1. Electronic Prescription Service (EPS)
Gary Mortimer, Senior Implementation Manager

2. EPS EPS Update Benefits of EPS EPS moving forward Questions?
electronic Repeat Dispensing (eRD)
EPS tracker
EPS moving forward
Developments / enhancements
EPS Phase 4
Questions?

3. EPS Update - National

4. EPS Update North Hampshire CCG (Aug 16)

5. EPS Benefits

6. EPS Benefits (£)

7. Release 2 Overview Electronic submission of reimbursement endorsements
Signatures
Nomination
Electronic repeat
dispensing
Electronic
cancellation
Electronic Signatures
One of the fundamental changes between Release 1 and Release 2 of the EPS is the ability for prescribers to apply electronic signatures to prescription messages. These electronic signatures are unique to individual users and are applied using their Smartcard and passcode. The application of an electronic signature makes the prescription message ‘the legal entity’.
Nomination
Nomination is the process that gives patients the option to choose, or ‘nominate’ a dispensing contractor(s) to which their electronic prescription(s) can be sent automatically, using the Electronic Prescription Service.
Electronic Cancellation
Prescribers (or other authorised staff working in the GP practice where the prescription was generated) are able to cancel electronic prescriptions at any point up until they are downloaded at the pharmacy. When an electronic prescription is cancelled, a reason for the cancellation must be given. A message is then sent to the Electronic Prescription Service.
Electronic Repeat Dispensing (aka batch scripts)
Electronic repeat dispensing is possible from a single electronic prescription, it does not require multiple paper issues to be printed. The first prescription is available straight away at the pharmacy and then each subsequent repeat will be made available to download seven days in advance
Electronic Submission of reimbursement endorsements
To support the reimbursement claim process, Release 2 of the EPS allows dispensing contractors to electronically submit endorsement messages to the reimbursement agency for dispensed electronic prescriptions.

8. Repeat Dispensing “batch prescribing”
Prescribe a batch of EPS prescriptions in one go for patients with repeat medication, for up to 12 months
NHS Community Pharmacy Contractual Framework essential service
Pharmacy responsible for carrying out checks with patient before dispensing each issue
ERD slides DF Jan 2016

9. Why use repeat dispensing?
Two thirds of prescriptions issued are for repeat prescriptions.
These prescriptions account for almost 80% of NHS medicine costs.
The time involved in processing them is significant.
There are over 400 million repeat prescriptions generated every year
(Average 200 per GP per week).
DH 2002 study 2.7 Million GP hours could be saved
AHSN Slides:
77% of all items are repeats.
This is 410 million repeat prescriptions – equivalent to an average of 200 per GP per week.
The average number of items per person per year is now 19.
DH showed in 2002, that if 80% of all repeats were given as RD 2.7 million GP hours would be saved.
For Wessex, this means that if we got to 80% of all repeats, we would save 108,000 GP hours
Which is roughly 61 WTE GPs

10. Electronic Repeat Dispensing - Benefits
Reduction in monthly repeat requests, issuing, signing, collection, Emergency / Urgent prescriptions
Patient convenience – just collect from pharmacy
No piles of paper FP10s/RA forms
Greater control and flexibility with EPS safeguards, tracking, and cancellation
Pharmacy workflow and Stock control
ERD slides DF Jan 2016

11. How does it work with EPS?

12. Issue 1 Issue 2 Cont…. Last Issue Day 21 Day 49 Day 1 Day 28 Day 56
Pharmacy second issue is downloaded automatically and has 7 days to prepare before due date.
Pharmacy
third issue is downloaded automatically and has 7 days to prepare before due date.
Pharmacy
last batch is dispensed. Informs patient this is the last issue
Last Issue
Day 21
Day 49
Issue 1
Issue 2
Cont….
Day 1
Day 28
Day 56
Last Issue GP
signs eRD prescription and uploads to Spine.
Patient
collects second issue.
Patient
collects third issue.
Patient
Collects last issue and contacts GP
Pharmacy downloads and prepares medication.
Pharmacy
Sends dispense notification.
Pharmacy
Sends dispense notification. GP
conducts review if required and issues next eRD prescription.
Patient collects
The prescriber can track the progress of the prescription using the Prescription Tracker and can cancel items at any point during the regime.
Pharmacy
Sends dispense notification.

13. North Hampshire CCG – eRD usage (Aug 2016)

14. Resources and activities
NHS England eRD Guidance
CPPE e-learning has been updated
Academic Health Science Network (AHSN)
eRD pilots in West Hampshire CCG - Learning
NHS Digital eRD toolkit to be launched 3rd October 2016
eLearning (GP system specific)
Strategy templates (GP an CCG)
Benefits calculator

15. EPS Prescription Tracker
Search using
Prescription ID
NHS Number
My Site
Add to Favourites

16. Prescription and Dispensing Details
Norwich eRD workshop handouts

17. Future EPS developments

18. EPS Enhancements Controlled drugs (schedule 2, 3)
Areas for development:
Enhancement of repeat dispensing functionality
More comprehensive dm+d drug mapping / adherence
Eliminate the need for paper dispensing tokens
Multiple nominations for patients
Self-service access for patients, view, add, change or remove their nomination
Ability for patients to manage their own medication via a mobile device (e.g. electronic tokens, prescription re-ordering, booking of appointments)
Sharing of prescribing /dispensing information with Summary Care Record.
Improvements to the management of larger prescriptions (more than four items)
‘Push’ delivery of prescriptions
EPS in other health care settings
Open API for prescription tracker

19. EPS Release 2 – Phase 4
The next phase of EPS will make it possible for all primary care prescriptions to use EPS and not just those where a patient has nominated a specific dispenser to receive their EPS prescriptions.
In the future, if a patient hasn’t chosen to nominate, then they will be able to collect their electronic prescription from any dispenser. Patients will still be able to nominate a dispenser if they decide that’s most convenient for them.
Read the slide

20. EPS Phase 4 - Pilots
16 Pilot sites across the country. Start dates TBC. 14 weeks then post evaluation to feed future National deployment stratagies.
Will include High / low utilisers and all prescribing systems

21. Any Questions?