Overview of EPS Release 2

1. Preparing for EPS2 in your PharmacyBusiness Process Change MeetingBecky GaylerCCG Informatics Project Manager

2. Overview of EPS Release 2

3. Release 2 Overview Electronic submission of reimbursement endorsements Electronic Signatures Nomination Electronic cancellation Electronic repeat dispensing

4. Key Benefits • Greater convenience • Increased freedom of choice • Reduced waiting times in the pharmacy • Potential reduction in workload. • Easier to use repeat dispensing • Greater efficiency and control . • Greater efficiency • Streamlined workflow • Easier month end processing Patients Prescribers/ Prescription Clerks Dispensers

5. Key Points • GPs and other prescribing staff will sign prescriptions electronically using their Smartcard and PIN • Patients will be able to “nominate” a dispensing contractor to receive their electronic prescriptions automatically • This will enable GPs to send electronic prescriptions to nominated dispensing contractors without the need for paper • Patients who do not want to nominate a dispensing contractor will continue to receive a paper prescription • Supports: acute, repeat and repeat dispensing models

6. Planned EPS2 GP Practices go-lives • Early Adopter Phase: • Sackville Road Hove 22/5/14 • Ardingly Court Brighton 04/6/14 • Stanford Medical Centre Brighton 05/6/14 • EMIS Web Sept / Oct 2014 • TPP SystmOne Nov / Dec / Jan 2014 • Vision March / April 2015

7. Prescribing Token

8. Cannot use EPS: Prescribing will not be possible for the following patients: • patients who are not synchronised with PDS. • patients who are marked as “sensitive” on PDS. The following medication is not eligible : • Controlled drugs from schedule 1. • Controlled drugs from schedule 2 and 3 unless this has been enabled in the system. • Private prescriptions, unless this has been enabled in the system. • Drugs without a dm+d code mapping. • Drugs without a dm+d description and unit. • Prescriptions without a nomination in Phase 3.

9. Processes for pharmacy staff

10. Dispensers - Site preparation • Capture patient nominations. • Release 1 usage – PDS synchronisation • Order dispensing tokens • Printing capability (2nd tray for tokens) • Supplies: printer toner / dispensing tokens • System training • SOPs • Smartcards

11. Smartcards Everyone who dispense prescriptions and / or process patient nomination requests will need a smartcard: • Pharmacists and locum pharmacists • Accredited dispensing technicians • Counter assistants and pharmacy support staff Area Team are arranging for new smartcards to be issued. For existing smartcard users contact Sussex IT Services 0845 845 4488 EPS Release 2 has three access levels: • Process patient nomination requests • Prescription receipt, dispensing, labelling and issue of medication • Prescription endorsing and reimbursement processes Many users, including probably all pharmacists, will be granted all 3. Special arrangements have been made for locum pharmacy staff to use a virtual national locum organisation code – FFFFF.

12. Check your card is working Certificates expire every 2 years, you will be given 30 days notice to renew. How to renew your Smartcard certificates: • At the renewal prompt click Yes. • You are taken to the Self Service Portal. • Click the Renew Certificates tab. • You are presented with Update My Card workflow. • Enter your Smartcard Passcode, to confirm your identity and the first certificate update. • Click OK. • Creating Card and Writing Certificates warnings appear one after another. A message indicates that the certificates have been renewed and the Smartcard has been updated successfully. • Click Continue to confirm the update. • Close the browser and authenticate again as normal. You can check your certificates at: http://nww.hscic.gov.uk/eps/cardexaminer

13. Key processes to consider before go live at the pharmacy • Approach to capturing nominations • Electronic Cancellation • Dispensing and downloading electronic prescriptions • Dispensing tokens • Electronic endorsement and patient declarations • Electronic claims • End of month processes

14. Approach to capturing nominations • Who will capture nominations in the pharmacy? • Consider patients who have delivery service • Consider process for inputting the nominations onto the system • How will you communicate with patients?

15. Dispensing and downloading electronic prescriptions • Consider process for requesting prescriptions (frequency/responsibility) • Overnight download • Requesting throughout the day • When will you send dispense notifications? • Clinical information from the prescriber needs to be communicated to the patient – how will you do this?

16. Dispensing tokens • Ensure dispensing token stationery has been received • Use of dispensing token for: • capturing signatures for payment/exemption declaration • giving to a patient who needs to go to a different pharmacy to collect their medication • aiding with dispensing process

17. Electronic cancellation • Ensure all staff are aware of electronic cancellation • What do cancelled prescriptions look like in the system? • Consider a local process for returning prescriptions to the spine if a GP practice advises they wish to cancel a prescription after it had been downloaded in the pharmacy

18. Electronic endorsements and patient declarations • Ensure all staff are aware of capturing patient declarations and ensure they are recorded on the system • Capture patient signatures on the reverse of dispensing tokens • Electronic prescriptions must be electronically endorsed. Paper prescriptions must be endorsed and submitted in the usual way • Do not handwrite endorsements on a dispensing token, these will not be used for pricing • Ensure electronic exemptions are correct before sending

19. Electronic claims • All electronic prescriptions must be claimed for electronically • An electronic claim can only be sent once the prescription has been completed; items should be marked as either ‘dispensed’ or ‘not dispensed’ • Consider when you will be submitting electronic claims • on patient collection, end of day, in batches, weekly • Once an electronic claim has been sent to NHS BSA Prescription Services, it cannot be amended or cancelled

20. End of month Processes • One FP34C form must be completed and submitted to the NHS BSA Prescription Services to cover both paper and electronic prescriptions • Understand month end process in relation to tokens • Signed tokens need to be separated from the FP10 paper prescriptions at the end of each month and sent to the NHS BSA Prescription Services • Age exempt patient tokens

21. Business Continuity

22. Business continuity and troubleshooting • Ensure local processes are in place to continue dispensing process if EPS becomes unavailable either nationally or locally • How are you going to work if: • A patient’s prescription does not arrive at the dispenser site straight away? • GP reports their system is unavailable? • Dispenser system is unavailable? • EPS is unavailable nationally?

23. Business continuity and troubleshooting • Surgery to pharmacy / pharmacy to surgery contact • Know who to contact for hardware support • Know who to contact for software support Sign up for alerts: http://nww.hscic.gov.uk/servicemanagement/status/subscribe • Prescription Tracker http://epstracker.cfh.nhs.uk/check.php

24. Prescription Tracker

25. Log it! Local helpdesks (system supplier) will provide first level issue diagnosis, resolution and support, and will be able to establish whether the incident is: • a local issue (local network failure, prescribing or dispensing system failure) • a national issue (central Electronic Prescription Service failure, national network failure). Your local helpdesk should also be able to identify which component of the Electronic Prescription Service is affected by the technical failure. These components include: • local GP clinical system • local dispensing system • Smartcard • prescription token printer • dispensing token printer • network connectivity • national system. Your local helpdesk will be responsible for any escalation process. Remember to always obtain and keep and reference log number as this will be required to escalate the issue.

26. Factors to Consider The health care professional should use their professional judgement and base a decision, as to the most appropriate action to be taken, on the information available at the time. Important factors to consider are: • What stage of the business process the failure has occurred. • The estimated time needed to resolve the issue - some technical failures will take longer to resolve than others. For instance, a printer failure due to lack of toner can be resolved quickly, whereas a local or national network connection may take longer to resolve.

27. The clinical need of the patient In some cases there may be an urgent need for the patient to receive the prescription items. There are a number of options to consider, including those listed below. In some scenarios, one or more different actions may be appropriate: • Contacting the prescriber to obtain a paper FP10 prescription • Using the emergency supply arrangements • Advising the patient to return to the dispensary at an alternative time • Advising the patient to use an alternative dispensing site • Capturing data on paper to be inputted at a later time.

28. Smart Cards If your smartcard is not working you will not be able to access the spine! The following scenarios give you some solutions to smartcard failures.

29. Scenario 1. What would I do if my smartcard is faulty? • Option 1: Check it is the card and not the reader that is faulty by trying your card in another machine. • Option 2: Contact Sussex IT Services on 0845 845 4488 and log a call for the attention RA department • Consider any issues which may result in a damaged card reader, and make suitable changes to current practices within the dispensary. Ensure liquids are kept away from keyboards, Smartcard readers and other equipment

30. Scenario 2. What would you do If your card is lost or stolen? • Option 1: Contact Sussex IT Services to report the missing card 0845 845 4488 (9.00 to 17.00 Monday to Friday excluding bank holidays). • Option 2:Ask a colleague to use their smartcards to download EPS prescriptions or set nominations. (It is good practice to ensure, where possible, that at least two staff on duty have working smartcards.) • Option 3: Follow your local Business Continuity plan

31. The following scenarios are based on the local clinical system being down or the server has failed

32. Scenario 3: I can’t download or access electronic prescription(s) ? • Option 1: Ask patient to return to prescriber to obtain paper FP10 prescription • Option 2: Contact GP practice to advise of failure and ask them to produce hand signed paper prescriptions • Option 3: Advise patient to use an alternative EPS Release 2 enabled dispensing contractor. (The patient will be able to set their nomination at the alternative site to divert the script to this site.) • Option 4: If urgent and appropriate, issue an emergency supply • Option 5: Advise patient to return at a later time Remember! You need to consider factors such as clinical need of the patient, the time it will take to resolve the problem and the communications required

33. Scenario 4: I Can’t Set, Change or Cancel Nomination! • Option 1: Provide information to patient, capture data and update at a later time (informing the patient that the nomination may not be recorded within the usual timeframe) • Option 2: Ask patient to set the nomination at any other EPS Release 2 enabled dispensing site

34. Raising support calls Ensure you know how to log calls to your supplier and know their escalation procedures GP: http://systems.hscic.gov.uk/gpsoc/performance/liveservice/index_html Pharmacy: Escalation procedures should be obtained from your supplier. It is important to: • Keep a log of calls made, ref numbers and time to resolve • Follow up and escalation

35. Training and Support

36. Training and Support • Concept training • New processes • System training • Best time to undertake EPS training? • Post go-live – what sort of training and support will be needed? • Locums / temporary staff?

37. Patient Communication

38. Patient communication • How will you communicate EPS to patients? • Patients should be informed about nomination: • Nomination is not mandatory • No need to collect paper prescription from the GP practice • Patient can choose who they wish to nominate • Nomination is flexible and can be changed or removed by their GP or any EPS2 pharmacy • Not restricted to nominating a pharmacy close to their GP practice. • What tools / resources will you use? • Pharmacy to customers • Surgery to patients

39. Connect with EPS

40. www.hscic.gov.uk/epsgp

41. www.hscic.gov.uk/epsmap

42. factsheets

44. Stay connected Like EPSnhs Follow @EPSnhs EPSnhs channel www.hscic.gov.uk/epssignup

45. Questions?