Electronic Prescription Service (EPS) Gary Mortimer, Senior Implementation Manager

EPS EPS Update Benefits of EPS EPS moving forward Questions? electronic Repeat Dispensing (eRD) EPS tracker EPS moving forward Developments / enhancements EPS Phase 4 Questions?

EPS Update - National

EPS Update North Hampshire CCG (Aug 16)

EPS Benefits

EPS Benefits (£)

Release 2 Overview Electronic submission of reimbursement endorsements Signatures Nomination Electronic repeat dispensing Electronic cancellation Electronic Signatures One of the fundamental changes between Release 1 and Release 2 of the EPS is the ability for prescribers to apply electronic signatures to prescription messages. These electronic signatures are unique to individual users and are applied using their Smartcard and passcode. The application of an electronic signature makes the prescription message ‘the legal entity’. Nomination Nomination is the process that gives patients the option to choose, or ‘nominate’ a dispensing contractor(s) to which their electronic prescription(s) can be sent automatically, using the Electronic Prescription Service. Electronic Cancellation Prescribers (or other authorised staff working in the GP practice where the prescription was generated) are able to cancel electronic prescriptions at any point up until they are downloaded at the pharmacy. When an electronic prescription is cancelled, a reason for the cancellation must be given. A message is then sent to the Electronic Prescription Service. Electronic Repeat Dispensing (aka batch scripts) Electronic repeat dispensing is possible from a single electronic prescription, it does not require multiple paper issues to be printed. The first prescription is available straight away at the pharmacy and then each subsequent repeat will be made available to download seven days in advance Electronic Submission of reimbursement endorsements To support the reimbursement claim process, Release 2 of the EPS allows dispensing contractors to electronically submit endorsement messages to the reimbursement agency for dispensed electronic prescriptions.

Repeat Dispensing “batch prescribing” Prescribe a batch of EPS prescriptions in one go for patients with repeat medication, for up to 12 months NHS Community Pharmacy Contractual Framework essential service Pharmacy responsible for carrying out checks with patient before dispensing each issue ERD slides DF Jan 2016

Why use repeat dispensing? Two thirds of prescriptions issued are for repeat prescriptions. These prescriptions account for almost 80% of NHS medicine costs. The time involved in processing them is significant. There are over 400 million repeat prescriptions generated every year (Average 200 per GP per week). DH 2002 study 2.7 Million GP hours could be saved AHSN Slides: 77% of all items are repeats. This is 410 million repeat prescriptions – equivalent to an average of 200 per GP per week. The average number of items per person per year is now 19. DH showed in 2002, that if 80% of all repeats were given as RD 2.7 million GP hours would be saved. For Wessex, this means that if we got to 80% of all repeats, we would save 108,000 GP hours Which is roughly 61 WTE GPs

Electronic Repeat Dispensing - Benefits Reduction in monthly repeat requests, issuing, signing, collection, Emergency / Urgent prescriptions Patient convenience – just collect from pharmacy No piles of paper FP10s/RA forms Greater control and flexibility with EPS safeguards, tracking, and cancellation Pharmacy workflow and Stock control ERD slides DF Jan 2016

How does it work with EPS?

Issue 1 Issue 2 Cont…. Last Issue Day 21 Day 49 Day 1 Day 28 Day 56 Pharmacy second issue is downloaded automatically and has 7 days to prepare before due date. Pharmacy third issue is downloaded automatically and has 7 days to prepare before due date. Pharmacy last batch is dispensed. Informs patient this is the last issue Last Issue Day 21 Day 49 Issue 1 Issue 2 Cont…. Day 1 Day 28 Day 56 Last Issue GP signs eRD prescription and uploads to Spine. Patient collects second issue. Patient collects third issue. Patient Collects last issue and contacts GP Pharmacy downloads and prepares medication. Pharmacy Sends dispense notification. Pharmacy Sends dispense notification. GP conducts review if required and issues next eRD prescription. Patient collects The prescriber can track the progress of the prescription using the Prescription Tracker and can cancel items at any point during the regime. Pharmacy Sends dispense notification.

North Hampshire CCG – eRD usage (Aug 2016)

Resources and activities NHS England eRD Guidance http://www.england.nhs.uk/ourwork/tsd/sst/erd-guidance CPPE e-learning has been updated www.cppe.ac.uk https://www.cppe.ac.uk/programmes/l/repeat-e-01/ Academic Health Science Network (AHSN) eRD pilots in West Hampshire CCG - Learning NHS Digital eRD toolkit to be launched 3rd October 2016 eLearning (GP system specific) Strategy templates (GP an CCG) Benefits calculator

EPS Prescription Tracker Search using Prescription ID NHS Number My Site Add to Favourites www.hscic.gov.uk/eps/tracker

Prescription and Dispensing Details Norwich eRD workshop handouts

Future EPS developments

EPS Enhancements Controlled drugs (schedule 2, 3) Areas for development: Enhancement of repeat dispensing functionality More comprehensive dm+d drug mapping / adherence Eliminate the need for paper dispensing tokens Multiple nominations for patients Self-service access for patients, view, add, change or remove their nomination Ability for patients to manage their own medication via a mobile device (e.g. electronic tokens, prescription re-ordering, booking of appointments) Sharing of prescribing /dispensing information with Summary Care Record. Improvements to the management of larger prescriptions (more than four items) ‘Push’ delivery of prescriptions EPS in other health care settings Open API for prescription tracker

EPS Release 2 – Phase 4 The next phase of EPS will make it possible for all primary care prescriptions to use EPS and not just those where a patient has nominated a specific dispenser to receive their EPS prescriptions. In the future, if a patient hasn’t chosen to nominate, then they will be able to collect their electronic prescription from any dispenser. Patients will still be able to nominate a dispenser if they decide that’s most convenient for them. Read the slide

EPS Phase 4 - Pilots 16 Pilot sites across the country. Start dates TBC. 14 weeks then post evaluation to feed future National deployment stratagies. Will include High / low utilisers and all prescribing systems

Any Questions?