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Migration From Transition

Most pharmacy contractors in Scotland were placed into transition in December 2004. The system was introduced to provide contractors with greater stability around remuneration as service provision moved from the traditional dispensing role to the delivery of pharmaceutical care services. Information on how these remuneration changes will affect members not in transition is contained here.

Now that the 4 core services have all been implemented, CPS has agreed that it is time to look at how we reshape the remuneration arrangements to reflect the new diversity in service provision.

Community and Care Home Elements

In our discussions SG has advised that it is considering how services to patients resident in care homes should be provided and funded in the future. The latest figures from the Care Home Census (available on the ISD website) show that at the end of March 2010, there were 943 care homes in Scotland with 32,865 long stay residents. Of these residents 48% had medically diagnosed dementia.

In the long term SG has indicated that it is its intention to separate payment for services to patients resident in care homes from the payment for services to patients in the community.

As a first step in this process, changes will be put in place for the payments due for activity carried out during October 2011. ISD is currently analysing prescriptions dispensed by every contractor to find out what proportion relates to activity for patients resident in care homes. Patients in care homes carry a different CHI marker. If the level of activity is found to be less than 2.5% no change will be made to the existing arrangements. If the level exceeds 2.5% then the Transitional Payments (TPs) /shadow fees and allowances will be split into community and care home elements. Contractors will have the opportunity to feed back to their Health Board by April 2012 if they have concerns about this split. The mechanism for this feedback is currently being produced and will be widely circulated when ready.

Splitting of the Community Element of Payment

The next proposal is to take the community patient element and to split that into three components. The 3 components and three relative proportions for each are:

1. Chronic Medication Service capitation payment – value 15%

2. Quality and Efficiency Initiative payment – value 5%

3. Community Migration Payment – value 80%

A summary diagram of what is proposed is below. Further information on what is intended and required for each section of the community element (the purple rectangles), is accessible by clicking on the appropriate section of the diagram.