EPS in Practice Manpreet Pujara GP National Clinical Lead & Clinical Director EPS

The size of the problem

Items

1 600,0 1 400,0 1 200,0 1 000,0 800,0 600,0 400,0 200,0 0,0 1 2 3 4 5 6 7 8 9 1011121314151617181920 Items

Items per person

20,0 18,0 16,0 14,0 12,0 10,0 8,0 6,0 4,0 2,0 0,0 1 2 3 4 5 6 7 8 9 10 11 Items per person

The size of the problem

• 926.7 million prescription items in 2010 an increase of 4.6% (40.7 million items) on 2009 and 67.9% on 2000 1  1.5 billion by 2020 • 2.5 million per day • 73 per day/GP • 293 per week/GP

1 Prescriptions Dispensed in the Community: England Statistics for 2000-2010 Information Centre

Repeat prescribing workload

Problem/Symptom

High number of repeat scripts Not all items considered at once High workload for front desk Increased pressure to meet QOF targets High GP workload

Why upgrade - EPS functionality Nomination Electronic signatures Electronic submission of reimbursement endorsements Electronic cancellation Electronic repeat dispensing

What’s in it for me & my practice?

• Makes me efficient!

• Less printing, less noise & more time to talk!

• More efficient prescribing/signing • Electronic repeat dispensing • Less wastage • Write a message for patient and/or pharmacist • Make more use of telephone consultations • Electronic cancellation means more control of medication regime

What’s in it for me & my practice?

• No need to sort and file prescriptions • Less traffic at the main desk • Fewer phone calls from patients asking for meds • Cannot lose the prescription – you know where it is • No hanging around outside consulting rooms for a signature/lost prescription • No sticky notes!

• Cost saving, printing, phone calls, less wasted time • Better clinical safety

So what do I need to do?

To maximise the benefits of using EPS you must review and change your business processes

Routine repeat request – Practice 1

1. Reception issues one of repeat regime e.g. 3 of 6 2. Paper FP10 printed 3.

FP10’s divided between GPs 4.

FP10s put into GP’s pigeon holes 5. GPs collect from pigeon holes 6. GPs checks and signs after surgery 7. GP takes signed FP10s back to reception

Routine repeat request – Practice 2

Routine repeat request with EMIS Web & EPS Release 2

So what do I need to do?

Review your current repeat request process

• • • • • • Prescription duration 28 or 56 days Single review date or number of issues?

Are review dates set as a default 6 or 12 months or dependent on clinical review?

Synchronising issues/drugs Do you use compliance figures or date of last issue?

Do you post date prescriptions?

So what do I need to do?

( Review your current repeat request process)

• • • • • • Do you use paper repeat dispensing?

Who signs the prescriptions & when?

Decide if you will print token for co-located pharmacies Training Engage – with patients Communicate with your local pharmacists – nominations are the key to a successful deployment

Practice decisions - streamlining

• Choosing the GP for EPS signing e.g. buddy system when one on holiday • GPs signing prescriptions between patients • Ensuring all outstanding prescriptions are signed by duty doctor at the end of the day • GPs consider amending items in patient record as requests come in • Consideration of different ways of notifying GP of immediate acute/repeat request for action • Benefits of using instant messaging

What’s EPS like in Web?

• Safety warnings • Compliance figures • Nomination • Cannot always change urgency on the fly • Cannot write a reason when rejecting a prescription – so no one knows why?

• Notes to patient/Pharmacy not recorded/visible in the electronic record

Compliance figures

Adding a message for patient or pharmacist

Nomination

Cancel an item in task screen

EPS Release 2 statistics

291 GP practices live 6,331 pharmacies live 20 dispensing appliance contractors live 613,763 patient nominations 3,298,925 items dispensed and claimed

Supplier status

Dispensing systems 6 dispensing systems have achieved FRA (full roll out approval ) 2 dispensing systems yet to achieve FRA Prescribing systems 4 prescribing systems have achieved FRA 1 prescribing system yet to achieve FRA

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All Isle of Wight GP and dispensing sites live

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All dispensers in Bexley live cfh.nhs.uk/epsstats

Process for EPS Authorisation Directions restart

33 PCTs gain SoS Directions Second closing date for applications: 21 September 2012 www.cfh.nhs.uk/eps/sos

Keep in contact……and sign up for the EPS bulletin!

[email protected]

EPS R2 Benefits Questionnaire

www.cfh.nhs.uk/eps/feedback