The NHS England East of England regional community pharmacy contracting team needed additional capacity to review over 200 Dispensary Service Quality Scheme clinical audits by the end of the 2022/23 financial year.
Arden & GEM’s medicines optimisation team was engaged to encourage submissions, review clinical audits and provide targeted support to practices in achieving audit approval. As a result, 99% of practices accessing the scheme delivered approved audits by the deadline, demonstrating a commitment to the highest levels of dispensing quality and enabling full payments to be made.
The challenge
For patients living in rural communities, dispensing doctors provide a vital service which accounts for 7% of all prescription items. The Dispensary Services Quality Scheme (DSQS) was first established in 2006 to reward those practices who can evidence they are providing a high-quality service to their dispensing patients by meeting the scheme’s quality requirements.
The NHS England East of England region covers Bedfordshire, Luton and Milton Keynes; Herts and West Essex; Cambridgeshire and Peterborough; Mid and South Essex; Norfolk and Waveney; and Suffolk and North East Essex ICSs. When the community pharmacy contracting team needed additional capacity to review over 200 DSQS clinical audits by the end of the 2022/23 financial year, Arden & GEM’s medicines optimisation team was engaged to deliver the necessary support.
Our approach
Arden & GEM put together a dedicated team, comprising pharmacy and administrative support, which included experience gained within community pharmacy and pharmacy inspections.
The team’s objective was to assess whether dispensing practices in the East of England, who had signed up for the DSQS, had provided sufficient self-assessment evidence to meet the required audit standards.
Reviewing clinical audits
Audits from dispensing practices were sent electronically to the CSU team where they underwent an initial high-level triage to ensure a sufficient level of information for review. Where a lack of information was identified, the audit would be returned to the practice with guidance to complete the missing areas.
Where sufficient information was available, the audit was reviewed by a pharmacist against the quality markers defined in the DSQS Guidance Summary 2022-23. Audits meeting the standards were passed and recorded, while practices not meeting the standard received targeted support to update and resubmit their audit.
Engaging with stakeholders
Regular check ins took place with the regional team to keep them appraised of project progress. A client tracker was also updated to monitor the progress of each practice in submitting audits and meeting the assessment criteria.
This enabled the client to always have access to the latest picture of project progress.
The review team also liaised directly with accountable GPs and practice mangers via email and telephone to encourage submissions by the deadline and support any practices not initially fulfilling requirements.
"I would like to thank you for your help in completing the DSQS audit. As someone new to GP practice management, I was unsure how to perform the audit. Without your guidance I would not have been able to do it at all. Thank you so much for your speedy response and regular email support. It was greatly appreciated."
Gillian Wright, Practice Manager at Great Barford Surgery, Bedfordshire
The outcomes
Following the targeted support provided by Arden & GEM, 99% of practices (203) accessing the scheme delivered approved audits by the deadline to enable their payment to be made – a valuable source of funding for rural practices.
Implementing a pharmacist-led review model also established an enhanced level of rigour within the assessment process, ensuring the highest dispensing service levels within scheme practices.
An end of project report was produced for the client following completion of the assessments which included an overview of the work delivered and project learning to inform the process in the future.
"We engaged Arden & GEM CSU to support with the assessment of our GP dispensing practices in meeting the requirements under the Dispensing Services Quality Scheme. We have approximately 200 dispensing practices in the East of England and we asked the CSU to review the dispensing clinical audits submitted by practices. Arden & GEM were quick to understand the initial “ask” and were supportive of adopting our established processes.
Arden & GEM were able to assign staff members to the task quickly and efficiently and it was particularly helpful that some colleagues were pharmacists and able to provide an additional layer of clinical support to our dispensing practices. The dispensing audits were all reviewed within the required timescales and throughout the project Arden & GEM were proactive in linking in with the team and providing regular updates.
At the end of the project, we received a full report outlining the outcomes of the project which included lessons learnt and key insights which will be beneficial for next year."
Jackie Bidgood, Senior Community Pharmacy and Optometry Contract Manager on behalf of all ICBs in East of England region