PQS Ready 23/24 – DECLARATION NOW CLOSED

Declaration Period NOW CLOSED

please note that the declaration period is

between 09:00 on 5 February 2024 and 23:59 on 1 March 2024.

You must have evidence to demonstrate meeting the gateway criteria and the domains that you have claimed for by the end of 31st December 2023.

Aspiration Payment

Contractors who wish to claim the aspiration payment, must do so

between 09.00 on 4 September 2023 and 23.59 on 29 September 2023

through the NHSBSA’s MYS application

Please click here to see a shortened summary of this years domains

Please see a SUMMARY of domains below and some useful links to assist when completing the modules.

The full official NHS guidelines can be found by clicking here.

Gateway Criteria

To qualify for the PQS 2023/24 payment, contractors will have to meet the following gateway criteria by the end of 31st December 2023.

You must have delivered a minimum of 15 NMS between 1^st April 2023 and end of 31^st December 2023.

Domain Summaries

Domain 1 – Medicines Safety & Optimisation
Domain 2 – Respiratory
Domain 3 – Prevention

Free Virtual Outcomes PQS Ready Link (awaiting new modules to be uploaded)

Domain 1 -Medicines Safety & Optimisation

High Risk Medicines – Anticoagulant Audit

You need to…

Implement the recommendations for Community Pharmacy from the first anticoagulant audit from PQS 2021/22 found in the Community Pharmacy oral anticoagulant safety audit 2021/22 report: NHS England » Community pharmacy oral anticoagulant safety audit 2021/22
The pharmacy must also have completed the revised audit, including notifying the patient’s GP where concerns are identified, sharing their anonymised data with NHS England, and incorporating any learnings from the audit into future practice by the end of 31 March 2024.
The information that needs to be submitted to NHS England is included in the audit document and must be reported on the MYS data collection tool.

Where no patients are identified for the audit, the contractor will still be eligible for payment if:

the contractor can evidence that they have robustly attempted to identify suitable patients and;
they will need to declare no patients have been identified as being suitable for review on the data collection tool on MYS by the end of 31 March 2024.

The audit must be carried out with a minimum of 15 patients over two weeks or over a four-week period if 15 patients are not achieved, and there must be a follow up of any patient that is referred to their prescriber to identify what actions were taken. Contractors should make a record of the start and end date of the audit as they will be required to enter this
information into the MYS application when they make their declaration.

Palliative and end of life care action plan

If you routinely hold the 16 palliative and end of life critical medicines, listed below, and can support local access to parenteral haloperidol…

You need to…

Update NHS Profile Manager NHS Profile Manager – NHS Digital – as soon as possible after 01st June 2023 (this is when NHS Profile Manager will be updated to allow this action) and by the end of 31st March 2024. Contractors who claimed this domain in 2022/23 must ensure their status is correct and updated for 2023/24 by logging into NHS Profile Manager and confirming this.
If NHS Profile Manager is updated centrally by head office, it will need to be confirmed that this will be done by the end of 31 March 2024.
Have an action plan in place to use when you do not have the required stock of the 16 critical medicines or parenteral haloperidol available for a patient – action plan template available here – Action plan template (Word)

If you are NOT a stockholder of these 16 palliative and end of life critical medicines, you are not required to update NHS Profile Manager.

The 16 critical end of life medicines are:

Cyclizine solution for injection ampoules 50mg/1ml;
Cyclizine tablets 50mg;
Dexamethasone solution for injection ampoules 3.3mg/1ml;
Dexamethasone tablets 2mg;
Haloperidol tablets 500 mcg;
Hyoscine butylbromide solution for injection 20mg/1ml;
Levomepromazine solution for injection ampoules 25mg/1ml;
Metoclopramide solution for injection ampoules 10mg/2ml;
Midazolam solution for injection ampoules 10mg/2ml;
Morphine sulfate oral solution 10mg/5ml;
Morphine sulfate solution for injection ampoules 10mg/1ml;
Morphine sulfate solution for injection ampoules 30mg/1ml;
Oxycodone solution for injection ampoules 10mg/1ml;
Oxycodone oral solution sugar free 5mg/5ml;
Sodium chloride 0.9% solution for injection ampoules 10ml; and
Water for injections 10ml.

Action Plan needs to include…

an awareness of any locally commissioned services for palliative care including any on call and delivery arrangements;
a list of community pharmacies stocking the 16 critical medicines for palliative/end of life care in their area and noting the ability to check the Directory of Services (DoS) to find pharmacies stocking these medicines;
details of where parenteral haloperidol can be accessed locally, e.g. through any local commissioning arrangements; and
awareness of other support services that may be useful for patients/relatives/carers.
It must be available for inspection from the end of 31st March 2024 at premises level.

To support you in achieving your actions…

Please refer to your previous PQS completion data from 2022/23
If still needed, please utilise your PCN Lead WhatsApp groups again – Initiate conversations if you stock, plan to stock or don’t stock the medications.
For more information on your local PCN’s, please click here.
Please find below the direct link to our palliative care service sites across Lancashire and South Cumbria (previously this would have been multiple locality based SLAs but now it is a single unified SLA spec covering the whole of the footprint) A full list of providers can be found in Appendix 2 and Appendix 4 using the link below, this also includes the parenteral haloperidol sites under Tier 1:
Palliative Care SLA

Domain 2 – Respiratory

Start now…!

Inhaler technique checks

By the day of the declaration you need to…

Evidence pharmacy staff have offered the NMS, with the appropriate inhaler technique check, to all patients presenting with a prescription for a new inhaler.
By the end of 31 March 2024 all pharmacists working at the pharmacy on the day of the declaration, who are providing NMS, with the appropriate inhaler technique check, must:

- have completed CPPE Inhaler technique for health professionals: getting it right e-learning or
- attended a CPPE face-to-face inhaler technique workshop and passed the current version of the Inhaler technique for health professionals e-assessment (updated on 15th April 2020).

The e-assessment must be completed if pharmacists have completed the e-learning or attended the face to face workshop, before providing inhaler technique checks.

Please click here to be sent straight to the CPPE PQS 23/24 easy view guide on personal completion requirements.

Inhaler waste management

By the end of 31 March 2024,

All patient-facing pharmacy staff working in the pharmacy on the day of the declaration must have been trained on the reasons why used, unwanted and expired inhalers should be returned to the pharmacy for safe disposal and the adverse effects on the environment when inhalers are disposed of in domestic waste.

To support this briefing, please click here for an easy one pager guide.

Evidence that staff have spoken verbally with all patients (rather than written communication) as well as carers and/or representatives, for whom they have dispensed an inhaler between 1st June 2023 and the day of the declaration, about the environmental benefits of them returning all unwanted and used inhaler devices to a community pharmacy for safe and environmentally friendly disposal. Discussions can be supplemented with other communication methods such as leaflets, emails and texts.

Use of a spacer in patients aged 5-15 years

By the end of 31 March 2024…

The pharmacy must be able to evidence that between 1st June 2023 and the day of the declaration that they have….

checked that all children aged 5 to 15 (inclusive) dispensed and inhaled press and breathe pressurised MDI for asthma have a spacer device, where appropriate, in line with NICE TA38; and
referred children aged 5 to 15 (inclusive) with asthma to an appropriate healthcare professional where this is not the case.

Personalised Asthma Action Plans (PAAP)

By the end of 31 March 2024….

The pharmacy must be able to evidence that you have:

checked that all patients aged five years and above dispensed an inhaler for asthma between 1 June 2023 and the day of the declaration have a PAAP.
the pharmacy contractor must be able to show that pharmacy staff have referred all patients aged five years and above dispensed an inhaler for asthma between 1 June 2023 and the day of the declaration to an appropriate healthcare professional where this is not the case.

Referrals for patients using 3 or more short-acting bronchodilator inhalers in 6 months

By the end of 31 March 2024…

Evidence that you have:

between 1 June 2023 and the day of the declaration that patients with asthma, for whom three or more short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a six-month period have, since the last review point, been referred to an appropriate healthcare professional for an asthma review.

The referral would normally involve a routine appointment booking with a GP, GP practice based respiratory nurse, asthma nurse or practice based pharmacist.

To view a one pager guide on inhaler prescribing errors, please click here

To view an inhaler technique poster, please click here

Domain 3 – Prevention

By the end of 31 March 2024…

Contractors must have implemented, into their day-to-day practice, the recommendations for community pharmacy from the first TARGET antibiotic checklist review from the PQS 2021/22.
This review must be carried out over four weeks with a minimum of 25 patients; or up to eight weeks if the minimum number of patients are not achieved within four weeks. Contractors should make a record of the start and end date of the review as they will be required to enter this information into the MYS application when they make their declaration.
Using the TARGET Antibiotic Checklist, appropriately trained staff must discuss the antibiotic prescribed with the patient or representative to help ensure safe and effective use. Attempts should be made for this discussion to occur with all eligible patients to promote antimicrobial stewardship. It may be appropriate to speak to an identified patient representative.
If there is a potential risk of antibiotic related adverse effects (for example, change in allergy status) or concerns about the patient’s therapy, the prescriber must be contacted to suggest a review is undertaken and the details of this intervention recorded in the pharmacy PMR.

To be completed between 1 September 2023 and end of 31 March 2024…

You need to…

Review pharmacy staff practice, to include two TARGET leaflets;

To help them assess walk-in / Community Pharmacist Consultation Service (CPCS) patients presenting to the pharmacy for advice and/or requesting antibiotics with suspected UTIs or RTIs without a prescription, who have not already seen a GP or other healthcare
professional for the current illness and provide tailored advice to patients and promote awareness of AMR and AMS.
This review must be completed by the end of 31 March 2024 and must be carried out over four weeks with a minimum of 15 patients for each leaflet, or up to eight weeks if the minimum number of patients are not achieved within four weeks for each leaflet. The data from the leaflets must be submitted via the MYS data collection tool by the end of 31 March 2024. The contractor must enter the start and finish dates of the data collection period on the MYS application at the point of declaration (which may be different from the date data is first entered on the MYS portal).

Useful links to documents:

Flow chart
Useful printable resources

You must collect data…

Data collection sheets will be available ahead of 1st September start date.

By 31 March 2024…

Complete (all non-registered pharmacy staff) the Infection prevention and control Level 1 e-learning and assessment on the elfh website.
Complete (all registered pharmacy professionals) the Infection Prevention and Control Level 2 e-learning and assessment on the elfh website.
Complete (all patient-facing staff who provide advice on medicines or healthcare) the  Antimicrobial Stewardship for Community Pharmacy e-learning and e-assessment.
All patient-facing staff who provide advice on medicines or healthcare should have become Antibiotic Guardians, if they have not already done so.
You must have available, at premises level, an AMS Action Plan for the pharmacy, available for inspection, which details how they will promote AMS.
All patient facing pharmacy staff working in the pharmacy on the day of the declaration, must have been trained on the reasons why unwanted and expired antibiotics should be returned to the pharmacy for safe disposal and the adverse effects to the environment.

A few useful videos and materials available here

Free Virtual Outcomes Link and Other Useful Links

CPPE training platform tells you which modules you need and don’t need to do based on when you completed them – https://www.cppe.ac.uk/services/pharmacy-quality-scheme

Virtual Outcomes – Band new PQS training modules are available now – Pharmacy Training – Virtual Outcomes