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Preparing for EPS in your GP practice and pharmacy Business Process Change Workshop. Introduction. To maximise the benefits of EPS Release 2, pharmacies and GP practices need to adapt existing business processes. These changes need to be agreed and communicated to staff.
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Preparing for EPS in your GP practice and pharmacyBusiness Process Change Workshop
Introduction • To maximise the benefits of EPS Release 2, pharmacies and GP practices need to adapt existing business processes. • These changes need to be agreed and communicated to staff. • Business processes are unique to every site so ensure any locums are briefed on these changes.
Workshop overview Today we will be covering: • Overview of EPS Release 2 • GP and dispenser site readiness • Business process change for GP practices and pharmacies • Business continuity & raising support calls • Training and support for EPS Release 2 • Patient communication • Connect with EPS and learn more • Question & answer session
Overview of EPS Release 2
EPS in a nutshell EPS enables prescriptions to be sent electronically from the GP to the dispensary of the patient’s choice.
Why is EPS needed? • Over a billion prescription items were issued in 2012 • About 70% of prescriptions are for repeat medication
What happens now? • Map out your current local processes and use these to help consider how they might change with EPS Release 2. • The following diagram shows an example of the current process.
Where will EPS be used? • GP practices (including dispensing practices) • Community pharmacies • Dispensing Appliance Contractors (DACs)
A phased approach • Release 1 introduced the technical infrastructure to enable prescribers and dispensers to operate the EPS. The implementation of Release 1 is now almost complete with over 95% of GP practices and pharmacies live with the service • Release 2 provides enhanced functionality for users which will deliver tangible benefits for patients, prescribers, dispensers and their staff
Release 2 overview Nomination Electronic Signatures Electronic submission of reimbursement endorsements Electronic cancellation Electronic repeat dispensing
Key benefits • Greater convenience • Increased freedom of choice • Reduced waiting times in the pharmacy • Potential reduction in workload. • Easier to use repeat dispensing • Greater efficiency and control . • Greater efficiency • Streamlined workflow • Easier month end processing Patients Prescribers/ Prescription Clerks Dispensers
Site preparation • Ensure all staff who will be dealing with prescriptions have smartcards and the correct roles – consider nomination setting and cancellation • Ensure all GP smartcards have been checked for duplicate certificates www.hscic.gov.uk/systemandservices/eps/library/check.pdf
Site preparation • Capture patient nominations • Release 1 usage – dispenser & practice • Medication synchronisation • Order dispensing tokens
Site preparation • Patient communication – leaflets/posters • Site Lead (admin and GP) – nomination, prescription preparation, issue resolution. • Review available factsheets: www.hscic.gov.uk/systemsandservices/eps/gppractice/help • www.hscic.gov.uk/systemsandservices/eps/dispensing/help
Site preparation • Ensure ODS code in dispenser system is correct • Ensure NHS Choices information for dispensers is correct • Schedule and agree system training
Key processes to consider before go live at the GP practice • Approach to capturing nominations • Preparing a repeat prescription • Signing electronic prescriptions • Electronic repeat dispensing • Split prescriptions. • Electronic Cancellation
Approach to capturing nominations • Will the practice be proactively capturing nominations? How far in advance? • Will the practice target specific patients? • What will the practice do if a patient asks about EPS and nomination? • What literature will the practice use to support patient communication?
Preparing a repeat prescription • Are they prepared by prescription clerk, pharmacist, prescriber? • Depending on who prepares, consider: • Who edits or amends the prescription • How do you deal with issues needing re-authorisation • How and when are queries communicated to the prescriber – virtual sticky note, email, diary entry, clinical note, • Does the prescriber amend or edit the patient repeat master? Or is it returned to the prescription clerk to amend master? • Consider how you will deal with urgent requests
Signing electronic prescriptions What is your current process? • Scripts divided equally into pigeon holes/ baskets? • Patient’s Usual GP signs all? • GP registrar signs all repeats? • All to duty Dr? Will you allocate electronic scripts in the same way? What about annual or sick leave cover? End of day process – ensuring all scripts have been signed – who is responsible, Admin, duty GP etc...?
Electronic repeat dispensing • Who will set up the repeat regimes – prescriber, medicines management, practice nurse/nurse practitioner/admin? • Which patients – any on repeats? • When – during medication review, during long term condition reviews, at the end of current authorised issues or ad hoc consultation? • How long are regimes set up for – determined by clinical judgement
Split prescriptions What is a split prescription? Possible options: • Replace the item with another description of the same product that is dm+d mapped and can be sent through EPS. • Revert all items to FP10 • Agreement that patient attends surgery to collect out of scope items on a FP10. • Agree prescription collection service (if appropriate) and add note to dispenser attached to release 2 prescription advising of extra items on prescription collection service. • Discuss with patient suitability if all items out of scope.
Electronic cancellation • Who will be responsible for cancelling electronic prescriptions? • How will this process be handled? • Who will be responsible for contacting the patient and/or pharmacy? • Ensure all staff are aware of the processes around each type of cancellation response. • Successful cancellation • Unsuccessful cancellation, prescription is with the dispenser • Unsuccessful cancellation, prescription has been dispensed
Key processes to consider before go live at the pharmacy • Approach to capturing nominations • Dispensing and downloading electronic prescriptions • Dispensing tokens • Electronic cancellation • 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? What do they want to know?
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 • Consider the 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 process in place for checking for replacement prescriptions. • 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 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 • As patient collects their medication, 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. • Unsigned tokens should be confidentially destroyed
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 with GP practices if: • A patient’s prescription does not arrive at the dispenser straight away? • GP reports their system is unavailable? • Dispenser system is unavailable? • EPS is unavailable nationally? Sign up for alerts: http://nww.hscic.gov.uk/servicemanagement/status/subscribe
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/index_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 • Plan training in advance of going live or in pharmacy case before your local GP practice goes live. • Consider the best time to undertake EPS training • Consider what kind of training will work best in the GP practice/pharmacy • Will you want/need post training support?
Patient communication • How will you communicate with patients? • What tools will you use to help communication • Do you know what is available to order or download?
