Building the case for eprescribing

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1 Building the case for eprescribing Medicines Management and Pharmacy Services Leeds Teaching Hospitals NHS Trust

2 Plan for session Introduction Small group discussion (10 minutes) Group feedback (10 minutes) Leeds experience and questions (10 minutes)

3 Leeds Teaching Hospitals NHS Trust One of the biggest NHS Trusts in the UK Specialist services e.g. cancer, cardiac surgery Non-foundation trust Rated Fair for quality of service Good IT infrastructure but no wireless network

4 Leeds Teaching Hospitals NHS Trust 5 hospital sites 114 wards plus day cases Approx 2,500 beds 14,000 staff Medicines budget approx 80 million in 2010

5 Medicines Management & Pharmacy Services Nine dispensaries Approx 480 staff, including: Deputy Medical Director Senior Nurse and 2 clinical educators Experience in clinical system development and implementation eprescribing team established in 2009 Support for implementation of ep in 2 clinical areas

6 Workshop Small group discussion (10 minutes) Group feedback (10 minutes)

7 1. What are the drivers for eprescribing? Medication safety; errors, SUIs, clinical negligence claims Modernisation; integration Improved efficiency Finding savings Improved patient experience Hospital of choice

8 2. Who are the stakeholders and what issues are important to them? Clinical staff; safety, efficiency, improved patient care - need a robust ep system, intuitive to use, need to feel engaged Informatics; modernisation, ep can be a driver for change (e.g. WiFi) need a robust system, interoperability, strategic fit Trust directors; financial benefits need credible financial info and positive drivers for change

9 3. How do you drive change? Business planning no surprises Capital planning Push more than pull concentrate on giving options and highlighting opportunities Engage at Board level Identify values: professional, personal Understand personal ambitions

10 4. What are the steps to building a case? Prepare trust senior management Understand your environment Investigate options and talk to colleagues in other trusts Talk to key stakeholders Understand the figures and how to present them Allow plenty of time to build and write a case and get feedback

11 5. What should be in a business case? Use the trust template if available Consider the strategic fit for your organisation Give options and reasons for the preferred option Highlight positive drivers for change (pull) Give assurance of stakeholder support Consider risks and how to mitigate them Review your track record Include a summary of capital and revenue and compare the options Use information from audit and surveys; e.g. medication errors, public opinion

12 6. What are the barriers to approval and how will you mitigate them? No capital Politics and lack of shared vision Difficult people Professional rivalry Be flexible Prepare the organisation Work to gain executive support Involve the key people Persevere

13 7. Are there any risks in the business case process? Could build expectations too high Chosen system not accepted by clinicians Savings and/or benefits not achieved Environment or circumstances change

14 Leeds Experience Large, complex organisation Challenging financial position Rigorous approach to business planning Embracing the CQUIN framework Culture of medicines safety Board to ward drive to improve prescription writing

15 Leeds Experience Evolving IT strategy Awaiting critical infrastructure (WiFi) Time-limited ep opportunity Significant support from key individuals Built a case for full approval; got agreement for small implementation

16 Our key lessons Network and lay the groundwork; get senior people on board Build your team; multidisciplinary involvement Recognise opportunities Be flexible and persevere Understand the figures and how best to summarise them

17

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