The Dispensing Services Quality Scheme (DSQS) was introduced in 2006/07 following work done by the NHS Employers, the GPC and the DDA.
There is payment for participating and achieving - £2.58 per dispensing patient as listed per financial year as on 1 January of that year. However, it is an all or nothing payment - you must achieve all standards in all sections in order to be paid.
Participation
In order to participate and receive payment for that year, you must provide the PCT with a written undertaking to carry out and achieve the standards by 1 July in each year. You need to provide the PCT with the name of the GP who will be accountable for the year; if that changes, you must tell the PCT within 28 days who the new person is.
SOPs
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Should be in place
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Should reflect good clinical practice
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Should reflect the procedures that are actually being performed by the practice
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Should be specific to the practice, setting out in writing what should be done, when where and by whom
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Should be reviewed at least once every 12 months
All staff ought to know what the SOPs (Standard Operating Procedures) are and should follow them - there is no point having a brilliant SOP if no one actually follows that process. If there are changes made to the SOPs, then a written trail should be kept, so that there is an audit trail.
Audit
The audit is contractor led, ie you choose what you want to audit as long as it involves dispensing services. This is a valuable tool to improve patient care and experience.
Training
Staff need to be competent. This needs to be demonstrated, either with certificates or qualifications. All staff involved in dispensing need an annual appraisal and must participate in continuing education and development. Trainee staff must be supervised unless they have worked at least 1000 hours and are certified competent.
Staff levels
Staff levels should be as per the guidance. There is a chart which acts as a guide and can be used to determine the staffing levels. It is not exact; however the specification states "the contractor must, in consultation with the PCT, agree a level of staffing that reflects the dispensary's configuration and hours of opening".
Risk Management and Policies
Practices should have a written policy for managing risk in dispensing. There are several examples given in the guidance, but most of these are already part of the practice and are required for other reasons, so it is often a case of sharing the policies with the DSQS.
DRUMs
You must perform a DRUM on at least 10 per cent of your dispensing patients every year. This is a face to face review.
The guidance makes some suggestions of what could be recorded. Concordance, compliance, side effects, special needs and waste could be recorded. The easiest way to record this information is probably through the use of a template and saving the information directly in the patient's notes.
There is the potential for real benefit and change through DRUMs. Reducing waste will reduce costs for the NHS, improving compliance can improve the clinical condition, becoming aware of side effects can change prescribing patterns and if patients are unable to open packaging can have result in significant change eg dosette boxes, liquid formulations, smaller tablets etc.
This is a brief summary of the Specifications. If you are a member of the DDA, please read the full specification for further information. The DDA also has a DSQS resource pack for DDA members.
The full specification can be found online.
Monitoring the Scheme
Eastern and Coastal Kent PCT carries out annual monitoring of this scheme. In previous years, we visited each practice that participated in the scheme, however, this year (2010/11) we have utilised a self-assessment process for most of the practices.
