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CHRONIC MEDICATION SERVICE. Dawn Balfour Community Pharmacy IT Facilitator. CMS – Early Adopter. NHS Fife was asked to be involved in the EA process in April 2009 Quickly identified sites to approach Pharmacy/GP practice with close links Spread across 3 CHP areas

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chronic medication service


Dawn Balfour

Community Pharmacy IT Facilitator

cms early adopter
CMS – Early Adopter
  • NHS Fife was asked to be involved in the EA process in April 2009
  • Quickly identified sites to approach
    • Pharmacy/GP practice with close links
    • Spread across 3 CHP areas
    • Incorporate all GP systems where possible
    • Pharmacies using Pharmacy Manager software
cms early adopter1
CMS Early Adopter
  • First sites commenced in May 2009 (Kirkcaldy)
    • Up to 10 patients
    • Levothyroxine
    • 8 week prescription to be dispensed weekly
cms early adopter2
CMS Early Adopter
  • July 2009 – commenced with a GPass practice (Anstruther) feeding 2 pharmacies
  • September 2009 – commenced with a further GPass practice (Pittenweem) feeding 2 pharmacies
  • October 2009 – commenced with an INPS practice feeding 1 pharmacy (Cowdenbeath)
cms early adopter3
CMS Early Adopter
  • All sites started with an 8-week script then moved to a 24-week script for the same patients, same drug
  • In mid October go ahead was given to add any other regular medication for the patients to the 24-week script but to date that has not been possible
cms early adopter4
CMS Early Adopter
  • Now working with 2 EMIS GP sites (St Andrews and Cupar)
  • This brings in 2 of the other pharmacy suppliers, Nexphase and Rx Proscript and the final GP system
  • Also working with a Boots site in Cowdenbeath (Nexphase)
  • Only other pharmacy system to be tested is Lloyds - Compass
cms who is eligible
CMS – Who is eligible?
  • Patients must
    • Be registered with a GP practice in Scotland
    • Receive regular prescriptions
    • Have a long-term condition
  • Not eligible
    • A patient in a care home setting
    • A temporary resident
cms eligibility
CMS - Eligibility
  • If the patient meets these conditions the pharmacist can register them for CMS – Stage 1
  • Once registered the pharmacist can enter into CMS Stage 2 with the patient – pharmaceutical care planning
  • Initially, only if the patient is exempt under age or medical grounds can they receive a serial prescription
cms data required
CMS – Data required
  • To register a patient for CMS you must have
    • Full name
    • Gender
    • Address, including Postcode
    • Date of Birth
    • Exemption category
    • CHI number
cms cp2 cp3 form
CMS – CP2/CP3 form
  • The registration form for CMS is now a combined form with the MAS CP2 form
  • MAS will print on the left hand side (CP2)
  • CMS will print on the right hand side (CP3)
  • There are 4 declarations on the reverse of the CP3 ALL of which MUST be crossed.
cms process
CMS – Process
  • Patient registers at the pharmacy for the service (very much like a MAS registration)
  • If the patient is registered at another pharmacy for CMS the system will prompt the pharmacist to check that the patient definitely wants to transfer their registration
  • Electronic message from pharmacy system is sent to the ePharmacy Message Store (ePMS)
  • GP system electronically requests any data from the store every day
  • Registration status is updated in GP patient record if exempt on age or medical grounds
cms process1
CMS – Process
  • From the date of registration the pharmacist has 3 months to undertake an initial priority profile (Stage 2)
  • Once registration is received in the GP practice system, the GP has the option to generate a serial prescription for either 24 or 48 weeks (Stage 3)
  • NB – you may never receive a serial prescription for a CMS registered patient
cms prescription
CMS – Prescription
  • How to identify a CMS prescription
    • CMS 24 (or 48) weeks printed in bottom left hand corner of GP10
    • Dispensing interval identified for each item
    • UPN (barcode number) starts with the letter K
cms process2
CMS – Process
  • When the prescription is scanned in the pharmacy, the system will pull down the relevant electronic message – same as AMS
  • Pharmacist will use the information to dispense the item(s) in line with the dispensing frequency identified by the GP – this includes setting up the schedule for 24/48 weeks
  • An electronic message will be sent to the practice confirming that the item(s) has been dispensed and on what date
cms process3
CMS – Process
  • Patient will present at the pharmacy the next time they are due their medication (there is no need to go back to their GP)
  • Pharmacy system will allow pharmacists to plan ahead
  • Scan script again at the next dispensing date – this action will check with the store to ensure that there are no cancellation messages from the GP
  • Schedule has already been set up from first dispensing so if nothing has changed the process is very quick
cms how it works
CMS – How it works
  • Each time the pharmacist does a dispensing on their system, and claims for it, an electronic claim will go to PSD and a dispensing notification will go back to the practice
  • Please bear this in mind when sending your claims – best practice is to wait until the patient has collected their medication if preparing in advance
cms gp10 submission
CMS – GP10 submission
  • The GP10 must be held in the pharmacy until the end of the dispensing period
  • At the last dispensing the patient should sign the back of the GP10
  • The GP10 is then submitted to PSD in the normal way
  • NB – there is no paper endorsing for CMS it is all electronic
treatment summary report
Treatment Summary Report
  • At the end of the dispensing period the pharmacy systems will generate an End of Treatment Summary Report
  • This report summarises the dispensing episodes, provides any additional information (free text) the pharmacist thinks is necessary and requests another prescription, if appropriate
treatment summary report1
Treatment Summary Report
  • The TSR will be available in the GP system the following day
  • Pharmacists/GP Practices need to think about how they will use this report.
  • Is this the method you want to use for the repeat prescription or would you rather use existing methods, eg the right hand side of the GP10