Pharmacy Quality Scheme 2025/26 – Medicines Optimisation Domain
The points allocation for meeting the Medicines Optimisation Domain for most pharmacies is 30.
Each point will be worth between £57.50 and £115.00 and so a contractor can earn between £1725.00 and £3450.00
Palliative and End of Life Care (PEoLC) Action Plan
The aim of this criterion is for sufficient arrangements to be in place so patients and their relatives/carers and healthcare professionals can obtain palliative/end of life care medicines in a timely manner and support dying at home.
As a patient’s disease progresses, it is likely that medication will be changed and adjusted. It is vital that patients, relatives and/or carers can access commonly prescribed palliative care medication in a timely manner either by supplying the medication or reserving and signposting the medication to their nearest pharmacy of choice, recognising that any delay is causing heightened distress.
To claim for this criterion the pharmacy must have updated NHS Profile Manager if they routinely hold the 16 palliative and end of life critical medicines listed below and can support local access to parenteral haloperidol, as soon as possible after 1st April 2025 and before the end of 31st March 2026. If contractors are not a stockholder of these 16 palliative and end of life critical medicines, they are not required to update NHS Profile Manager.
The 16 critical medicines for palliative and end of life care are:
- Cyclizine solution for injection ampoules 50mg/1ml
- Cyclizine 50mg tablets
- Dexamethasone solution for injection ampoules 3.3mg/1ml
- Dexamethasone tablets 2mg
- Haloperidol tablets 0.5mg (or 1.5mg tablets or 5mg/5ml liquid)
- 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 10g/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
- Water for injections 10ml
Drug availability for patients is the main concern, and therefore there are no stipulated pack sizes that must be kept by contractors.
Actions
- Contractors who routinely hold the 16 palliative and end of life critical medicines listed and can support local access to parenteral haloperidol must, as soon as possible after 1st April 2025, update the NHS Profile Manager to show they are a ‘Pharmacy palliative care medication stockholder’. Contractors who are not stockholders of these 16 palliative and end of life critical medicines are not required to update NHS Profile Manager but can still claim for this domain if they can support access to these medicines by completing an action plan.
- Complete, or update an action plan, available for inspection, on how to manage patients requesting palliative and end of life care drugs within the local area, as swiftly as possible by redirecting them to the nearest open community pharmacy that stocks the 16 critical palliative and end of life medicines and/or parenteral haloperidol (parenteral haloperidol may be accessed locally, e.g. through any local commissioning arrangements).
The action plan must 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 DoS to find pharmacies stocking these medicines.
- Details of where parenteral haloperidol can be accessed locally, e.g. through any local commissioning arrangements.
- Awareness of other support services that may be useful for patients/relatives/carers.
Resources
Palliative and End of Life Care Action Plan
Consulting with People with Mental Health Problems
To support the quality of New Medicine Service consultations following the expansion of the NMS service later in the year, all pharmacists working at the pharmacy on the day of the declaration must have satisfactorily completed the CPPE online Consulting with people with mental health problems e-learning training, within the last 4 years (between 1st April 2022 and end of 31st March 2026),
Actions
- Eligible staff to complete the CPPE training module Consulting with people with mental health problems e-learning. As there is no e-assessment, pharmacists need to document the completion in their CPPE record, this allows a certificate of study to be downloaded as evidence.
- Use the Training Log to record numbers of staff who have successfully completed and passed the course
Resources
Spacers in children aged 5-15 years and referrals for 3 or more short-acting bronchodilators
Pharmacy professionals are in an ideal position to detect under and over usage of asthma inhalers through monitoring of patients’ ordering of inhalers over a fixed period and to identify children between the ages 5 and 15 years (inclusive) that may benefit from using a spacer.
For referrals for patients using three or more short-acting bronchodilator inhalers without any corticosteroid inhaler in six months, the patient will normally be referred to their GP, GP practice based respiratory nurse specialist/asthma nurse or practice-based pharmacist for a routine appointment.
For contractors who claimed elements of these criteria previously as part of PQS 2023/24, a new review will be required. In addition, the pharmacy team’s knowledge and understanding of the process to identify suitable patients should be reviewed. Methods used to identify ‘at risk’ patients for referral should be reviewed for effectiveness.
Where no patients are identified for referral, the contractor will still be eligible for payment if they can evidence that they have robustly attempted to identify suitable patients and that they have processes in place for referrals should they identify a patient who is suitable. Contractors are advised to record any intervention and/or referral made in the PMR.
Contractors should retain evidence that they have completed all aspects of this domain at the pharmacy premises, which should be available for inspection.
Actions
- Show evidence that all children aged 5 to 15 prescribed a press and breathe pressurised MDI for asthma have a spacer device, where appropriate and refer children aged 5 to 15 with asthma to an appropriate healthcare professional where this is not the case.
- Show evidence 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.
Resources
Numark Respiratory Data Collection Form
CPE Suggested Process for Spacer Referrals
CPE Suggested Process for Review when no Corticosteroid prescribed
Emergency Contraception - CPPE Learning & E-Assessment
To support the quality of Pharmacy Contraception Service consultations following the expansion of the service to include Emergency Contraception later in the year, all pharmacists and any pharmacy technicians intending to provide the Pharmacy Contraception Service working at the pharmacy on the day of the declaration, must have satisfactorily completed, within the last 3 years (between 1st April 2023 and end of 31st March 2026), the CPPE online Emergency Contraception training and passed the e-assessment.
Actions
- Emergency Contraception Eligible staff to complete the CPPE training module Emergency Contraception and pass the e-assessment and show, as evidence, the certificate of completion.
- Use Training Log to record numbers of staff who have successfully completed and passed the course.