Let's talk EPS - Barnet PCT Hub

Let's talk EPS - Barnet PCT Hub

Lets talk EPS Developing the best way forward for practices and pharmacy to maximise EPS Agenda

Objectives Introduction to the NHSBSA Primary Care Services Icebreaker EPS and benefits NHSBSA offering Where are we now? Barnet CCG

Group Session 1 All things EPS (tokens, claiming, RBs, Tracker, Cancellations) Patient Engagement Group Session 2 BREAK eRD Group Session 3 Useful tips Phase 4 Group Session 4 Close Objectives Developing the best way forward for practices and pharmacy to maximise EPS

Develop and agree a way forward which improves patient experience with EPS and eRD Discuss the challenges related to EPS and eRD Discuss the benefits of EPS and eRD and how we can help to maximise usage An Introduction to NHSBSA Primary Care Services

ICEBREAKER! Has your EPS % improved? The Electronic Prescription Service The Electronic Prescription Service (EPS) creates savings by making prescribing and dispensing processes more efficient while improving patient care. EPS currently accounts for 70% of all primary care prescribing*, which has already created significant benefits across the NHS. If the level of EPS use reached its full potential (currently 91%), the associated benefits would be huge. *as of June 2019

Benefits for prescribers, patients and the wider NHS Benefits for prescribers, patients and the wider NHS Benefits for prescribers, patients and the wider NHS Benefits for Dispensers Automated downloads, making prescription processing more efficient Less time spent on administration and collecting prescriptions, which means

more time for helping customers Improved stock control and greater accuracy A prescription collection service no longer required between pharmacy and practices Benefits for Dispensers Improved patient satisfaction through reduced waiting times

Increased accuracy, meaning fewer prescription queries Less sorting and less paper to send to NHS Prescription Services NHSBSA Offering We are working in collaboration with NHS Digital and are committed to supporting CCGs, practices, pharmacies and other NHS organisations in maximising their EPS use, delivering the best possible service to patients.

To help us understand the support required, we work on an individual basis with practices, maintaining a close working relationship throughout the EPS process. We can offer a range of reports and other resources to help your organisation at each stage of the journey towards making the most of EPS. We have developed an EPS Prescribing Dashboard which offers key metrics on EPS use, electronic repeat dispensing volumes and EPS opportunity items. Where are we now Barnet CCG EPS

Nominations 60% 49% 50% 39% 40% 30% 20% 10% 0%

National Barnet 70.7 70.65 70.6 70.55 70.5 70.45 70.4 70.35 70.3 70.44%

National eRD Barnet Opportunity Items 25 460000 19.20% 20

15 70.64% 449038 450000 440000 10.17% 430000 10 420000

5 417505 410000 0 National Barnet 400000 National Barnet

Group Session 1 Have a discussion about the problems you currently experience with EPS- can anyone come up with a solution? How we process prescriptions In 2007 we redesigned our systems to ensure that we would be able to accept electronic prescriptions We use scanners and intelligent character recognition software (ICR) to read a lot of the information on paper prescriptions we need to calculate payments.

We follow the rules set out in the NHS England and Wales Drug Tariff for both paper and EPS forms Electronic prescriptions and tokens Tokens are scanned for exemption purposes, there is no need to submit tokens that are automatically age exempt. We use the exemption / charge paid status that you have submitted in your claim message Ensure all patient information regarding exemption or charge paid is set up

in your system before you send the Dispense Notification when the patient collects their medication - some systems default to chargeable status Electronic claiming EPS v Paper returns Only around 0.05% of all EPS items are referred back to contractors compared to around 0.17% of paper items The majority of returns are due to missing packs, prices and suppliers

As items prescribed via EPS must match the DM+D listing, this also avoids the return of a lot of appliances and handwritten items Access to EPS Prescription Tracker Ensure you can access the Prescription Tracker. Provides a detailed prescription event history

Some pharmacy systems have the internet blocked but access is obtained through intranet - check with your IT helpdesk https://portal2.national.ncrs.nhs.uk/prescriptionsadmin Content created by NHSDigital Repeat Dispensing and the Prescription Tracker All issues have the same Prescription ID EPS Prescription Tracker

shows each issue individually You can manually pull down next issue once previous issue collected. Copy/paste or [show barcode] Content created by NHSDigital Cancellation (Spine) Content created by Ali Shariff @ NHSDigital

Cancellation Guidance http://webarchive.nationalarchives.gov.uk/20160921135209/http://systems.digital.nhs.uk/eps/library/0212.pdf Cancellations A 'prescription cancelled successfully' response confirming that the prescription has been cancelled A 'cancellation unsuccessful with dispenser' response, confirming that the patient's nominated pharmacy has already downloaded the prescription from the NHS Spine

A 'cancellation unsuccessful dispensed' response, confirming that the prescription has already been dispensed to the patient Content created by NHSDigital Increasing EPS and eRD usage Patient engagement Many patients not using EPS may not be convinced by the benefits to themselves

The NHSBSA has developed content specifically to engage these patients looking more at the impact to the wider NHS This content is available for use: As a slide show Text messaging content We also have other resources to help engage pharmacy and identify suitable patients for EPS

TOP TIP: Search for patients on repeats and send them this content via SMS (iPLATO /MJog ) to inform them of the EPS service Nominations EPS still relies on patient choice through nomination. Patients must be fully informed about EPS before the nomination can be set on the system.

Nomination consent doesn't have to be in writing, but you do need to have an auditable process. TOP TIPS: Set monthly nomination targets Incorporate a section on recording patient consent for EPS nominations in New Patient Registration Processes. Set up alerts to remind GPs to speak to non-nominated patients during consultations Encourage local pharmacy to nominate prescription collection service patients Promote EPS and acquire nomination information on recall letters Promote EPS to all patients using online access Group Discussion 2

Patient Engagement- how can we work together to give the patient the best experience? Electronic Repeat Dispensing (eRD) Up to 410 million repeat prescriptions are generated every year, which is equivalent to an average of more than 375 per GP, per week. Two thirds of prescriptions issued in primary care are repeat prescriptions This accounts for 80% of NHS medicine costs for primary care.

Introduce eRD NHSBSA data To support GP practices we can provide NHS numbers for patients who are potentially suitable for eRD. This data shows stable patients who have had no change in their medication in at least 10 of the last 12 months Information governance protocols need to be observed to receive the data

To request this information, please visit www.nhsbsa.nhs.uk/eRD Practices receiving our data in 2017/18 increased their eRD over 3% more than similar practices who did not get our data That equates to a minimum of 5 hours GP time saved each month! Introduce eRD Patient information NHSBSA patient flyer GP practices, Dentists, Opticians and Pharmacies

can order through the following link www.pcse.england.nhs.uk Trusts, CCGs, Local Authorities etc. can order here www.nhsforms.co.uk Work with PPGs Patient presentations Pharmacies & eRD

Contractual obligation to ask 4 questions on eRD: Have you seen any Health Professional since your last repeat was supplied? Have you recently started taking any new medicines either on prescription or that you have bought over the counter? Have you been having any problems with your medication or experiencing any side effects? Are there any items on your repeat prescription that you dont need this month? Identify potentially suitable patients

Greater Manchester LPC conducted a project which used pharmacy to support eRD getting started EPS and eRD utilisation Communication is key between practice and pharmacy which is why we are arranging workshops such as this to facilitate communication The prescription tracker is a key component of EPS as electronic prescriptions cant get lost

Promote to patients using BSA messaging, if we do not hold materials suitable for your needs we may be able to build specific packages Identify patients potentially suitable for eRD We are also working closely with system suppliers for Pharmacy software Group Discussion 3

eRD- how can we work together to enhance utilisation? Increasing EPS and eRD use Other useful tips Correct and consistent smartcard use Ensure no PDS mismatches Staff training both existing and new staff

Regularly monitoring stats Use searches regularly to identify suitable patients Use the EPS Tracker

Use EPS for Appliances with patient consent Phase 4 https://psnc.org.uk/dispensing-supply/eps Phase 4: Prescribers Currently, patients have to nominate a pharmacy in order to send scripts electronically, and non-nominated patients receive a paper FP10 After phase 4, a token will be printed rather than a paper FP10 for nonnominated patients EPS will therefore be a default method to send most of your scripts

KEY POINTS: There will be no downtime to enable phase 4 Full rollout is aimed for Summer this year. To reduce the impact this will have, try and increase your EPS usage as much as possible now by encouraging your patients to nominate If a token is lost, the GP practice will be able to re-print the token Content created by Ali Shariff @ NHSDigital

Patients on repeat prescriptions (i.e. they request their repeats) will be given a new token for each time a repeat prescription is issued, unless they are on eRD For patients mid way through a paper-based repeat dispensing regime when phase 4 is switched on, they will continue the batch on paper until the full batch has been issued and dispensed. Patients without a nomination will receive one repeat dispensing token for the entire regime, they can keep hold of this or leave it with their chosen pharmacy until the end of the batch Content created by Ali Shariff @ NHSDigital Phase 4: Dispensers Top Tips from PSNC:

If you receive a Phase 4 token, you should scan the barcode and dispense it as you would any other electronic prescription. Pharmacy teams can use the green Phase 4 prescription tokens to capture any patient exemption-related or charge-related signatures. Some pharmacy teams that process the Phase 4 token used a highlighter pen to highlight the Prescriber signature not required wording on the token, to highlight that it is a Phase 4 token rather than a barcoded paper prescription. Green Phase 4 tokens should be filed with all the other white EPS tokens and not within the main bundle of paper prescriptions before the submission

is sent to the NHSBSA. Consider your system and print settings. Many PMR systems have settings to customise which types of EPS prescriptions may automatically have a white EPS dispensing token printed. During the pilot, patients have sometimes filled in the back of the green Phase 4 token before they arrived at the pharmacy. If the pharmacy process involves shredding the green Phase 4 token and replacing it with a newly printed white dispensing token, the patient will have to complete the reverse of the dispensing token. To address this scenario, some pharmacy teams have changed their initial Phase 4 approach so that they use the green

Phase 4 token for patient declarations, rather than printing out a new white EPS dispensing token for each Phase 4 script. https://psnc.org.uk/our-news/eps-phase-4-pilot-update-and-top-tips-for-pharmacyteams/ Group Discussion 4 Commit to 3 actions Contact Us Email us at [email protected] Well contact you to discuss the support you need. We may already have resources that can help you, or we can work with you to develop a bespoke support package to help you achieve your targets. Wed also like to gather some examples of best practice to further develop the

support we can offer. Visit us at: www.nhsbsa.nhs.uk/EPS www.nhsbsa.nhs.uk/eRD www.nhsbsa.nhs.uk/EPSdashboard Also see: https://digital.nhs.uk/services/electronic-prescription-service Twitter: @NHSBSA

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