What is the Pharmacy Quality Scheme for 2026/27, and what pays?

What is the Pharmacy Quality Scheme for 2026/27?

It is a £20m incentive scheme, set out in Drug Tariff Part VIIA, that pays pharmacies in England for meeting quality criteria on top of the core contract. The 2026/27 scheme started on 2 June 2026. It has a three-part gateway on palliative and end of life care, then two domains worth 15 points each. Community Pharmacy England (CPE) announced it on 2 June 2026, four days after the 2026/27 settlement.

The money is down again. The 2023/24 scheme carried £45m, the 2025/26 scheme £30m, and this one £20m. The settlement on GOV.UK describes "a revised Pharmacy Quality Scheme (PQS) will be introduced for 2026 to 2027 with a value of £20 million". CPE's briefing 009/26 calls it a "smaller budget", and it is. The £340m uplift went elsewhere, mainly to the single activity fee and the new prescribing service.

Two other things changed. NHS England is not publishing separate PQS guidance this year; CPE's hub says so, and the Drug Tariff determination is the authority. And the structure has shrunk from 50 points across two domains in 2025/26 to 30 points now, with a gateway that asks for work rather than a service registration. For the wider contract, see what the 2026/27 contract actually pays.

What are the gateway criteria?

Three palliative and end of life care (PEoLC) requirements, and you must meet all three to be paid for either domain. In 2025/26 the gateway was a registration for Pharmacy First and the contraception service. This year it is a questionnaire, a profile update and an action plan. The checklist sets them out with their deadlines, taken from CPE's hub and the NHSBSA page.

The questionnaire deadline is the one that bites. It falls three months before everything else, and a pharmacy that misses it is out of the scheme regardless of the domains. NHSBSA's wording is that the questionnaire "must be submitted by the end of 31 December 2026".

The stockholder criterion does not force you to stock the medicines. It requires your Directory of Services entry, edited through NHS Profile Manager, to be accurate about whether you do. The action plan is where the real work sits: you need a current list of which nearby pharmacies hold the 16 medicines, and a process for using it out of hours. CPE publishes a template on its hub.

What does Domain 1 require?

Two criteria, one on respiratory training and one on urgent supply SOPs, for 15 points in total. Domain 1 is titled medicines optimisation and patient safety. Both criteria must be met to claim the domain.

The respiratory criterion is a training requirement. It covers every pharmacist working at the pharmacy on the day of your declaration. By the end of 31 March 2027, each must have completed the CPPE Asthma for Pharmacy Quality Scheme 2026/27 e-learning. Unit 4 of the CPPE Fundamentals of respiratory therapeutics e-learning is the accepted alternative. The learning must date from 19 February 2025 or later, when CPPE updated it for the new clinical guideline. Each pharmacist must also have passed the CPPE asthma e-assessment between 19 February 2025 and 31 March 2027.

There is a concession for new starters and staff returning from long-term leave. You can count them as complete if a training plan is in place for them to finish within 30 days of the declaration or by 31 March 2027, whichever is later. Keep the training plan with your evidence.

The second criterion is documentary. By the end of 31 March 2027 you must have updated all relevant standard operating procedures. They must say what staff do if the pharmacy cannot respond to a request or referral for an urgent supply of medicines. CPE's wording adds that the procedures must cover time-critical medicines and give "specific guidance about the supply of Controlled Drugs in line with regulations". If your SOPs are already living documents, this is an afternoon; our guide on SOPs your team will actually follow covers the format.

What does Domain 2 require?

One criterion, a clinical audit of your Pharmacy First clinical pathway consultations, for 15 points. Domain 2 is titled professional practice. NHSBSA's page says the audit "must be carried out with a minimum of 10 patients", and that the data submission in MYS is an essential part of the criterion.

The audit has four parts. A pharmacist reviews at least 10 Pharmacy First clinical pathway consultations against the audit template, looking at the quality of the consultation and the record. The pharmacist writes an action plan. The pharmacist then holds a peer discussion of one to two hours with a "buddy" pharmacist, reviewing the findings and the plan. Finally, the pharmacy submits the audit data to NHS England through MYS, with no patient-identifiable data. All four must be done by 31 March 2027.

NHSBSA advises choosing a period that gives you enough patients and enough time to finish the audit, the peer discussion and the declaration from 1 February 2027. A pharmacy doing 30 consultations a month has the patients in a fortnight. One doing five a month needs to plan. CPE also lists optional CPPE learning on reflective practice, which is not required for the points. For getting the consultation volume in the first place, see how to make Pharmacy First pay.

How much does PQS pay?

Between £64.20 and £128.40 per point, according to NHSBSA, with 30 points available to most pharmacies. NHSBSA's page says: "Each point will be worth between £64.20 and £128.40. The funding will be divided between qualifying pharmacies based on the number of points they have achieved." The minimum applies if every pharmacy claims every point. The maximum is twice the minimum, and applies only if half the points go unclaimed nationally.

The table shows what that means for a pharmacy outside Band 1. The values are our arithmetic on NHSBSA's range. Last year's figures come from the 2025/26 Drug Tariff Part VIIA determination.

Bands matter for a small number of contractors. NHSBSA says there are "different points allocated for contractors in Band 1" and publishes the banding list. In 2025/26 Band 1 covered pharmacies with 1,800 items a year or fewer, and their points were a fraction of Band 2's. If you are a very low-volume contractor, check the list before you plan.

One warning on the arithmetic. Because the fund is fixed, high national uptake pushes every pharmacy towards the £64.20 floor. In a year when the domains are this achievable, the floor is the number to budget on. £1,926 for 30 points is the realistic figure.

How does the aspiration payment work?

It is an optional advance on points you intend to earn, claimed in July and paid on 1 September 2026. NHSBSA's rule is that "the maximum number of points you can receive an aspiration payment for is 80% of the number of points within your band". That is up from 75 per cent in 2025/26. The claim window ran from 9am on 13 July 2026 to 11.59pm on 28 July 2026.

It is an advance, not a bonus. NHSBSA's page is direct. "If you do not achieve the full number of points you have claimed for, payment issued for the remainder will be reclaimed." A pharmacy that claimed for both domains and then fails the gateway will repay the lot. In 2025/26 the aspiration payment was priced at the minimum point value. On that basis, 24 points at £64.20 is £1,540.80 landing on 1 September 2026, with the balance following after the February declaration.

If you did not claim, nothing is lost. CPE's reminder of 21 July 2026 said the payment is optional, that not claiming has no effect on the final payment, and that prior PQS participation is not required. You still declare in February and are paid in full afterwards.

What are the deadlines?

Five dates, and they are not all at the end. The table collects them from CPE's hub and the NHSBSA page. Add them to your compliance calendar now, because the first one is only four months away.

The declaration is made on a day of your choosing between 1 and 26 February 2027. The choice matters for the respiratory criterion, because the training rule covers every pharmacist working at the pharmacy on that day. Pick a day when your regular pharmacists are in and locums are not, or make sure the locums' CPPE records are in your file.

Which criteria are worth the effort?

All of them, this year. With only 30 points and two domains, there is no criterion where the hours outrun the money. The question is sequencing, and where the hidden cost sits. The table sets out our estimate of the time for a single-site pharmacy with two pharmacists. The hours are the author's estimates, not published figures.

On those estimates, both domains pay well above locum rates even at the £64.20 floor. Domain 1 returns £963 for roughly seven to nine hours across two pharmacists. Domain 2 returns £963 for five to eight hours, most of it a pharmacist's. The gateway is unpaid, but it is the price of admission for £1,926.

The hidden cost is not in the criteria. It is in the audit's dependency on Pharmacy First volume and records. A pharmacy with thin consultation notes will spend longer reconstructing 10 records than reviewing them. And a pharmacy without 10 clinical pathway consultations in a sensible window cannot claim Domain 2 at all. The domain is only cheap if the underlying service is running.

The other trap is people, not paperwork. The respiratory criterion follows the pharmacists on the declaration day, and the audit needs a buddy pharmacist willing to give one to two hours. Line both up in the autumn. Everything else in this scheme can be done by one organised person with a calendar.

Key takeaways

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