Electronic Repeat Dispensing (ERD)

1. Electronic Repeat Dispensing (ERD) Pre-launch information for both Emis Web and SystmOne practices Medicines Management Team V1.0 Review October 2018 Sovereign House, Heavens Walk, Doncaster DN4 5HZ Tel: 01302 566229 Email:- medicinesmanagement@doncasterccg.nhs.uk Acknowledgement to Raz Saleem, Prescribing Advisor, NHS Rotherham CCG 1

2. What is Electronic Repeat Dispensing (ERD) ? • ERD is the issuing of a predetermined ‘batch’ of prescriptions from a GP clinical system in one issue electronically. • The nominated community pharmacy can draw down each prescription from the system at the appropriate time ( usually every 28 days ) without ordering individually. 2

3. Considering Risks • Staff training • Adherance to process- ensure all staff can identify patients who are on ERD • Selection of patients • Ensure all staff understand the selection criteria • Communication to patients • Ensure that patients know the process and understand how to order their ‘PRN’ medication directly from the practice when needed, 3rd party ordering should not occur for ERD patients, unless the patient is considered vulnerable by the practice. • Housekeeping • Standardise quantities to 28 days, remove any medication not currently ordered • Communication with community pharmacies • ERD can be easily tracked 3

4. For GP’s Decreased workload Fewer prescriptions to sign Electronic signature is more efficient than signing prescriptions ERD can be set up during consultation Simple mechanism for pulling back prescriptions from the spine For Practice staff Fewer requests each month for repeat medication Less filing and ordering of prescriptions Patients / third party will not need to order and collect prescription every month from the practice Paperless process, no printing, filing storage Long term benefits to GP Practices 4

5. ERD can only be set up for patients who :- are considered stable and have had no changes made to their medication in the last 6 months have already nominated or wish to nominate a community pharmacy to receive electronic prescriptions who are not prescribed schedule 2/3 controlled drugs Patient Selection and obtaining consent Verbal consent should be obtained and added to the patient’s record using READ CODE 8BM1 (Emis Web) and XaJus (SystmOne TPP) The patient should be made aware that any ‘PRN’ medication should not be ordered by a 3rd party (e.g. community pharmacy) and they should order these items directly from the GP practice when needed. e.g. creams, antihistamines, GTN sprays, laxatives, or any item that is not taken regularly each day. 5

6. Examples of unsuitable patients • Patients with medical conditions that are unstable with frequent admissions to hospital and frequent changes to medication • Patients prescribed only acute medication e.g. oral contraception • Patients prescribed only ‘ when required’ medication e.g. GTN spray • Patients on a 7 day NOMAD/ MDS • Patients prescribed controlled drugs ( these patients are not currently able to nominate for electronic prescribing) 6

7. Next steps Once the practice has decided to go ahead the practice should :- • Arrange a second meeting with the Medicines Management Team to discuss the process of how to set up ERD on your clinical system 2.Invite all relevant practice staff who would be involved. 3.Community pharmacy staff can also be invited if appropriate At the second meeting you can :- • Discuss how the practice will train staff on the launch date and afterwards • Develop a plan of action for housekeeping prior to launch date • Develop a plan of patient selection Questions ? 7