Independents have a chance to claw back some money via the Quality Payments Scheme, and they ignore this at their peril, says Mukesh Lad, chairman of the LIPCO federated group

The government introduced the Quality Payments Scheme (QPS) to direct community pharmacy towards a much higher standard of efficiency and service delivery. It’s a clever way of bringing community pharmacy management into the 21st century. With it comes the need to embrace IT and improve patient experience, safety and clinical effectiveness.

Is it fair or equitable? There’s no point in arguing. Our representative bodies are already doing just that with a highly charged legal challenge against a government that is determined to push its agenda forward.

Survival of the fittest?
The QPS is a quid pro quo. It’s an offer of additional funding in return for more effort from pharmacy teams.

With the funding cuts already imposed and yet more reductions to come, we can’t afford to ignore the £75m earmarked for QPS from the global sum. The guaranteed return for participating pharmacies is at least £6,400. It could be more if a lot of pharmacies choose to ignore the opportunity.

I don’t condone these actions by the government, but I do wonder if it will lead to a sort of Darwinian selection of the fittest pharmacies in the community.

Qualification and engagement in the QPS programme is onerous when added to the rest of a daily pharmacy routine. The ‘gateway’ entry criteria into the scheme are designed to prove to NHS England that pharmacies are meeting their contractual responsibilities. Every one of the remaining eight criteria for 2017-18 is designed to ensure quality and ability to meet specific service needs.

It’s only right that patient safety is put at the top of the healthcare agenda. It simply means that the time has come for pharmacy to keep accurate records and to organise its administrative processes properly. We need to learn from errors and improve our professional practice. Is it so difficult for us to ensure that our teams are looking after vulnerable adults and young people suitably?

The majority of our profession is proud to play an active role in the public health  agenda and surely it can only be right and proper for us to broaden our understanding of those clinical conditions that overlap into social wellbeing, such as dementia. After all, any one of us could become a patient on the other side of the pharmacy counter in our later years.

So why then make such an issue of completing the quality payments process? I think the answer is because it has unwittingly underlined a total lack of understanding on the part of the government of the actual community pharmacy process.

A matter of time
The QPS gives no consideration to the time pressures on the pharmacy owner simply to accomplish his or her daily duties towards patients. Commissioners don’t understand that pharmacy owners spend their non-patient facing hours completing business administration which at best is onerous and is more often than not extremely complicated.

The difficulty of the entire QPS programme lies in allocating time for staff training to achieve ‘points’. The lack of clarity in the detail and the missing links at the NHS England end of the project don’t help the situation either.

The sheer volume of information and its many interpretations by pharmacy representative groups, suppliers, wholesalers and even buying groups has served to complicate the situation even further for the independent pharmacist. Not unsurprisingly, many have deemed the process too complicated to be accomplished in the time they have available, and have chosen to concentrate on improving their drug buying or reducing staff to fund the shortfall in their remuneration instead.

Ultimately, those ignoring quality payments are making the wrong choice. QPS is a path we need to follow. It’s going to underpin the way in which our profession and services will change in the coming years.

Leicestershire example
The Leicestershire Independent Pharmacy Federation (LIPCO) has been supporting its members to achieve maximum quality points. By developing its own IT platform as an integral part of the LIPCO Healthcare website, the latest updates are filtered into concise information with clear actions that enable members to track their progress through the criteria regularly.

With the LIPCO operating officer as the central reference point, every member is supported. Group CPD events have allowed independent pharmacies to accomplish learning activities with certified evidence. The Leicestershire and Rutland LPC chief officer has also played a significant role in securing Health Education England funding to support pharmacy up-skilling.

The Leicestershire experience is one of great collaboration that will result in 90 per cent of federation members achieving full points at the first review. It has also provided a platform for integrated learning and sharing of best practice aligned with the aims of the QPS.

Only a few months ago we were facing what seemed like a crisis in our profession. Those who choose to embrace the damage will come out stronger and in a better position for the future. The worst thing to do is ignore it.

For more information on the LIPCO QPS programme, visit www.lipcohealthcare.co.uk or email admin@lipcohealthcare.co.uk.