The ESPS scheme is now closed in England and no further
applications may be made under this scheme. It has been
replaced by the Essential Small Pharmacies Local Pharmaceutical
Services (ESPLPS) payment, which was set out in the
Local Pharmaceutical Services (Essential Small Pharmacies)
Directions 2005. The ESPS arrangements for Wales have
continued. Details can be found in Part XII of the Drug
Tariff.
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