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Preparing for EPS2 in your GP practice and pharmacy Engagement Meeting Becky Gayler Informatics Project Manager. Today we will be covering. Overview of EPS Release 2 Benefits Feedback from Early Adopters GP and Dispenser readiness Steps to go-live Where to get information?
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Preparing for EPS2 in your GP practice and pharmacyEngagement MeetingBecky GaylerInformatics Project Manager
Today we will be covering • Overview of EPS Release 2 • Benefits • Feedback from Early Adopters • GP and Dispenser readiness • Steps to go-live • Where to get information? • Question & Answers
Overview of EPS Release 2
Prescriptions - the need for change • 1.7 million paper prescriptions are issued every working day in England • This figure is expected to rise by over 5% each year • About 70% of these prescriptions are for repeat medication
Release 2 Overview Electronic submission of reimbursement endorsements Electronic Signatures Nomination Electronic cancellation Electronic repeat dispensing
Key Points • GPs and other prescribing staff will sign prescriptions electronically using their Smartcard and PIN • Patients will be able to “nominate” a dispensing contractor to receive their electronic prescriptions automatically • This will enable GPs to send electronic prescriptions to nominated dispensing contractors without the need for paper • Patients who do not want to nominate a dispensing contractor will continue to receive a paper prescription • Supports: acute, repeat and repeat dispensing models
Additional Points • Authorised staff working in the GP practice where the electronic prescription was generated can cancel it at any point up until it is dispensed • Repeat dispensing can be administered electronically, alleviating the need for multiple paper batch issues to be printed (only a single prescription token is printed) • Prescription tokens can be issued for nominated electronic prescriptions if required
Cannot use EPS: Prescribing will not be possible for the following patients: • patients who are not synchronised with PDS. • patients who are marked as “sensitive” on PDS. The following medication is not eligible : • Controlled drugs from schedule 1, schedule 2 and 3 (unless this has been enabled in the system). Please participate in EPS Consultation https://www.gov.uk/government/consultations/extending-the-scope-of-the-electronic-prescription-service • Private prescriptions, unless this has been enabled in the system. • Drugs without a dm+d code mapping. • Drugs without a dm+d description and unit. • Prescriptions without a nomination - coming in Phase 3.
Key Benefits • Greater convenience • Increased freedom of choice • Reduced waiting times in the pharmacy • Potential reduction in workload. • Easier to use repeat dispensing • Greater efficiency and control . • Greater efficiency • Streamlined workflow • Easier month end processing Patients Prescribers/ Prescription Clerks Dispensers
Latest Statistics – August 2014 • GP Practices 31% 2,493 / 8,049 • Pharmacies 95% 11,159 /11,724 • Disp. Appl. Con. 66% 74 /113 • Live Site Usage 37% Average • Patient Nominations 9.4 million
Feedback from Early Adopters GPs • Has made the process of prescribing in house much simpler. • Very good for emergency scripts and telephone consultations • No faxing emergency scripts; less lost scripts; easier to manage repeat prescribing; freed up time in the office; much less printing and signing and paper in your pigeonhole; easier to do medication reviews as in the record already • “I think its bl**dy brilliant! Easy as pie, you can see the patients notes during the process and if any pop ups also can remind patients if need to come in for reviews etc. • “I think the concept of it actually being in the notes is great” Pharmacies • Overall positive change - “Not as bad as feared” • Makes a big difference with pharmacy end of month • Can access scripts on Saturdays / early mornings when GP not available / too busy
Lessons Learned • Business Process change workshops are crucial: • work out what you’re going to do if script doesn’t arrive e.g. will fax tokens be allowed. • how to manage 7 days scripts • alerts for urgent scripts • EPS GP practice lead role important to co-ordinate preparation and communicate with pharmacies. • Nominations; the more the better, GPs can collect too. • Time spent on GP house-keeping before go-live will ensure smoother transition. • Pharmacy staff need to be trained, smartcard ready and printers set up in advance to go-live • Project team effort on go-live day is required mainly to support support Pharmacies - also need point of contact for trouble-shoorting. • Always report issues to systems suppliers ASAP.
GP Practice Checklist • Confirm that local pharmacies are live with EPS 2 / have been informed at least 8 weeks before go-live • Area Team have Authorised EPS application • All staff have smartcards with correct role based access controls. • Business process change session is scheduled to consider current processes and how they will change in EPS Release 2 • Agree how you will handle nominations. • Consider your approach to patient communications. • Ensure you are using the most up to date drug dictionary. • Know who to contact in the event of a problem. • Know how to use your clinical system • Nominate a EPS Practice Lead
EPS Practice Lead • Point of contact for CCG and Pharmacies • Ensure Business Change Checklist completed and returned prior to go-live • Co-ordinate arrangements for go-live day • Post go-live trouble-shoot and escalate issues.
Key processes to consider before go live at the GP practice • Approach to capturing nominations • Benefits and how to measure • Preparing a repeat prescription • Signing electronic prescriptions • Electronic repeat dispensing • Split prescriptions • Electronic Cancellation
Approach to capturing nominations http://systems.hscic.gov.uk/eps/library/nomination.pdf • Will the practice proactively capture nominations? How far in advance? • Will the practice target specific patients? e.g. Nursing Homes, Collection Service • What will the practice do if a patient asks about EPS and nomination? • Update registration procedure? • What literature will the practice use to support patient communication? • Ensure ALL patients PDS details are synchronised.
Dispensers - Site preparation • Capture patient nominations. • Scan Release 1 scripts • Patient details on local PMR • Order dispensing tokens • Printing capability (2nd tray for tokens) • Supplies: printer toner / dispensing tokens • System training • SOPs • Smartcards
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
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?
Business Continuity
Prescription Tracker NHS Number look up from end August
Training and Support • Concept training • New processes • System training • Best time to undertake EPS training? • What kind of training will work best in the GP practice/pharmacy? • Post go-live – what sort of training and support will be needed? • Locums / temporary staff?
Patient communication • How will you communicate EPS to patients? • Patients should be informed about nomination: • Nomination is not mandatory • No need to collect paper prescription from the GP practice • Patient can choose who they wish to nominate • Nomination is flexible and can be changed or removed by their GP or any EPS2 pharmacy • Not restricted to nominating a pharmacy close to their GP practice. • What tools / resources will you use? • Pharmacy to customers • Surgery to patients
Go Live support • Project team at site • Note NHS number and nominated pharmacy of EPS R2 prescriptions • Follow prescription to pharmacy • Help identify and resolve issues
Key Considerations • Sufficient nominations? • Key pharmacies live or able to go live? • Smartcards issued and working? • Patients have been informed?
Next Steps • Confirm Go-live / Training date • Agree Business Change Workshop date • Patient communications? PPG? • Materials needed? • Smartcards? • Further information? • Leads / Contacts?
CCG EPS Web-page http://www.brightonandhoveccg.nhs.uk/staff/planning-and-delivery/information-and-technology/programme-of-work/electronic-prescription
Stay connected Like EPSnhs Follow @EPSnhs EPSnhs channel www.hscic.gov.uk/epssignup