e Pharmacy overview and update Alison Strath Principal

e. Pharmacy overview and update Alison Strath ~ Principal Pharmaceutical Officer, Scottish Government & David Green ~ e. Pharmacy Programme Manager, Atos Origin Alliance SCIMP Conference 7 November 2007

Agenda • • • e. Pharmacy introduction Acute Medication Service (AMS ) overview Chronic Medication Service (CMS) overview e. Pharmacy update on delivery Questions

e. Pharmacy Introduction

e. Pharmacy delivery programme : • To establish an e. Pharmacy Programme to underpin and support the delivery of the new community pharmacy contract (n. CPC) and…. In doing so introduce the ‘Electronic Transmission of Prescriptions’ (ETP) and support improvements in the end to end prescribing, dispensing and payment processing of prescriptions

Four core elements, three with IT support • Minor Ailment Service (e. MAS) • Acute Medication Service (e. AMS) • Chronic Medication Service (e. CMS) • The IT also supports initiatives such as: – e. Pay (electronic support in payments process) – Future Shipman requirements – Future connections to other areas (e. g. Out of Hours, other prescribers, the wider e. Health strategy)

e. Pharmacy programme organisation Ministerial / National IM&T & e. Health strategy e. Pharmacy Programme Policy Group SRO – Jonathan Pryce S Gov, NSS, e. Pharmacy Programme Manager (plus other key stakeholders) Other Programmes And projects e. Pharmacy Advisory & Support Groups: NHS Boards, Clinicians, CPS, SGPC, SCIMP… e. Pharmacy Programme Implementation team e. Pharmacy Message Store & interfaces ISD Data Warehouse PSD e. Pharmacy Programme: PRS, e. MSG, e. Pay, DCVP…. GP system suppliers CP system suppliers X 5 PMRs x 8

Core components - System • • • N 3 network connection Central e. Pharmacy Message Store (e. PMS) Central Patient Registration System (PRS) GP application changes CP application changes e. Pay functionality in NSS

Core components - Support • • • e. Pharmacy helpdesk IM&T facilitators SEF process for GP systems accreditation GP and CP support National communications and supporting material

Core components summary 2006/8 GP CHI NSS Patient Registration Service GP System Elec msgs via N 3 network e. Pharmacy Message Store Information Services Division Payment process D C V P CP e. Pay rules engine CP System Scanning and message processing Forms sent to PSD

Acute Medication Service Overview

AMS with ETP support • Electronic messages support the existing paper forms • Includes all GP 10 prescriptions. Acute and repeat • Electronic message contains same patient information as on the prescription form • Electronic messages are used in the pharmacy and by NSS

AMS with ETP support - Benefits • Patient safety improved through use of patient identifier • Patient safety maximised by minimising the need to re-key information • Type, accuracy and availability of prescription information is improved • NSS realise significant efficiencies using the electronic message

High level e. AMS Process GP Barcoded prescription form(s) produced PSD reconcile GP 10 & e. Msg Elec messages Sent to e. PMS GP Prescription form(s) received at pharmacy e. PMS Barcode Scanned Issue medication and submit claim Pap er fo Pharmacy system Uses elec data to support process rm DCVP e. PMS sg c. M e l E PMR e. PMS

e. AMS GP 10 looks like this: See it working today !

Chronic Medication Service Overview

CMS: an overview • Patient registers for the service (and signs to provide consent) at a Pharmacy • e. CMS allows prescriber to issue an e. CMS ‘master’ GP 10 which provides 6 to 12 months regular items • Pharmacy (at which Patient registered for CMS) dispenses without need for repeat prescriptions • GP practice receives regular compliance information plus an end of period patient report • Reduced paper, reduced GP practice visits, more convenient for patient, improved monitoring and feedback

e. CMS prescribing at GP practice GP sys GP identifies patient as suitable for a CMS GP 10 because CMS ‘flag’ set or may refer to CP for registration Patient presents at GP practice e. Pharmacy Message Store Patient leaves with a ‘Master’ e. CMS GP 10 Alternative Path = patient Leaves with e. AMS GP 10 X Patient goes To their chosen CMS Pharmacy

e. CMS dispensing Pharmacy Scan GP 10 & CP checks Registration (First & every interval) And if/when Registered can proceed To dispense. Patient presents at Pharmacy with e. CMS GP 10 (1 st time) CP manages Intervals and Provision until GP 10 time or total prescribed expires e. CMS is claimed and paid with each Dispensing e. Pharmacy Message Store CP sys GP 10 sent to PSD with Final claim Scanning and message processing ISD Data Warehouse Patient Registration System DCVP

e. CMS Service administration at GP Data From CP systems: CMS Registration data Dispensing activity on CMS registered Patients Care related Information, No dispensing Repeat CMS Prescription requests e. Pharmacy Message Store (message/ report sorting & holding) Daily File By GP Practice System GP sys • Retrieve information for CMS patients from e. PMS (automated) • Add information to patient record or view only (summary report) • Review Patient from GP perspective as now • Respond to repeat requests using prescribing process

e. Pharmacy Update on Delivery

e. Pharmacy Programme Timeline (Aligned to the new Pharmacy Contract & Delivering for Health e. Health Strategy): 2006 2007 2008 2009 e. MAS Completed e. AMS Live implementation Within context of national And UK changes and in Supplier & user markets e. CMS Futures: Other Initiatives E. g. , Shipman, OOH Nurse Prescribing….

e. AMS progress report GP systems CP systems • All Completed SEF testing • 4 completed beta testing • Roll out of software from September 2007 • Matched to SQL 2 K/GP 2007 • Substantial numbers (200+) by year end • Due to complete 31 May 2008 (latest) • Two Beta testing since October 2007 • Others in development or Fitness for Purpose • Roll out starts from December 2007 • Circa 150 sites by year end • Due to complete 30 September 2008 (latest)

e. CMS progress report GP systems CP systems • Start SEF testing November 2007 • Extended Ff. P including clinicians review • Beta testing and roll out thereafter • Due to complete 31 August 2008 (latest) • Start Fitness for Purpose testing July 2008 • Beta testing and roll out thereafter • Due to complete 28 February 2009 (latest)

e. Pharmacy delivery programme : • A Key national implementation as part of Scottish Government Delivering For Health and e. Health sub programmes. • Future commitment to ‘single’ technology approach using standards and integration of clinical systems and shared data for patient benefit • Real progress on a national level, a step change in its own right but also a platform for future developments and integrated health solutions.

Questions ?