1. eRD- The Bigger Picture
Tees LPC

2. The Murray Review
Independent review undertaken by Richard Murray, Director of Policy at the King’s Fund, was published by NHS England on 14th December 2016.
Now significantly informing DH plans for community pharmacy- summary available on PSNC website

3. “Full use should be made of the electronic repeat dispensing service
“Full use should be made of the electronic repeat dispensing service. Except for patients not yet stabilised on their medication, electronic repeat dispensing should become the default for repeat prescribing… This redesign should ensure that they are an integrated part of a multifaceted approach to helping people with long-term conditions that includes medicines optimisation, providing advice and helping people stay well… and have a focus on patients at high risk and those with multiple co-morbidities as well as those with single conditions that are clinical priorities such as diabetes, hypertension and COPD where evidence is already strongest. It should also include consideration of appropriate prescription duration to optimise outcomes and convenience for patients. Ultimately MURs should evolve into full clinical medication reviews utilising independent prescribing as part of the care pathway.”

4. So Why Here, Why Now? ETP rollout in GP Surgeries has progressed well
Recognition of the potential by CCG and many GP surgeries locally
Time saving advantages for GPs and Pharmacies alike
Simplifies patient journey
Potential to better integrate MURs & NMS
Increases awareness of importance of medication reviews
Standardises process for repeat ordering

5. The Managed Repeat Concerns
Misunderstanding of processes
Non-contractual
Patients ordering everything “just in case”
Variations of process, checks and balances etc.
Time between ordering and need
Most do it well, but bad news travels fast and far
“Bans” in many areas of the country. Some implemented more sensitively than others but all ultimately pejorative in tone and damaging to relationships.

6. eRD is the future. Success requires:
Getting the basics right first
Understanding of processes and requirements
Good communication with surgeries and patients alike
Support for pharmacies & surgeries
The journey starts this evening

7. Electronic Repeat Dispensing
Note for Practice Prescribing Clerks / Pharmacy:
When issuing repeat medication ALWAYS check that the patient is not set up to receive eRDs (See how to identify if patient is set up to receive eRDs document)
 If an eRD patient has requested a repeat of their prescription, phone the patient/pharmacy to explain the process
 Check for outstanding eRDs for deducted/deceased patients. Any future issues will need to be cancelled.
Before you start
Smartcard needed to set up with correct access rights
The best point to initiate an eRD is at the patient’s medication review
Who is setting up the eRD? -GP -Patient - Pharmacy
Has the patient got a nominated pharmacy?
Is the patient suitable for eRD
Yes - The patient is on regular stable medication – See NHS England eRD guidance for further information
No – The patient has not had Items issued for a while – consider medication review before setting up  PRN’s should be set up on a separate e’RD
Useful information
Post-dated prescriptions do not leave the practice clinical systems until the date stated on the prescription (prescription can not be cancelled until date stated on the prescription)
Resources
Prescription Tracker
eRD guide—SystmOne/eRD guide—EmisWeb
eRD guide—Microtest /eRD patient letter Explaining eRDs to patients/NHS England eRD Guidance
Note
Forward dated eRD prescriptions
Once signed the first issue will download to the nominated pharmacy, other issues will sit on the spine. Pre-set post-dated scipts will arrive in Dr’s signing list straight away but will not be available to the pharmacy until the date they are set to start on. Notification of cancellation of these items will not arrive until the date of the prescription.
Notes:
Practice prescribing team should note that this is a eRD patient and not re-issue repeat prescriptions Changes to individual items will require all future issues to be cancelled Practice will need to contact the pharmacy to let them know if a downloaded issue has been cancelled
If an item is unavailable at the nominated pharmacy or if the patient will be away when next prescription is due the pharmacy should print off a token to give to the patient. The patient can then take the token to an alternative pharmacy to collect items. Once pharmacy has issued token they need to return the prescription to the spine to allow the alternative pharmacy to issue. Issuing a token and returning to the spine WILL NOT change the patients nominated pharmacy

8. Workshop What is the flow of an eRD prescription?
What can go wrong at each stage?
How can problems be prevented?

9. Workshop Feedback
Each table to highlight relevant issues and how to overcome or prevent issues.