Integrated Community Pharmacy Services Agreement FAQ. 1/ How does this contract advance the goals of the Pharmacy Action Plan?

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1 Integrated Community Pharmacy Services Agreement 30 July 2018 FAQ 1/ How does this contract advance the goals of the Pharmacy Action Plan? The Integrated Community Pharmacy Services Agreement is a very important step towards delivery of the Pharmacy Action Plan. It gives DHBs and community pharmacies the ability to work with, develop and deliver local services to target inequities, it recognises the value DHBs place on pharmacists skilled advice, and it encourages greater integration of health services in the future as DHBs work with a range of pharmacy, health and consumer groups to develop new services. 2/ Will I be offered all parts of the contract? All current contract-holders will be offered all ongoing services they currently provide. Everyone will be offered: Dispensing and Professional Advisory Services (Schedule 1) The Additional Professional Advisory Services Payment (Schedule 2) in recognition of the advice they currently provide that may not be linked to a dispensing. All other ongoing services you currently provide (within Schedule 3A, B and C) Integrated Community Pharmacy Services Agreement

2 3/ What changes have there been to the proposed contract as a result of consultation? The contract has changed considerably as a result of the feedback on the proposed contract received during consultation in March-April The title is Integrated Community Pharmacy Services Agreement, and this contract is only available to licensed pharmacy owners Dispensing and advisory services and their associated funding have been put back together in Schedule One, now called Dispensing and Professional Advisory Services. The process for any future change to this approach is clearly outlined in the contract. An Additional Professional Advisory Services Payment will be paid to all contract-holders through Schedule Two, now called Additional Professional Advisory Services. Community pharmacies are not required to do anything extra to receive this payment it recognises the value pharmacists provide when giving advice that may not be linked to a dispensing. The contract provides greater clarity about the annual review process, and local change and commissioning processes. The contract states that representatives of contract-holders (provider representatives) will be involved in the National Annual Agreement Review and on the Expert Advisory Group. You can find more information about each of these topics below, and in the Fact Sheet ICPSA:Changes since Consultation. Funding 4/ How much are DHBs spending on community pharmacy? DHBs forecast they will increase community pharmacy spending by more than $20 million in the first year of this new contract. This will include forecast demand growth, new local services, the new Additional Professional Advisory Services Payment, and increases in rates for flu vaccination, special foods and margins. 5/ Has any funding been re-allocated to local service commissioning? No, an additional $4.1 million has been allocated for locally commissioned services. The contract states that each year from 1 October, each DHB will make available an amount equal to the DHB s portion of the $4.1 million allocated nationwide, to fund locally commissioned services. The funding can be used to continue funding LTC services, workforce development, and smoking cessation, as well as for local commissioning of a new service, or increased investment in existing services. 6/ How much additional money has been set aside for the new Additional Professional Advisory Services Payment? The total sum in the first year of the contract will be $8.4 million nationwide. Further details can be found in the Fact Sheet: Additional Professional Advisory Services Payment. 2

3 7/What are DHBs doing about cost pressures? $8.4 million funding for the Additional Professional Advisory Services Fee and 2% additional funding for margins reflects how the cost pressure adjuster has been applied. All rates can be found in the Fact Sheet: ICPSA Fees and Payments Services 8/ Will the new services funded for the year - workforce development, smoking cessation, and LTC Mental Health - continue? Local DHBs will advise on their approach to these services for the 1 October September 2019 year. However, all LTC patients registered as at 30 September 2018 will continue to be funded. At least until 30 September 2020, if any changes are made to LTC Services by a DHB following a local commissioning process, the DHB must continue to contract with existing LTC providers for the amended service, so long as the providers have the eligible population and can meet service standards and any other requirements. 9/ Is each DHB going to have their own LTC, Smoking Cessation, ARRC or CPAM service? Current services remain the same, unless an individual DHB decides to go through a local process to amend a service. The process to do that is outlined in the contract. See above re any LTC changes. (Also see Local commissioning, below) 10/ What would happen to my contract if a DHB wants to change services described in Schedule 3B that I am already offering? Schedule 3B contains services that have been nationally specified. Each DHB can change the specification if they wish, but must follow the processes outlined in the contract. (Also see Local commissioning, below) 11/ Will LTC continue to be capped? All LTC patients registered as at 30 September 2018 will continue to be funded. Your local DHB will have a cap in on the number of LTC patients that can be registered. Schedules One and Two 12/ Will dispensing and professional advisory services be able to be provided by different community pharmacies in the future? All dispensing and professional advisory services have been combined and are in Schedule 1, and must be provided by the same provider. The funding (dispensing transaction fees and case mix service fees) has been put back together in Schedule 1 following consultation feedback. The contract specifies that there will be a review of Schedule 1 (Dispensing and Professional Advisory Services) to determine whether, and if so how, Dispensing and Professional Advisory Services could be provided by different entities. The review will consider patient access, needs and safety; service design; funding implications; and any necessary IT changes. The review must occur before these services can be offered separately. 3

4 No changes to Schedule 1 will be made prior to 1 October 2019, or if the Pharmacy Council advises proposed changes are inconsistent with pharmacists professional obligations and Code of Ethics. Patient needs and patient safety will be the primary consideration in any future work programme to delineate these services and offer them separately, and in any subsequent DHB decisions to allow a pharmacy to offer only one or the other service. Any change proposed from the Schedule 1 review would then become part of the National Annual Agreement Review. 13/ Will all pharmacies be offered both dispensing and professional advisory services after the work to offer them separately has been completed? That will be up to the individual DHB, but we expect most community pharmacies will continue to provide both dispensing and advice services. 14/ Who will carry out the review? The DHBs collectively will undertake the review with the Expert Advisory Group, which includes contractholder representatives, community pharmacists and consumers. This group focuses on service design aspects of the contract and the wider Pharmacy Action Plan. No changes will occur if the Pharmacy Council advises proposed changes are inconsistent with pharmacists professional obligations and Code of Ethics. Local commissioning 15/ How can I find out more about my DHB s plans for local commissioning? Please talk to your DHB Pharmacy Portfolio Manager. DHBs and contract-holder representatives have agreed to undertake a joint exercise across the country on how the contract and local commissioning will work. This is likely to include training seminars for contractholders. 16/ How will these new services be developed and procured? New local services will be developed by a DHB working collaboratively with local community pharmacies and pharmacists, other health providers, and community groups. You can be involved in these discussions yourself, or you can choose a person or organisation to represent you. The contract details local commissioning processes. DHBs are required to notify affected providers and their representatives of the proposed change, provide a summary of the proposed change and a proposed implementation plan, and advise how the DHB intends to procure the services and indicative timeframes. It must give people and organisations that it notifies, a reasonable opportunity to respond to the proposed change. 17/ As the contract is evergreen, does that mean that any new local services will also be evergreen ie have no end-date? If a DHB wants to add or change a service in Schedule 3B, and the new or changed service will not be offered to all providers, the service must be for a fixed term. 4

5 National Annual Agreement Review 18/ When will this Review take place and what will it cover? The Terms of Reference for the National Annual Agreement Review and an indicative timeline are attached to the Letter of Offer. The National Annual Agreement Review will begin by 30 November and any changes will take effect the following October. It will cover all nationally consistent parts and services in the Agreement. It will include a review of payments. Contact-holders or their representatives can put topics on the agenda for discussion. It will make recommendations to DHB Chief Executives. Any resulting changes to the contract would have to be agreed between the individual contract-holder and the DHB, through a Voluntary Variation to the contract. There is also the ability for the review process to make recommendations more frequently than annually if required. 19/ Who will represent me in the National Annual Agreement Review discussions with the DHBs? You have the choice. You are welcome to represent yourself, or you may wish to choose a representative. You can choose different representatives for national and local conversations. 20/ Is the National Annual Agreement Review the only way the contract will be reviewed? The contract states that DHBs and contract-holders can carry out additional reviews of the nationally consistent parts of the contract in advance of the timelines of the National Annual Agreement Review, if desirable to do so. Local parts of the contract are reviewed through the local commissioning processes outlined in the contract. Relationships 21/ How will the contract be managed? A Relationship Structure diagram is included in the Letter of Offer. DHB Chief Executives: The District Health Board chief executives and/or boards make all decisions about the contracting approach with community pharmacy, as they do for all DHB contracts with providers. National Annual Agreement Review: The National Annual Agreement Review will make recommendations to the DHB Chief Executives, through the General Managers Planning & Funding, about any changes to the nationally consistent parts of the contract, including services and funding. You can participate in the National Annual Review directly, or through your representatives. You can find more detail in the Terms of Reference. Expert Advisory Group: The Expert Advisory Group will also be involved. It will make recommendations to the National Annual Agreement Review. 5

6 The Expert Advisory Group includes community pharmacists and consumers, who focus on service design aspects of the contract and the wider Pharmacy Action Plan. The contract states there will be two contractholder representatives on the Expert Advisory Group, up from one currently. The Terms of Reference of the current Expert Advisory Group are being revised. 22/ How will the contract be monitored? Operational reporting will continue and regular reports will be posted on the TAS website. Supply chain 23/ Is work continuing on the supply chain? DHBs are committed to finding a solution to supply chain challenges, and that work continues. 6