NHS Connecting for Health

1. NHS Connecting for Health The Electronic Transmission of Prescriptions (ETP) Programme Introduction Graham Spearing (gs@nhs.net), 12th May 2005

2. Content • ETP Background • ETP Model • ETP Implementation

3. ETP Background

4. Prescription activity • Every year in the NHS in England: • 350 million prescriptions are issued in primary care by GPs and other prescribers (70% repeats) • This equates to 625 million items prescribed • The annual primary care drugs bill is £6.2 billion

5. ETP Objectives • To enable the electronic transmission of prescription data in England between: • Prescribers • Dispensers • The NHS Care Record • Reimbursement Agencies (e.g. the Prescription Pricing Authority) • To facilitate the provision of enhanced patient centred services by community pharmacists which require access to the NHS Care Record • To enable the Prescriptions Pricing Authority to re-engineer their processes to increase capacity and reduce the unit cost of processing prescriptions

6. ETP benefits • Greater choice for patients • improved access to medication • new models of pharmacy operation such as mail order • Supporting the new range of community pharmacy services • Increased patient safety • better information to support prescribing and dispensing activity • Improved clinical outcomes • Improved information • to help manage the drugs bill • ability to compare prescribing activity against dispensing activity • Freeing up resources for front line patient care. • administrative savings • reduction in the unit cost of processing prescriptions at the PPA

7. ETP Model

8. For illustrative purposes only Print prescription token START Patient presents token at pharmacy. PRESCRIBER DISPENSER PATIENT Prescribing System    Electronic prescription sent to the NCRS Spine. Dispense Notification Prescription Prescription Response Prescription Request Prescriber submits prescription and prints token. Clinical information updates patient’s central medical record within PSIS. Reimbursement Claim Dispensing System Reimbursement Agency (PPA) PSIS Claim rejections sent back to the dispenser via the Spine (not shown). Claim sent to reimbursement agency. Claim Processing System Reimbursement Claim ETP – Prescribing, Dispensing & Reimbursement (Simplified) NCRS Spine

10. ETP Implementation

11. The scale of the task • Roll out ETP compliant systems to: • 9,746 pharmacies • 8,600 GP Practices • Register • c. 20,000 community pharmacy users (if only pharmacists) • c. 100,000 if all community pharmacist staff • Roll out • Hardware • PCs • Scanners • Smart card readers • Software upgrades • Connectivity • Training • Change management

12. Keighley First Implementer • Ling House Surgery and National Co-op Chemist first National Core ETP implementation • Wave One GP and Pharmacy site selected based on: • Installed systems in place passed ETP compliance • Prescribing volumes and site proximity • Willingness to participate • Local organisation support • Went Live 21st February 2005

13. Keighley First Implementer • Purpose of initial implementation sites? • Examine impact on local processes in surgery and pharmacy • Maximise workflow benefits • Inform future system design • Prove technical stability • Benefits and Lessons Learned in progress

14. Feedback “All the features of the technology mean that the whole process of dispensing medicines is streamlined and made easier” “It’s difficult to quantify, but I’ve already seen a reduction in potential dispensing/labelling errors, and we are able to work faster and more efficiently” Pharmacist, Co-op Pharmacy, Keighley

15. Delivering the service • Likely timescale? • Initial implementations underway now • All suppliers working towards an initial implementation • Wider rollout • Building capacity • Commence Summer 2005 • Complete end 2007 • Objectives during delivery? • The rapid and safe deployment of ETP into live service across England • Maintain patient choice