EPS in Practice Manpreet Pujara GP National Clinical Lead & Clinical Director EPS

The size of the problem

926.7 million prescription items in 2010 an increase of 4.6% (40.7 million items) on 2009 and 67.9% on  1.5 billion by million per day 73 per day/GP 293 per week/GP 1 Prescriptions Dispensed in the Community: England Statistics for Information Centre

Repeat prescribing workload

Electronic signatures Electronic repeat dispensing Electronic cancellation Nomination Electronic submission of reimbursement endorsements Why upgrade - EPS functionality

What’s in it for me & my practice? Makes me efficient! Less printing, less noise & more time to talk! More efficient prescribing/signing Electronic repeat dispensing Less wastage Write a message for patient and/or pharmacist Make more use of telephone consultations Electronic cancellation means more control of medication regime

What’s in it for me & my practice? No need to sort and file prescriptions Less traffic at the main desk Fewer phone calls from patients asking for meds Cannot lose the prescription – you know where it is No hanging around outside consulting rooms for a signature/lost prescription No sticky notes! Cost saving, printing, phone calls, less wasted time Better clinical safety

So what do I need to do? To maximise the benefits of using EPS you must review and change your business processes

Routine repeat request – Practice 1 1. Reception issues one of repeat regime e.g. 3 of 6 2. Paper FP10 printed 3. FP10’s divided between GPs 4. FP10s put into GP’s pigeon holes 5. GPs collect from pigeon holes 6. GPs checks and signs after surgery 7. GP takes signed FP10s back to reception

Routine repeat request – Practice 2

Routine repeat request with EMIS Web & EPS Release 2

So what do I need to do? Review your current repeat request process Prescription duration 28 or 56 days Single review date or number of issues? Are review dates set as a default 6 or 12 months or dependent on clinical review? Synchronising issues/drugs Do you use compliance figures or date of last issue? Do you post date prescriptions?

So what do I need to do? ( Review your current repeat request process) Do you use paper repeat dispensing? Who signs the prescriptions & when? Decide if you will print token for co-located pharmacies Training Engage – with patients Communicate with your local pharmacists – nominations are the key to a successful deployment

Practice decisions - streamlining Choosing the GP for EPS signing e.g. buddy system when one on holiday GPs signing prescriptions between patients Ensuring all outstanding prescriptions are signed by duty doctor at the end of the day GPs consider amending items in patient record as requests come in Consideration of different ways of notifying GP of immediate acute/repeat request for action Benefits of using instant messaging

What’s EPS like in Web? Safety warnings Compliance figures Nomination Cannot always change urgency on the fly Cannot write a reason when rejecting a prescription – so no one knows why? Notes to patient/Pharmacy not recorded/visible in the electronic record

Compliance figures

Adding a message for patient or pharmacist

Nomination

Cancel an item in task screen

EPS Release 2 statistics 291 6, ,763 3,298,925 patient nominations items dispensed and claimed GP practices live pharmacies live dispensing appliance contractors live

Supplier status Dispensing systems 6 dispensing systems have achieved FRA (full roll out approval ) 2 dispensing systems yet to achieve FRA Prescribing systems 4 prescribing systems have achieved FRA 1 prescribing system yet to achieve FRA All Isle of Wight GP and dispensing sites live All dispensers in Bexley live cfh.nhs.uk/epsstats

Process for EPS Authorisation Directions restart 33 PCTs gain SoS Directions Second closing date for applications: 21 September

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