Electronic Prescription Service (EPS2)

Transcription

1 Electronic Prescription Service (EPS2) The Fort House Surgery 6 TH October Ashley Medical Centre - 20 th October Business Process Change Workshop Gary Mortimer EPS Implementation Manager gmortimer@hscic.gov.uk

2 Workshop overview Today we will be covering: 1. Overview of EPS Release 2 2. GP and dispenser site readiness 3. Business process change for GP practices and pharmacies 4. Business continuity & raising support calls 5. Training and support for EPS Release 2 6. Patient communication 7. Connect with EPS and learn more 8. Question & answer session

3 Overview of EPS Release 2

4 EPS in a nutshell EPS enables prescriptions to be sent electronically from the GP to the dispenser of the patient s choice providing a more efficient and consistently accurate system that is better able to cope with the continuing increase in prescription volumes

5 1,100 Why is EPS needed? Over a billion prescription items were issued in 2012 About 70% of prescriptions are for repeat medication Number of prescription items dispensed each year (Millions) 1,

6 Who are the key players? GP practices (including dispensing practices) Community pharmacies Dispensing Appliance Contractors (DACs) Patients

7 Release 2 overview Electronic submission of reimbursement endorsements Electronic Signatures Electronic repeat dispensing Electronic cancellation Nomination

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9 Key benefits Greater convenience Increased freedom of choice Reduced waiting times in the pharmacy Patients Prescribers/ Prescription Clerks No lost scripts- prescription tracker Greater efficiency/streamlined workflow Easier month end processing Reduced collection of paper scripts Electronic batch signing of scripts by GPs Easier to use repeat dispensing Greater efficiency and control Reduced footfall Dispensers

10 Prescribing and dispensing site readiness

11 User smartcard Key Readiness Dictionary of Medicines +Devices (DM+D) medication map, synchronise, PDS Patient has nominated a dispenser and/or Appliance contractor Nominations for go-live day

12 Smartcards Ensure all staff who will be dealing with prescriptions have smartcards and the correct roles consider nomination setting and cancellation Ensure all GP smartcards have been checked for duplicate certificates Smartcard contacts Telephone: Self Service Portal: Selfservice.southlondoncsu.nhs.uk

13 EPS Messages

14 Prescribing Possible EPS outputs: EPS R2 message EPS R2 message + prescription token FP10, for signing EPS Script Types: Acutes Repeats Repeat dispensing

15 Prescription Token - GP Nomination details Barcode & prescription ID Text in the signature box Printed: Patient - different Pharmacy Communicate Clinical information Patient requests it Start of Repeat dispensing regime

16 Dispensing Token Pharmacy Printed : when returning a prescription to EPS spine To capture payment/exemption declaration Provide counterfoil for patient information or repeat medication list

17 Processes for prescribers

18 Key processes to consider before go live at the GP practice Capturing nominations Preparing a repeat prescription Signing electronic prescriptions Electronic repeat dispensing Split prescriptions Electronic Cancellation Training

19 Approach to capturing nominations Will the practice be proactively capturing nominations? Will the practice target specific patients? What will the practice do if a patient asks about EPS and nomination? Literature? Update new patient registration procedure ( Lesson) Temporary and Short term nominations (Lesson) Nominated vs preferred pharmacy? (lesson)

20 Approach to capturing nominations Who will capture nominations in the pharmacy? Consider patients who have delivery service (Lesson) Consider process for inputting the nominations onto the system How will you communicate with patients?

21 Preparing a repeat prescription How do patient currently order their prescription? Repeat slip / E- mail / online? Are they prepared by prescription clerk, pharmacist, prescriber? Depending on who prepares, consider: Who edits or amends the prescription How do you deal with Rx issues needing re-authorisation How and when are queries communicated to the prescriber? virtual sticky note, , diary entry, clinical note Does the prescriber amend or edit the patient repeat master? Or is it returned to the prescription clerk to amend master? How will you deal with queries and notes? Consider how you will deal with urgent requests

22 Signing electronic prescriptions What is your current process? Scripts divided equally into pigeon holes/ baskets? Patient s usual GP signs all? GP registrar signs all repeats? All to duty Dr? Home working? Will you allocate electronic scripts in the same way? What about annual or sick leave cover? End of day process ensuring all scripts have been signed

23 Split prescriptions What is a split prescription? Possible options: Replace the item with another description of the same product that is dm+d mapped and can be sent through EPS Revert all items to FP10 Agreement that patient attends surgery to collect out of scope items on a FP10 Agree prescription collection service (if appropriate) and add note to dispenser attached to release 2 prescription advising of extra items on prescription collection service Discuss with patient suitability if all items out of scope

24 Electronic cancellation Who will be responsible for cancelling electronic prescriptions? How will this process be handled? Who will be responsible for contacting the patient and/or pharmacy? Ensure all staff are aware of the processes around each type of cancellation response. Successful cancellation Unsuccessful cancellation, prescription is with the dispenser Unsuccessful cancellation, prescription has been dispensed

25 Electronic cancellation Ensure all staff are aware of electronic cancellation What do cancelled prescriptions look like in the system? Consider a local process for returning prescriptions to the spine if a GP practice advises they wish to cancel a prescription after it had been downloaded in the pharmacy

26 Electronic repeat dispensing Who will set up the repeat regimes prescriber, medicines management, practice nurse/nurse practitioner/admin? Which patients? When? during medication review, during long term condition reviews, at the end of current authorised issues or ad hoc consultation? How long are regimes set up for determined by clinical judgement Medication Synchronisation (56 / 28 days) 7 Day scripts?

27 Processes for pharmacy staff

28 Site preparation Release 1 usage PDS synch Order dispensing tokens Printing capability (2 nd tray for dispensing tokens) System training / SOPs Smartcards

29 Key processes to consider before go live at the pharmacy Approach to capturing nominations Electronic Cancellation Dispensing and downloading electronic prescriptions Dispensing tokens Electronic endorsement and patient declarations Electronic claims End of month processes

30 Approach to capturing nominations Who will capture nominations in the pharmacy? Consider patients who have delivery service Consider process for inputting the nominations onto the system How will you communicate with patients?

31 Dispensing and downloading electronic prescriptions Consider process for requesting prescriptions (frequency/responsibility) Overnight download Requesting throughout the day When will you send dispense notifications? Clinical information from the prescriber needs to be communicated to the patient how will you do this?

32 Dispensing tokens Ensure dispensing token stationery has been received Use of dispensing token for: capturing signatures for payment/exemption declaration giving to a patient who needs to go to a different pharmacy to collect their medication aiding with dispensing process

33 Electronic cancellation Ensure all staff are aware of electronic cancellation What do cancelled prescriptions look like in the system? Consider a local process for returning prescriptions to the spine if a GP practice advises they wish to cancel a prescription after it had been downloaded in the pharmacy

34 Electronic endorsements and patient declarations Ensure all staff are aware of capturing patient declarations and ensure they are recorded on the system Capture patient signatures on the reverse of tokens Electronic prescriptions must be electronically endorsed. Paper prescriptions must be endorsed and submitted in the usual way Do not handwrite endorsements on tokens, these will not be used for pricing Ensure electronic exemptions are correct before sending

35 Electronic claims All electronic prescriptions must be claimed for electronically An electronic claim can only be sent once the prescription has been completed; items should be marked as either dispensed or not dispensed Consider when you will be submitting electronic claims on patient collection, end of day, in batches, weekly Once an electronic claim has been sent to NHS BSA Prescription Services, it cannot be amended or cancelled

36 End of month Processes One FP34C form must be completed and submitted to the NHS BSA Prescription Services to cover both paper and electronic prescriptions The NHSBSA has a new ask us facility on their website in the EPS section Understand month end process in relation to tokens Signed tokens need to be separated from the FP10 paper prescriptions at the end of each month and sent to the NHS BSA Prescription Services Age exempt patient tokens to confidential waste

37 Business Continuity

38 Business continuity and troubleshooting Ensure local processes are in place to continue dispensing process if EPS becomes unavailable either nationally or locally How are you going to work if: A patient s prescription does not arrive at the dispenser site straight away? GP system is unavailable? Dispenser system is unavailable? EPS is unavailable nationally?

39 Business continuity and troubleshooting Surgery to pharmacy / pharmacy to surgery contact Know who to contact for hardware support Know who to contact for software support Sign up for alerts: Prescription Tracker: NEW Smartcard status:

40 Raising support calls Ensure you know how to log calls to your supplier and know their escalation procedures GP: ex_html Pharmacy: Escalation procedures should be obtained from your supplier. It is important to: Keep a log of calls made, ref numbers and time to resolve Follow up and escalation

41 Training and Support

42 Training and Support Plan training in advance of going live or in pharmacy case before your local GP practice goes live Consider the best time to undertake EPS training Consider what kind of training will work best in the GP practice/pharmacy

43 Patient Communication

44 Patient communication Patients should be fully informed: 1. Nomination is not mandatory 2. No need to collect paper prescription from the GP practice 3. Patient can choose where they wish to nominate 4. Nomination is flexible and can be changed or removed by their GP or any EPS2 pharmacy 5. Not restricted to nominating a pharmacy close to the GP practice

45 Planned implementation dates and next steps

46 Go Live support GP System supplier training on site, on live system. Noting NHS number and nominated pharmacy of EPS R2 prescriptions Follow prescription to pharmacy Help identify and resolve issues

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50 factsheets

51 Stay connected Like EPSnhs EPSnhs channel

52 Bulletin

53 Questions?

54 Meds Management Housekeeping Non-DM+D Drugs - switch to DM+D mapped alternative Synchronise drug quantities in line with practice repeat protocol: 28 days / 56 / 84? Synchronise authorised issues/review date Update practice repeat prescribing protocol to take into account EPS R2 Personal Demographics Service (PDS) matches patient record