1. Noel Dempsey Pharmacy Systems Manager St Helens & Knowsley Teaching Hospitals NHS Trust 4th June 2008

2. Background Problem identified when stocked drugs are required by wards between top up visits from pharmacy staff Procedure Security / Efficiency How do wards request additional drugs? Which drugs can they have? Which section within the pharmacy do they need to contact? - Stores or Dispensary Who can request additional stocks? Who is requesting additional stocks? Is the drug available?

3. Solutions? 1. Telephone requests No security No Audit Trail 4. Fax requests Little or no security Legibility of request (hand written) Incomplete forms Drug limitations (Profiles) 2. Requisition Books Legibility of request (hand written) Drug limitations (Profiles) Time and distance (remote sites) 3. Ward Access to Pharmacy Computer System (JAC) Loss of pharmacy budgetary controls Potential exceeding User Licence limits Interruption to work

4. Which Ward? Authorised staff? Stocked Drug?

7. 1.Web based application (Trust Intranet) 2.Fully secure and auditable Available from any networked PC Available to any authorised nurse Only drugs stocked on their own ward can be ordered Records name of person ordering ADVANTAGES Stops telephone requests for additional drugs

8. ADVANTAGES 3.Evidential support for: C.N.S.T. (Clinical Negligence Scheme for Trusts) Medicine Management Standards Criteria 7.1.6 Criteria 7.2.5 Standards for Better Health Safe and Secure Handling of Medicines Assurance marker C4d Duthie Report (New Edition March 2005) Safe and Secure Handling of Medicines

9. 4.Time Efficient Reduces time to create an order ADVANTAGES Improves legibility of the order Stops requests for non stocked drugs Improves communication between wards and the Pharmacy department

10. 5.Stock Efficiency Reduces duplication of work Identifies items where the stock level on the ward needs to be addressed Reduces telephone calls ADVANTAGES

11. 1.The user must register themselves on the Trust Intranet Staff Directory and know their username and password (Nursing staff reluctance regarding new computer procedures) 2.Being Web based, it will not be available in the event of a network failure 3.The user must be set up and activated by the system administrator before they can access the application DISADVANTAGES

12. 1.The value of issues to wards will increase drastically! 2.The number of issues will increase if nursing staff have an easier route to order stocks 3.Pharmacy staff will not have enough time to process the requests, and assemble and……and… CONCERNS RAISED

13. Launch of E-Top Up 1st September 2005

14. Launch of E-Top Up 1st September 2005

15. Launch of E-Top Up 1st September 2005

19. Number of Wards / Departments able to use: Number of Authorised users: 186 1748

20. Noel Dempsey Pharmacy Systems Manager St Helens & Knowsley Hospitals NHS Trust