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Deployed EPS R2? View and Share Top Tips
NHS Connecting for Health are collecting top tips on all aspects of deploying EPS Release 2. Tips can be submitted by pharmacies and reviewed online at the Connecting for Health Website.
Top tips submitted to date include:
Working with suppliers to improve system usability: A number of lessons learned have related to system configuration issues identified by early users of EPS Release 2. For example, in one case pharmacy staff found they needed to make 3 clicks (Print, OK print preview, OK) to print every dispensing token, a problem that was easily resolved by a call to the supplier who was able to advise on how to change the system configuration. In another case, after deployment of EPS Release 2, staff found they had to remember to print bag labels after they had finished dispensing rather than during it as they had done pre-EPS Release 2; again this was a system configuration issue that was quickly solved by working with their supplier. Not all system usability issues will be able to be resolved so quickly but it is essential to report problems and make suggestions for improvement so that suppliers can build enhancements into workplans for the ongoing development of systems.
Managing Patient Expectations: A problem identified in Sunderland was patients not being given realistic expectations about the time to prepare prescriptions, for example patients leaving the GP surgery with a prescribing token for an acute medicine, visiting the pharmacy next door and expecting the medicine to be bagged-up ready for collection. Although the message will be available for download from the Spine shortly after the prescriber has sent the prescription, pharmacies need to manually check and download messages during the day so a prescription is unlikely to have been downloaded by the time the patient visits the pharmacy in this scenario. Patients need to be given realistic expectations.
Nomination: A number of pharmacies have reported that it is time-consuming to manually enter patient demographic information to change a patient's nomination setting on the system. The lesson learned is that if the pharmacy is using EPS Release 1, the patient's details are automatically populated on the PMR system, significantly increasing the efficiency of the nomination process.
Repeat Dispensing: Repeat Dispensing has the potential to offer significant operational benefits for pharmacies; however problems reported include a low awareness of these benefits amongst GPs and in one case, patients not being identified for repeat dispensing as GPs tended only to see acute patients who were not suitable for repeat dispensing. Lessons learned include the need to encourage uptake of repeat dispensing and put in place appropriate processes in GP Practices to identify patients, for example practice nurses involved in the management of patients with long term conditions may be best placed to support patient sign-up.
Split prescriptions: There are some prescription items that cannot be transmitted electronically, for example it is currently not permitted to issue an electronic prescription for a Controlled Drug specified in Schedule 1, 2 or 3 of the Misuse of Drugs Regulations. Patients not being able to obtain all medicines electronically has created problems. The key lesson is that pharmacists need to work with GPs to have a process in place to be able to identify patients who may have split prescriptions and ensure that affected patients are aware of the risks that nomination could create. Nomination may not be the best option for these patients. Another option is for prescribers to include a note in the electronic message to indicate that there is also an FP10 for the patient. PSNC is continuing to call for the law to be changed to allow Schedule 1, 2 and 3 Controlled Drugs to be sent via the service.
Staff support: A successful approach to implementation recorded by NHS North West was the appointment of an in-store 'pharmacy champion' to provide first line support to other pharmacy staff during deployment of EPS R2.
Smartcards: A problem reported in Sunderland has been locum pharmacists arriving in EPS Release 2 enabled pharmacies without an operational smartcard. It can take time for cards to be upgraded so it is important that as pharmacies plan to deploy EPS Release 2, regular locums are kept informed. If a pharmacist may need to work within many community pharmacies at short notice, they can request that their card is registered with a user profile registered against a generic organisation ODS code for a "locum pharmacy" (FFFFF). This will enable the pharmacist to access the service at any pharmacy in England with an EPS R2 system.
Business Continuity: A number of pharmacies have reported disruption caused by local connectivity problems. Lessons learned from these experiences include the need for pharmacies to have service level agreements in place with suppliers to ensure that any loss of connectivity is resolved within the shortest possible time. These problems have also emphasised the importance of business continuity plans to minimise the impact of any problems that arise. Almost all of the problems that have arisen have been linked to local connectivity or the supplier's infrastructure, but there are reports that some suppliers have claimed that the national EPS Service or the Spine is at fault. Pharmacy staff can register to receive text or email alerts in the event that the national NHS CFH systems that support EPS are off-line.
Already deployed EPS Release 2 and have a top tip to share?
Tips can be logged and viewed online at: http://www.cfh.nhs.uk/epstips. All tips received are reviewed by Connecting for Health to ensure they are valid.
Background information on EPS Release 2 can be found online at http://www.psnc.org.uk/EPS.
Posted 16 February 2012