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The Pharmacist > Pharmacy management and business > Flashcards

Pharmacy management and business Flashcards

1
Q

What is the economic framework controlling community pharmacy?

A
  • responsibility for profitability lies entirely with the pharmacy owners
  • not all pharmacies provide NHS services, though the vast majority do
  • most pharmacies are in retail locations, rather than an integral part of NHS systems
  • across the sector, the NHS provides the major source of income
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2
Q

Ways in which you make a profit in a pharmacy?

A
  • no of prescriptions dispensed
  • payment for services
  • accurate renumeration and reimbursement
  • cost containment
  • quality payments
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3
Q

What is the quality payments scheme?

A
  • introduced as part of the contracutal framework in 2017/18

- payments made to pharmacy contractors meeting certiain quality criteria

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4
Q

What are the gateway criteria for being able to claim quality payments?

A
  • provision of at least one advanced service
  • NHS.uk entry up to date (BH opening hours, patient questionnaire results)
  • ability for staff to send and receive nhs mail
  • link to NHS digital systems (e.g. electronic prescriptions, summary care record)
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5
Q

What are the criteria related to different domains needed to receive a quality payment?

A
  • Patient safety (part 1-3)
  • public health
  • digital/urgent care
  • clinical effectiveness
  • workforce
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6
Q

What is the patient safety criteria for quality payments?

A

1: written patient safety report (incident patterns and analysis, shared learning), identifies risk from LASA errors, reports LASA errors to NRLS
2: 80% registered staff completed CPPE risk management training and risk review complete for one risk with minimisation actions
3: completed an audit on NSAIDs and gsatric protection

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7
Q

What is the public health criteria for quality payments?

A

HLP status, 80% of staff completed CPPE children’s oral health training

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8
Q

What is the digital/urgent care criteria for quality payments?

A

NHS 111 directory of services entry up to date

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9
Q

What is the clinical effectiveness criteria for quality payments?

A

referral of patients >6 short acting bronchodilators, use of spacers in children

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10
Q

What is the workforce criteria for quality payments?

A

80% staff are ‘dementia friends’

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11
Q

How does renumeration work for community pharmacies?

A
  • payment for NHS services, determined by department of health
  • global sum ofr NHS pharmaceutical services in England
  • free structure and conditions for individual pharmaceutical services
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12
Q

How does reimbursement work for community pharmacies?

A

arrangement for repayment of costs of medicines dispensed against NHS prescriptions, determined by the department of health

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13
Q

What is the price at which community pharmacies are reimbursed for dispensing NHS medicines?

A
  • branded products: naufacturers NHS list price
  • generic products: current drug tariff price

same for GP prescribing budgets

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14
Q

Cost control of generic medicines dispensed under the NHS?

A
  • fixed price regardless of the actual price paid by the pharmacy
  • price determined and updated monthly by the department of health
  • price listed in the drug tariff
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15
Q

How does import/export of medicines affect the NHS?

A
  • until the recent weakening of the pound, many licensed medicines could be sourced more cheaply from other EU countries
  • it is currently profitable to sell medicines to other EU member states, leading to shortages of some medicines here
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16
Q

Problems caused by stock shortages?

A
  • increased pharmacy workload: double dispensing, phone calls
  • inconvenience to patient
  • reduced compliance, leading to worsening of condition
  • substitution of medicines causes confusion for patient and pharmacist - safety issue
  • decreased satisfaction with patient-pharmacist relationship
17
Q

Adjustment to discounts to community pharmacies?

A
  • pharmacies buy medicines at less than the list price, through wholesaler discounts, bulk buying, parallel importing
  • department of health estimates differences between actual costs and list prices
  • applies a discount deduction scale to reimbursement of community pharmacy based on monthly total of prices of NHS dispensed medicines
18
Q

Equation for total monthly reimbursement paid to NHS pharmacy contractors for dispensed medicines

A

total cost of branded products + total cost of generic products (list price) - appropriate percentage discount deduction (dependant on total monthly value of products dispensed)

19
Q

What behaviours are induced to pharmacy owners by these cost control mechanisms?

A
  • attempt to purchase medicines cheaper than the list price (bulk buying or parallel importing)
  • attempt to increase the level of discount beyonf the NHS scale
  • minimise community pharmacy stock levels (commonly affects availability to dispense)
20
Q

What other costs are involved in running a community pharmacy

A
  • staff, training
  • rent, utility bills
  • equipment
  • stock loss
  • loss due to incorrect claims
  • collection and delivery services
21
Q

Where do hospital pharmacies get their money from?

A
  • non-profit organisations, exposed to strict financial restraints
  • payment via national tariff: contains fixed prices hat reflect national average prices for procedures
  • payment via commissioning for quality and innovation (CQUIN)
22
Q

What are the CQUIN indicators?

A
  • improving staff health and wellbeing
  • reduce impact of serious infections (resistance and sepsis)
  • improving physical healthcare to reduce premature mortality in people with serious mental illness
  • improving services for people with mental health needs who present to A&E
  • transitions out of children and young peoples MH services
  • offering advice and guidance
  • e-referrals (only for 17/18)
  • supporting proactive and safe discharge
  • preventing ill health by risky behaviours - alcohol and tobacco
  • improving assessment of wounds
  • personalised care and support planning
  • ambulance conveyance
  • NHS 111 referrals
23
Q

What do CQUIN indicators reflect?

A

The ambitions of the 5YFV and NHS mandate

24
Q

Aims of cost control in hospitals?

A
  • increase efficiency, effectivness and reduce costs

- promotion of efficient and rational use of medicines via Drug and Therapeutic committees

25
Q

Some approaches to reduce costs in hospitals?

A
  • home care services
  • NHS procurement division
  • Skill mix
  • Patient’s own drugs
  • recycling drugs e.g. seretide inhalers

The Pharmacist (9 decks)

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