Preparing for EPS2 in your
Pharmacy
Business Process Change
Meeting
Becky Gayler
CCG Informatics Project Manager
Overview of
EPS
Release 2
Release 2 Overview
Electronic
submission of
reimbursement
endorsements
Electronic
repeat
dispensing
Electronic
Signatures
Electronic
cancellation
Nomination
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
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
Planned EPS2 GP Practices go-lives
• Early Adopter Phase:
– Sackville Road Hove
22/5/14
– Ardingly Court Brighton
04/6/14
– Stanford Medical Centre Brighton
05/6/14
• EMIS Web
Sept / Oct 2014
• TPP SystmOne
Nov / Dec / Jan 2014
• Vision
March / April 2015
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.
• Controlled drugs from schedule 2 and 3 unless this has been
enabled in the system.
• 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 in Phase 3.
Processes for pharmacy staff
Dispensers - Site preparation
Capture patient nominations.
Release 1 usage – PDS synchronisation
Order dispensing tokens
Printing capability (2 tray for tokens)
Supplies: printer toner / dispensing tokens
System training
SOPs
Smartcards
nd
Smartcards
Everyone who dispense prescriptions and / or process patient nomination
requests will need a smartcard:
• Pharmacists and locum pharmacists
• Accredited dispensing technicians
• Counter assistants and pharmacy support staff
Area Team are arranging for new smartcards to be issued.
For existing smartcard users contact Sussex IT Services 0845 845 4488
EPS Release 2 has three access levels:
• Process patient nomination requests
• Prescription receipt, dispensing, labelling and issue of medication
• Prescription endorsing and reimbursement processes
Many users, including probably all pharmacists, will be granted all 3.
Special arrangements have been made for locum pharmacy staff to use a
virtual national locum organisation code – FFFFF.
Check your card is working
Certificates expire every 2 years, you will be given 30 days notice to renew.
How to renew your Smartcard certificates:
1. At the renewal prompt click Yes.
2. You are taken to the Self Service Portal.
3. Click the Renew Certificates tab.
4. You are presented with Update My Card workflow.
5. Enter your Smartcard Passcode, to confirm your identity and the first
certificate update.
6. Click OK.
7. Creating Card and Writing Certificates warnings appear one after another. A
message indicates that the certificates have been renewed and the Smartcard
has been updated successfully.
8. Click Continue to confirm the update.
9. Close the browser and authenticate again as normal.
You can check your certificates at:
http://nww.hscic.gov.uk/eps/cardexaminer
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?
Dispensing and downloading
electronic prescriptions
• Consider process for requesting prescriptions
(frequency/responsibility)
– Overnight download
– Requesting throughout the day
• When will you send dispense notifications?
• Clinical information from the prescriber needs to be
communicated to the patient – how will you do this?
Dispensing tokens
• Ensure dispensing token stationery has been received
• Use of dispensing token for:
– capturing signatures for payment/exemption declaration
– giving to a patient who needs to go to a different
pharmacy to collect their medication
– aiding with dispensing process
Electronic cancellation
• Ensure all staff are aware of electronic cancellation
• What do cancelled prescriptions look like in the system?
• Consider a local process for returning prescriptions to
the spine if a GP practice advises they wish to cancel a
prescription after it had been downloaded in the
pharmacy
Electronic endorsements and
patient declarations
• Ensure all staff are aware of capturing patient declarations
and ensure they are recorded on the system
• Capture patient signatures on the reverse of dispensing
tokens
• Electronic prescriptions must be electronically endorsed.
Paper prescriptions must be endorsed and submitted in the
usual way
• Do not handwrite endorsements on a dispensing token, these
will not be used for pricing
• Ensure electronic exemptions are correct before sending
Electronic claims
• All electronic prescriptions must be claimed for electronically
• An electronic claim can only be sent once the prescription has
been completed; items should be marked as either ‘dispensed’
or ‘not dispensed’
• Consider when you will be submitting electronic claims
 on patient collection, end of day, in batches, weekly
• Once an electronic claim has been sent to NHS BSA
Prescription Services, it cannot be amended or cancelled
End of month Processes
• One FP34C form must be completed and submitted to
the NHS BSA Prescription Services to cover both paper
and electronic prescriptions
• Understand month end process in relation to tokens
 Signed tokens need to be separated from the FP10
paper prescriptions at the end of each month and
sent to the NHS BSA Prescription Services
 Age exempt patient tokens
Business
Continuity
Business continuity and troubleshooting
• Ensure local processes are in place to continue
dispensing process if EPS becomes unavailable either
nationally or locally
• How are you going to work if:
– A patient’s prescription does not arrive at the
dispenser site straight away?
– GP reports their system is unavailable?
– Dispenser system is unavailable?
– EPS is unavailable nationally?
Business continuity and troubleshooting
• Surgery to pharmacy / pharmacy to surgery
contact
• Know who to contact for hardware support
• Know who to contact for software support
Sign up for alerts:
http://nww.hscic.gov.uk/servicemanagement/status/subscribe
• Prescription Tracker
http://epstracker.cfh.nhs.uk/check.php
Prescription Tracker
Log it!
Local helpdesks (system supplier) will provide first level issue diagnosis, resolution and
support, and will be able to establish whether the incident is:
• a local issue (local network failure, prescribing or dispensing system failure)
• a national issue (central Electronic Prescription Service failure, national
network failure).
Your local helpdesk should also be able to identify which component of
the Electronic Prescription Service is affected by the technical failure. These
components include:
• local GP clinical system
• local dispensing system
• Smartcard
• prescription token printer
• dispensing token printer
• network connectivity
• national system.
Your local helpdesk will be responsible for any escalation process.
Remember to always obtain and keep and reference log number as this will be required to
escalate the issue.
Factors to Consider
The health care professional should use their professional judgement and base a
decision, as to the most appropriate action to be taken, on the information
available at the time. Important factors to consider are:
• What stage of the business process the failure has occurred.
• The estimated time needed to resolve the issue - some technical failures
will take longer to resolve than others. For instance, a printer failure due
to lack of toner can be resolved quickly, whereas a local or national
network connection may take longer to resolve.
The clinical need of the patient
In some cases there may be an urgent need for the patient to receive
the prescription items. There are a number of options to consider,
including those listed below. In some scenarios, one or more different
actions may be appropriate:
•
•
•
•
•
Contacting the prescriber to obtain a paper FP10 prescription
Using the emergency supply arrangements
Advising the patient to return to the dispensary at an
alternative time
Advising the patient to use an alternative dispensing site
Capturing data on paper to be inputted at a later time.
Smart Cards
If your smartcard is not working you will not
be able to access the spine!
The following scenarios give you some
solutions to smartcard failures.
Scenario 1.
What would I do if my smartcard is
faulty?
• Option 1:
Check it is the card and not the reader that is faulty by trying
your card in another machine.
• Option 2:
Contact Sussex IT Services on 0845 845 4488 and log a call
for the attention RA department
• Consider any issues which may result in a damaged card
reader, and make suitable changes to current practices within
the dispensary. Ensure liquids are kept away from keyboards,
Smartcard readers and other equipment
Scenario 2.
What would you do If your card is
lost or stolen?
• Option 1:
Contact Sussex IT Services to report the missing card 0845
845 4488 (9.00 to 17.00 Monday to Friday excluding bank
holidays).
• Option 2:
Ask a colleague to use their smartcards to download EPS
prescriptions or set nominations. (It is good practice to
ensure, where possible, that at least two staff on duty have
working smartcards.)
• Option 3:
Follow your local Business Continuity plan
The following scenarios are based on the
local clinical system being down or the
server has failed
Scenario 3: I can’t download or
access electronic prescription(s) ?
•
•
•
•
•
Option 1: Ask patient to return to prescriber to obtain paper
FP10 prescription
Option 2: Contact GP practice to advise of failure and ask
them to produce hand signed paper prescriptions
Option 3: Advise patient to use an alternative EPS Release 2 enabled
dispensing contractor. (The patient will be able to set their nomination
at the alternative site to divert the script to this site.)
Option 4: If urgent and appropriate, issue an emergency
supply
Option 5: Advise patient to return at a later time
Remember! You need to consider factors such as clinical need of the patient,
the time it will take to resolve the problem and the communications required
Scenario 4: I Can’t Set, Change or
Cancel Nomination!
• Option 1:
Provide information to patient, capture data and update
at a later time (informing the patient that the nomination
may not be recorded within the usual timeframe)
• Option 2:
Ask patient to set the nomination at any other EPS
Release 2 enabled dispensing site
Raising support calls
Ensure you know how to log calls to your supplier and know
their escalation procedures
GP:
http://systems.hscic.gov.uk/gpsoc/performance/liveservice/ind
ex_html
Pharmacy: Escalation procedures should be obtained from
your supplier. It is important to:
– Keep a log of calls made, ref numbers and time to resolve
– Follow up and escalation
Training and
Support
Training and Support
•
•
•
•
•
Concept training
New processes
System training
Best time to undertake EPS training?
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
www.hscic.gov.uk/epsgp
www.hscic.gov.uk/epsmap
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