Preparing for EPS2 in your
GP practice and pharmacy
Engagement Meeting
Becky Gayler
Informatics Project Manager
Today we will be covering
1. Overview of EPS Release 2
2. Benefits
3. Feedback from Early Adopters
4. GP and Dispenser readiness
5. Steps to go-live
6. Where to get information?
7. 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
repeat
dispensing
Electronic
Signatures
Electronic
cancellation
Nomination
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
Prescribing Token
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-thescope-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
Patients
Reduced waiting times in the pharmacy
Prescribers/
Prescription Clerks
Potential reduction in workload.
Easier to use repeat dispensing
Greater efficiency and control .
Greater efficiency
Streamlined workflow
Easier month end processing
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 troubleshoorting.
• Always report issues to systems suppliers ASAP.
Go-Live Dates
PRACTICE
Usage end June
Go-live date
2014
Sackville Road Surgery 22/05/2014
50%
Ardingly Court Surgery 04/06/2014
10%
Stanford Medical Centre 05/06/2014
24%
Provisional dates:
Pavilion Surgery
22/10/2014
Warmdene Surgery
Regency Surgery
23/10/2014
24/10/2014
Ship Street Surgery
27/10/2014
Portslade Health Centre 03/11/2014
Prescribing
and
Dispensing
Site
Readiness
Processes for Prescribers
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



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
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.
Processes for pharmacy staff
Dispensers - Site preparation
Capture patient nominations.
Scan Release 1 scripts
Patient details on local PMR
Order dispensing tokens
Printing capability (2 tray for tokens)
Supplies: printer toner / dispensing tokens
System training
SOPs
Smartcards
nd
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
Business Continuity
What if ….
• A patient’s prescription
does not arrive at the
correct dispenser site?
• GP reports their
system is unavailable?
• Dispenser system is
unavailable?
• EPS is unavailable
nationally?
Communicate and Check….
Patient
• Right pharmacy?
• Right time?
• Check
nomination
• Return to spine.
GP
Practice
• Script signed and
sent?
• Check “EPS
Prescription
Tracker”.
Pharmacy
• Spine / Internet
down?
• Local system?
• Smartcard
working?
IT
Supplier
• Report all
problems
Prescription Tracker
NHS
Number
look up
from end
August
Training and
Support
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
Patient communication
How will you communicate EPS to patients?
Patients should be informed about nomination:
1.
Nomination is not mandatory
2.
No need to collect paper prescription from the GP practice
3.
Patient can choose who 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 their GP
practice.
What tools / resources will you use?
 Pharmacy to customers
 Surgery to patients
Planned
implementation
dates and next
steps
Standard Deployment Model
Communications and Engagement
At least 8 weeks notice for pharmacies, Nominations and
Patient information, GP Practice based “Kick-Off” meetings
Business Process Change, Training, Technical
Workshops, Checklists, System Training, SOPs, Smartcards,
Medicines Management "housekeeping”, IT checks
Go-live
Support and trouble-shooting
Post go-live
Benefits evaluation, develop good practice
and lessons learned,
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?
www.hscic.gov.uk/epsgp
www.hscic.gov.uk/epsmap
factsheets
CCG EPS Web-page
http://www.brightonandhoveccg.nhs.uk/staff/planning-anddelivery/information-and-technology/programme-of-work/electronicprescription
Stay connected
Like EPSnhs
Follow @EPSnhs
EPSnhs channel
www.hscic.gov.uk/epssignup
Questions?