This domain contains five criteria:

• 80 per cent of all registered pharmacy professionals working at the pharmacy have satisfactorily completed the CPPE risk management training and assessment.

• 80 per cent of all registered pharmacy professionals working in the pharmacy have satisfactorily completed the CPPE sepsis online training and assessment, and are able to show how they have managed patients who they suspect have sepsis, and all patient-facing staff know when to refer patients with signs of sepsis.

• The pharmacy has updated their previous risk review including a reflection on the risks and actions it contains and identified new actions as a result.

• 80 per cent of all registered pharmacy professionals working at the pharmacy have satisfactorily completed the CPPE training and assessment for reducing look-alike, sound-alike (LASA) errors e-learning and assessment.

• Pharmacies must have a new written safety report covering analysis of incidents and incident patterns, evidence of sharing learning locally and nationally (e.g. from the medication safety officer), and actions taken in response to national patient safety alerts.

A simple model for your risk review might include a table with the following headings in columns:

• Identified risk.

• Quantify the risk; score the probability (how likely is it) and the impact (the severity of the consequences) then rate the overall risk as low, medium or high.

• Mitigating actions – what you intend to do to reduce the probability and/or impact if this happened.

• The person responsible for actioning it.

• A deadline, and;

• A review date.

Look at your previous review and reflect on whether the identified actions have happened and been maintained, the effectiveness of the action and any further actions that would reduce the risk further. The updated risk review should include the risk of missing sepsis identification. To complete your safety report:

• Review the errors and near misses over the last year to identify any themes.

• Review the reports you have received from your Medication Safety Officer.

• Identify any patient safety alert you have received.

List what you have done in response to these sources of information to reduce risks and create an action plan for other actions that could be implemented to reduce the risks further (remember to identify who will do these and provide a deadline. You could include your risk register for this. This report must specifically include any errors/near misses and identified risks from look-alike, sound-alike (LASA) drugs and the actions taken to avoid them, including reports to the NRLS.

Criteria in this domain has been designed to complement the quality improvement activity in the GPs Quality Outcome Framework (QOF). There are two new audits that must be completed:

• The lithium audit (if no ongoing lithium patients are using the pharmacy the audit should be for methotrexate, amiodarone or phobarbital)

• Valproate audit for all girls/women of child-bearing age.

A review of the previous audit of NSAIDs in patients over 65 years old without gastro-protection should be undertaken. This should identify how your practice could be improved to improve outcomes for patients and an action plan to implement these. This audit must be repeated to evaluate the success of these actions and identify further improvements to practice. Frameworks for these audits are available from the PSNC and are on PharmOutcomes. Submission of information from these audits should be done on the MYS portal. It is important to ensure you plan to complete the audits in plenty of time as the timescale over which the audit must be completed will need to be extended if you do not include sufficient patients initially.

This domain encourages initial engagement with primary care networks (PCNs). Pharmacies must align to a PCN and collaborate with other pharmacies aligned to the PCN to make initial engagement with the clinical director. They should identify a lead pharmacy representative to provide a communication channel between the PCN and the network of pharmacies aligned to it. Extra quality points (and extra remuneration) will be awarded to the lead representative. If no pharmacist is prepared to take on this role, no pharmacies within the PCN will be able to claim for this domain.

The single criteria for this domain is to have evidence that the pharmacy has referred patients with asthma who:

• Have received six short acting bronchodilators within six months without receiving a corticosteroid, or;

• Children (5-15 years) receiving a pressurised MDI who have not received a spacer and don’t have a personalised action plan.

Evidence can be recorded in the pharmacy PMR but must be retrievable (i.e. you can search for the information). Alternatively it can be recorded in a portfolio of evidence for the quality scheme. Using a referral form to contact another healthcare professional would improve the quality of the referral and a copy of this form would provide suitable evidence.

The two criteria associated with this domain are:

• To update the Directory of Services (DoS) for opening hours for the pharmacy, including bank holidays. The window to complete this criteria was October 1 – November 31, 2019. If this has not been completed the pharmacy will not be able to claim for this domain

• Access the Summary Care Record since October 1.

This domain includes five criteria, including:

• The pharmacy being a Healthy Living Pharmacy level 1.

• All patient-facing staff being Dementia Friends (Alzheimer’s Society)

• The pharmacy completing a specified dementia-friendly environment checklist and created an action plan to make demonstrable changes to the environment in line with the checklist.

• Checking that all patients with diabetes aged 12 years or over, who presented from October 1, 2019 to January 31, 2020, have had foot and eye checks in the last 12 months. The pharmacy must record the patient’s response on the PMR or appropriate form and referred patients as appropriate, with all relevant information documented accordingly.

• Sales by the pharmacy of sugar sweetened beverages (SSB) accounting for no more than 10 per cent by volume in litres of all beverages sold or declaring that this will be met by 31 March 2020.