Pharmacy Quality Scheme outcomes
Published on: 14th November 2021 | Updated on: 24th September 2024
The Pharmacy Quality Scheme was introduced in 2016 under the previous name for the Scheme, ‘Quality Payments Scheme’.
This page contains information on the outcomes of the different Schemes.
Click on a heading below for more information.
Anticoagulant audit
Community Pharmacy England, NHS England and the Department of Health and Social Care won the ‘Patient Safety Team of the Year’ Award at the Health Service Journal (HSJ) Patient Safety Awards 2022/23. This award was for the Pharmacy Quality Scheme (PQS) patient safety work that community pharmacy teams have participated in.
The entry was based on five of the medicines safety audits that have been carried out in PQS (the non-steroidal anti-inflammatory drugs audit; the anticoagulant audit; the medicines safety audit (lithium, methotrexate, amiodarone and phenobarbital); the TARGET antibiotic checklist review; and the TARGET Treating Your Infection leaflets review).
The judges were impressed with the widespread impact and outcomes of these audits; some of the statistics used to demonstrate this included:
- Around 9,000 pharmacies took part in each audit;
- 600,000 patients prescribed high risk medicines have been screened by pharmacy teams carrying out audits as part of PQS;
- Clinical advice has been given 385,000 times to improve medicines safety; and
- Pharmacy teams have identified 90,000 people at sufficiently high risk to require referral/clinical intervention.
Further information on the outcomes of the above audits and other outcomes of the scheme can be found in the sections below.
TARGET treating your infection leaflets criterion
8,363 community pharmacies submitted data for 104,142 patients presenting with urinary tract infection symptoms and 8,221 community pharmacies submitted data for 115,095 patients presenting with respiratory tract infection symptoms for this criterion of the 2022/23 Pharmacy Quality Scheme. Two papers have been published on this:
Read the article on Responding to Urinary Tract Infection Symptoms in England’s Community Pharmacies (August 2023)
Community Pharmacy England Briefing 021/22: Outcomes of the 2021/22 Pharmacy Quality Scheme is a two-page document providing information on the outcomes of the Scheme, derived from analysis of the NHSBSA declaration data.
Infographic on the outcomes of the 2021/22 Pharmacy Quality Scheme is a one-page infographic on the headline outcomes of the Scheme.
Anticoagulant audit
9,303 community pharmacies participated in the anticoagulant audit and data was submitted for 131,526 patients.
Pharmacy teams provided advice and made significant clinical intervention, preventing potential harm, for patients at increased risk of harm 33,173 times throughout the course of the audit.This demonstrates they have an important role to play in educating and managing patients who are prescribed these high-risk medicines.
Read the 2021/22 anticoagulant audit report
Read the evaluation of oral anticoagulant safety indicators
TARGET antibiotic checklists
8,374 community pharmacies submitted data from 213,105 TARGET antibiotic checklists. Three reports have been published on this:
The Pharmacy Quality Scheme 2020/21 consisted of two parts. Pharmacy owners were required to make their declaration for Part 2 of the Scheme between 1st February 2021 and 26th February 2021.
NHS England has not published an infographic on this Scheme; however, the following information has been made available:
Suicide awareness and action plan
As part of the ‘Prevention’ Domain, all patient-facing staff* working at the pharmacy were required to complete the Zero Suicide Alliance (ZSA) training, available on the Zero Suicide alliance website. Once all members of the team (who do not fall under the exemption outlined below), had completed the training, a suicide prevention action plan was required to be prepared which included the action to take if anyone reported to staff that they were having suicidal feelings. The action plan needed to include making some demonstrable recorded changes such as compiling resources to provide to people who required support.
Results of the suicide awareness and action plan criterion
- More than 72,000 pharmacy staff completed the ZSA training; and
- 10,631 pharmacies trained all pharmacy staff* and completed a suicide prevention action plan.
*Staff members, who had been affected by suicide and did not wish to undertake the ZSA training, were exempt from completing it. Contractors were required to record the number of staff at the pharmacy who did not undertake the training under this exemption.
Antimicrobial stewardship
The Pharmacy Quality Scheme 2020/21 consisted of two parts. Pharmacy owners were required to make their declaration for Part 1 of the Scheme by 29th January 2021.
NHS England has not published an infographic on this Scheme.
The fifth Scheme was renamed to the Pharmacy Quality Scheme (PQS). This Scheme had a review period, rather than a review point (a specific date on which pharmacy owners had to complete their declaration). The review period was between 3rd February 2020 and 28th February 2020.
NHS England has not published an infographic on this Scheme yet; however, the following information has been made available:
Valproate safety audit
As part of the Medicines safety audits complementing General Practice (GP) Quality and Outcomes Framework (QOF) Quality Improvement (QI) module Domain, pharmacy teams were required to complete a valproate safety audit, over three consecutive months for all girls and women of childbearing potential who have had valproate dispensed from the pharmacy.
Results of the valproate safety audit
- 10,293 (over 90%) of pharmacy owners completed the audit with 12,068 (94.3%) patients/patient representatives agreeing to take part in the audit (724 (5.7%) did not agree to take part);
- Most pharmacies (67.8%) dispensed valproate to between 1 and 5 female patients of childbearing age during the three month audit period, while 28% did not dispense valproate to any eligible patients;
- 675 women (5.6%) said they had not been provided with advice and information in line with the MHRA Drug Safety Update 2018 concerning the potential impact on the unborn child;
- 10.6% did not have the Patient Guide and 11.1% did not have the Patient Alert Card;
- 73.3% of patients reported that they had discussed their valproate medicine and the need for appropriate contraception with a GP or specialist in the last 12 months, but 17.7% had not and 9.1% were unsure;
- 63.8% reported having highly effective contraception (e.g. LARC, IUD, sterilisation) but 36.2% reported they did not;
- Of those reporting that they did not have highly effective contraception (4,374), 26.5% (1,159) agreed to be referred to the GP by the pharmacist and this was recorded in the PMR;
- Pharmacy teams recorded the GP referral and/or the provision of the Patient Guide or Alert Card in the PMR for 63.6% of these patients.
NHS England has since published the results of the PQS 2019/20 valproate audit.
High risk medicines audits
As part of the ‘Medicines safety audits complementing GP QOF QI module’ Domain, pharmacy teams were required to complete a lithium audit, over three consecutive months, aligned with requirements of the National Patient Safety Agency (NPSA) alert on lithium. If the pharmacy had no patients who had had lithium dispensed from the pharmacy in the previous three months, the pharmacy owner was required to complete a safety audit of patients prescribed one of the following medicines instead, in the following order of preference: either methotrexate; amiodarone; or phenobarbital, which were in line with alternatives suggested in the GP QOF QI Prescribing Safety Module.
Read the 2019/20 high risk medicines audit report
NSAID audit
As part of the ‘Medicines safety audits complementing GP QOF QI module’ Domain, pharmacy teams were required to complete an updated non-steroidal anti-inflammatory drug (NSAID) and gastroprotection audit for all patients 65 years and over (the previous NSAID audit was completed as part of the previous Pharmacy Quality Scheme (February 2019 review point).
Results of the NSAID audit
- 8,557 pharmacies reviewed the safety of almost 75,000 older people prescribed oral NSAIDs;
- 85% of patients aged 65 or over prescribed NSAIDs were co-prescribed a gastro protective agent, compared to 80% in 2018/19. Data from the NHS Business Services Authority National Medicines Safety Indicators shows further improvement since this second audit and a reduction in related hospital admissions;
- The referral rates for patients not prescribed gastroprotection reduced from 58% in 2018/19 (the audit was originally completed as part of the previous Pharmacy Quality Scheme (February 2019 review point)) to 53%;
- However, 17% without gastroprotection had already discussed this with the prescriber and declined treatment. Common reasons for not referring were acute/short term or occasional use;
- 17% of patients were prescribed medicines which increase the gastrointestinal risk from NSAIDs;
- More of this group were co-prescribed gastroprotection (89%) and patients in this group without gastroprotection were more likely to be referred;
- Pharmacists discussed NSAID safety with 76% of patients, compared to 63% in the first audit (the audit was originally completed as part of the previous Pharmacy Quality Scheme (February 2019 review point)); improved communication with patients, a recommendation from the first audit, had been actioned; and
- Many patients not attending the pharmacy were contacted by phone to discuss the risks of taking an NSAID without gastroprotection.
Evaluation of the NSAID audit
An evaluation of the 2018/19 and 2019/20 PQS NSAID audits has been published in the British Medical Journal Open Quality.
The evaluation shows that community pharmacy teams spoke to over 165,000 patients during the two audit periods and referred more than 15,000 patients at risk of preventable harm from NSAIDs to prescribers for review.
Infographic for the February 2019 review point
The fourth Pharmacy Quality Scheme had a review point (the date on which pharmacy owners had to make their declaration) of 15th February 2019. Following this review point, NHS England published an infographic to show how many contractors had declared they had met certain criteria of the Scheme:
NHS England – Pharmacy Quality Payments infographic for the February 2019 declaration review point
Evaluation of the NSAID audit
NHS England and Specialist Pharmacy Service have published an interim report of the 2018/19 NSAID audit.
Interim report of the 2018/19 NSAID audit
An evaluation of the 2018/19 and 2019/20 PQS non-steroidal anti-inflammatory drugs (NSAID) audits has been published in the British Medical Journal Open Quality.
The evaluation shows that community pharmacy teams spoke to over 165,000 patients during the two audit periods and referred more than 15,000 patients at risk of preventable harm from NSAIDs to prescribers for review.
The third Quality Payments Scheme had a review point (the date on which pharmacy owners had to make their declaration) of 29th June 2018. Following this review point, NHS England published an infographic to show how many pharmacy owners had declared they had met certain criteria of the Scheme:
NHS England – Pharmacy Quality Payments infographic for the June 2018 declaration review point
The second Quality Payments Scheme had a review point (the date on which pharmacy owners had to make their declaration) of 24th November 2017. Following this review point, NHS England published an infographic to show how many pharmacy owners had declared they had met certain criteria of the Scheme:
NHS England – Pharmacy Quality Payments infographic for the November 2017 review point
They also published a combined infographic for the April 2017 and November 2017 Schemes:
NHS England – Pharmacy Quality Payments infographic for the June and November 2017 review points
The first Quality Payments Scheme (the previous name for the Pharmacy Quality Scheme) had a review point (the date on which pharmacy owners had to make their declaration) of 28th April 2017. Following this review point, NHS England published an infographic to show how many pharmacy owners had declared they had met certain criteria of the Scheme:
NHS England – Pharmacy Quality Payments infographic for the April 2017 declaration review point
For more information on this topic please email services.team@cpe.org.uk
