C-19 PPE reimbursement: how contractors can make a claim

December 23, 2020

PSNC and the Department of Health and Social Care (DHSC) have agreed a mechanism by which pharmacy contractors can claim reimbursement for their expenditure on personal protective equipment (PPE) during the COVID-19 pandemic in 2020. This is part of a wider scheme covering reimbursement of PPE for primary healthcare as a whole.

Drug Tariff determination on the NHSBSA website

PPE purchased by contractors for use in the delivery of NHS pharmaceutical services, as a result of the COVID-19 infection control guidance, between 27th February 2020 and 31st December 2020 will be covered by the reimbursement mechanism, providing the PPE will be used by the end of March 2021.

However, contractors should be aware that any PPE purchased directly by them from 1st January 2021 will not be reimbursable via the agreed mechanism.

Contractors can continue to order free of charge PPE for use in their pharmacy via the DHSC’s PPE portal, and should ensure they have registered for this.

Find out more about the PPE portal

How the reimbursement mechanism works

Claims need to be made via the NHSBSA’s Manage Your Service (MYS) platform between 1st January and 12th February 2021. A central claims process option is also available for multiple pharmacies (with six or more pharmacies) as it is recognised that PPE supply may have been managed centrally for pharmacy groups.

Each pharmacy will be able to make two types of claims, where necessary.

 1) Standard claims – this claim is for a set payment to cover the estimated standard PPE use of pharmacies from 27th February 2020 to 31st October 2020.

Contractors will be able to claim the amount set out in the table below, based on their average (mode) monthly prescription volume over the period of the claim. This is the most frequent band that pharmacies have found themselves in over the eight months from March – October 2020, with the higher band taken if there is more than one most frequent band. Pharmacy contractors will also have to state whether they were either open up to (and including) sixty hours per week on average, or more than sixty hours.

Band Range of number of items dispensed per month Standard claim, <=60 opening  hours Standard claim, >60 opening hours
1 0 – 100 £830 £1,650
2 101 – 2,500 £830 £1,650
3 2,501 – 5,000 £1,030 £1,850
4 5,001 – 12,500 £1,640 £2,460
5 12,501 – 19,167 £2,490 £3,310
6 19,168 + £3,240 £4,060

The claim amounts in the table above have been calculated based on estimated usage and costs of standard PPE (aprons, gloves, Type IIR masks (sessional use and some additional masks for provision of clinical services) and hand sanitiser) by pharmacies dispensing different volumes of prescriptions up to 31st October 2020. These bands have been created to recognise pharmacies may not have kept detailed records on PPE spend during the pandemic period due to the unusual operating environment, and where the standard claim is made in isolation, no further evidence of spend will be required.

The NHSBSA will be emailing contractors around 8th January 2021 to confirm which band they are in, in case of doubt.

Please note that any pharmacies that were open for less than 90% of the time from 27th February 2020 to 31st October 2020, or that changed ownership during that period, will not be able to make a standard claim. These pharmacies will instead need to claim their actual PPE costs via the Exceptional claim process below.

2) Exceptional claims – this type of claim can be used to cover any PPE purchased:

  1. between 27th February 2020 and 31st October 2020 in excess of the standard claim value and to be used up until 31st March 2021; and/or
  2. between 1st November 2020 and 31st December 2020* and to be used up until 31st March 2021.

* From 21st September 2020, pharmacies could obtain all their COVID-19 PPE free of charge from the DHSC portal.

When making an Exceptional claim, contractors will be required to confirm that they have documentation to evidence the value of their combined standard and exceptional claims and can make this documentation available on request.

Between 27th February 2020 and 30th June 2020, any PPE (including visors) used as a substitute for unavailable standard items can be covered as part of an exceptional claim. Where PPE is claimed up to 30th June 2020 outside of the now standard list (aprons, gloves, Type IIR masks and hand sanitiser) the contractor will need to be able to evidence the need for that PPE, if requested to do so.  This evidence may take the form of a staff risk assessment or similar.

Additionally, Exceptional claims should be made where the pharmacy was open for less than 90% of the time from 27th February 2020 to 31st October 2020 or where they changed ownership during that period, as the standard claim amount option will not be available to them.

Multiples may make a single central claim if they wish, however, this must be supported by appropriate evidence. A template spreadsheet will be published by NHSBSA to allow contractors to do this, splitting spend between the various categories. The link for this template will be included within the NHSBSA email confirming pharmacy’s standard claim team around the 8th of January 2020