Claiming and payment schedule for Pharmacy First

We have received several queries regarding the deadline for claiming Pharmacy First payments and when pharmacy owners will receive payments for the Pharmacy First service.

The service specification states, “Claims for payments should be submitted within one month of, and no later than three months from the claim period for the chargeable activity provided”. Therefore, if you have not yet submitted your claim for your February 2024 consultations (this includes consultations carried out on 31st January 2024), you must do so by 5th June 2024 to be entitled to payment. Later claims will not be processed.

The table below details the date on which pharmacy owners will receive their £1,000 monthly fixed payment (if the pharmacy has reached the minimum threshold of clinical pathway consultations for that month) as well as their consultation fees and reimbursement of medicines/appliances supplied.

FAQs

Q. I met the minimum threshold for clinical pathway consultations in April 2024, but I forgot to submit my Pharmacy First claim by 5th May 2024. Will I still be entitled to the £1,000 monthly fixed payment for April 2024?

Pharmacy owners have three months to claim for Pharmacy First consultations so as long as pharmacy owners claim for this on MYS by 5th August 2024 (and have met the minimum number of clinical pathway consultations for April 2024), they will still be paid the £1,000 monthly fixed payment.

Q. I submitted my February 2024 and March 2024 Pharmacy First claims on 1st April 2024. I have met the minimum threshold of consultations for the clinical pathway consultations for both months, will I still receive a £1,000 fixed payment for both months?

Yes. If a pharmacy owner submits a claim for two months that meet the minimum threshold of clinical pathway consultations together, they will be paid £2,000 (£1,000 for February 2024 and £1,000 for March 2024) in the same month (in this case, on 31st May 2024).

Q. How will my Pharmacy First payments appear on my Schedule of payments?

NHSBSA has published an example of the Schedule of payments highlighting the breakdown of Pharmacy First payments, alongside activity data relating to this.

Q. How do I reconcile what I submitted using my clinical system compared to what NHSBSA have received?

See our guidance at: cpe.org.uk/reconciling.

Q. If we don’t agree with the Pharmacy First claim information pre-populated into MYS by our IT system, what should we do?

The claim information pre-populated into MYS comes from a direct feed from your Pharmacy First IT system, based on the consultation information you have entered into the system. If the data in MYS does not tally with your expectation, you should first check that all relevant referrals have been correctly processed in the IT system; if a consultation has not been completed within the system, it will not appear in your MYS claim. Any consultations subsequently completed after the month end will appear in the claim created for the subsequent month.

If the above guidance does not address the discrepancy, you should contact your IT system’s helpdesk and check that you’ve used the guidance at cpe.org.uk/reconciling.