Agenda EPS Overview amp Update eRD amp the Benefits Patient Selection amp Synchronisation How does it work Animation eRD Prescribing and cancelling basic principles Questions amp Feedback ID: 627806
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EPS and eRD
Great Yarmouth & WaveneySlide2
Agenda
EPS Overview & Update
eRD & the Benefits
Patient Selection & Synchronisation
How does it work - Animation
eRD Prescribing and cancelling – basic principles.
Questions & Feedback?Slide3
EPS Overview & UpdateSlide4
Local Overview – GY&W
100 successfully deployed
Average usage in April 2017 was 74%
120,133 nominations
51.7% of registered population
3
rd
highest nominated CCG in England (% terms)
1.9% eRD in April
4Slide5
National Perspective
5
GMS
Contract 2017/18
Local Digital Roadmaps (LDRs)
Strategic Transformation Planning (STPs)
Universal Capability
i
GPs and community pharmacists can utilise electronic prescriptions
All permitted prescriptions are electronic
By the end of 2016/17 80% of repeat prescriptions to be transmitted electronically*
(80% of repeat prescriptions target = 56% of all prescriptions)
25%
Electronic Repeat
Dispensing for all appropriate patients by 31/3/18
*
non-dispensing patients only, until solution available for GP dispensariesSlide6
eRD & the BenefitsSlide7
What is
eRD
?
Electronic Repeat Dispensing (
eRD
) is an integral part of EPS which offers extra benefits over paper repeat dispensing and regular repeat prescribing.
eRD
allows regular medicines to be prescribed for suitable patients in batches of up to a year and stores the prescriptions securely on the spine.
7Slide8
What is
eRD?
Prescriber issues
batch of EPS prescriptions in one go for
suitable patients
with repeat
medication
, for up to 12
months.
Pharmacy responsible for carrying out checks with patient before dispensing each issue.
Patient liaises regularly with pharmacy and has flexibility throughout the regime.Slide9
How does eRD work at a practice?
Prescriber can authorise and issue a batch of repeat prescriptions until the patient needs to be reviewed.
Repeat dispensing can be issued for up to 12 months, but can also be issued for shorter periods.
Repeat items that have not yet been downloaded by the pharmacy can be cancelled by the GP Practice.
An electronic prescription for repeat dispensing this will contain the following information:
the intended interval between each issue
of the repeatable prescription
how many issues the repeatable prescription
can be dispensed
9Slide10
Benefits for the GP practice
Reduction
in workload
in re-signing requested
repeat prescriptions
.
Reduction in the amount of requests/queries coming into the
practice.
C
ancellation
at any point during the regime
at
item or
at prescription level.
New
medication
can be added to
the
regime.
Possible reduction in
m
edicines waste.Slide11
Benefits for the patient
Reduction in unnecessary visits to the GP practice.
Ability to request
multiple
issues of medication when necessary
e.g. holidays, Christmas, Easter
Potential
reduction in
out of hours requests
for routine
medication.
Patient doesn't need to remember to order their
prescription.
Patient cannot lose their
prescription
.
Pharmacy
nomination can be changed in the middle of a repeat dispensing regime.Slide12
Benefits for the Pharmacy
Improved
stock
control.
Increased efficiency.
Effective time management.
Reduction in managed
r
epeat workload.
Less “Emergency Supply” at peak periodsSlide13
Patient selection & synchronisationSlide14
Suitable patients
Long term condition, stable therapy
Medication expected to remain stable between reviews, e.g. 3m, 6m, 12m
Exclusions
14
Patients with unstable condition or frequent admission to hospital
Patients requiring frequent testing and/or review of their medication or condition
Patients who do not wish to participate in the serviceSlide15
Prescribing eRD
When
a prescriber issues an electronic prescription for repeat dispensing this will contain the following information:
the intended
duration
of each issue of the prescription
how many
times
the repeatable prescription can be issued before the patient/medication should be reviewed
6 issues x 28 day duration = 6 months supply
15Slide16
Preparing repeats for eRD
Check the issue duration / interval is correct for each repeat template.
Synchronise
all items to be issued in the same eRD batch.
Ensure the number of authorised issues and/or review dates match up.
Consider issuing items in separate batches – eg CD 4 or 5 (28 day expiry) or PRN items (irregular issue duration).
Use
the
patients’
usage history to
calculate PRN intervals e.g. 4 issues in
12 months =
84
days between issues.Slide17
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How Does eRD process Work?Slide18
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Review?
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Patient going on holiday.Slide28
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3Slide31
How does eRD Work? In words!
Once the prescription is signed; the 1st prescription will be available immediately for download by the nominated dispenser (unless post-dated).
All other prescriptions will remain on the spine until the previous issue has been completed i.e. ‘Dispensed’ or ‘Not Dispensed’ and a Dispense Notification (DN) sent to the spine.
Subsequent prescriptions will automatically download into the pharmacy system 7 days in advance of its due date.
Where clinically appropriate, a prescription can be downloaded early as long as a DN has been sent for the previous issue.
31Slide32
Community Pharmacy – The 4 Questions
Have you seen any health professional (GP, nurse or hospital doctor) 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 don’t need this month?
eRD
and this monthly “review” is part of the Community Pharmacy Contractual Framework
32Slide33
33Slide34
eRD Prescribing and cancelling – basic principles. Slide35
Do
you need an RA token
?
No,
i
t
is no longer mandatory to
print an RA token
at the start of a repeat dispensing
regime, but all systems still do
RA Token can be passed to patient, pharmacy or shredder
A token can still be printed at the request of the patient or pharmacy.Slide36
Patient consent?
Patients are required to give consent
to the introduction of
sharing
of their
information
between the dispensing and prescribing site.
Formal
written consent is not required.
Consent can be read coded in the patient’s notes if
required.
CTV3
code: XaKRX V2 code: 9Nd3.
SNOMED
CT code: 416224003Slide37
Can a patient change nomination part way through the regime?
Yes. Patients
can
change
their nominated pharmacy before the
end of the repeat dispensing period.
Any
outstanding issues which have not been downloaded will be
available to download at
the new nominated pharmacy. Slide38
Patient changes practice or dies.
Any
outstanding repeat dispensing batches should be cancelled.
Make it part of your deduction checks.
If PDS is notified of death the spine will automatically cancel outstanding prescriptions
.
38Slide39
Prescriber changes
practice
Any outstanding repeat dispensing batches should be cancelled and re-issued by another prescriber
eRD Prescriptions would move with the Prescriber and be charged to their new practice.
Ensure any new eRD regimes are authorised by a GP least likely to leave
39Slide40
How to get started?
Start small!
Identify potential patients
a
t medication review
opportunistically
by advertising in the surgery.
Target
specific
conditions/regimes
Hypertension, thyroid
#EPSr2Slide41
eRD Resources and Activities
NHS England eRD Guidance
http
://www.england.nhs.uk/ourwork/tsd/sst/erd-guidance
CPPE e-learning has been updated
www.cppe.ac.uk
https://www.cppe.ac.uk/programmes/l/repeat-e-01/
eRD Toolkit for Prescribers
https
://
www.digital.nhs.uk/Electronic-Prescription-Service/Electronic-repeat-dispensing-for-prescribers
NHS Digital EPS
https
://digital.nhs.uk/eps
41Slide42
Questions & Feedback
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