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part 3d > EPS > Flashcards

EPS Flashcards

1
Q

what is the aim of EPS

A

To develop a paperless system that:

Enables prescriptions to be sent electronically from GP surgeries to a pharmacy or dispensing contractor or the patient’s choice.

Send prescriptions to the NHS Business Services Authority (NHSBSA) electronically to claim for payment.

Make the process of prescribing and dispensing medications more efficient.

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2
Q

what are the advantages of EPS

A

Future-proofing the prescription pricing system

More accurate payments to contractors (pharmacies)

Less risk on loss of paper prescriptions (Data Security and Protection/financial implications)

More powerful analysis of data possible

Part of a huge NHS project to allow greater patient data sharing amongst healthcare professionals

Fewer dispensing errors

Saves money

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3
Q

what is NHS spine

A

NHS spine

A national secure central server of patient and NHS service information / programs

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4
Q

what is dm+D

A

dm+d
Dictionary of Medicines + Devices

The spine was developed based on dm+d coding for drug and medical device data.
Each dm+d code enables the electronic transmission of prescriptions (ETP) and the accurate population of patient recDords.
The same dm+d code is used throughout the NHS.

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5
Q

what is the function of NHS spine

A

Stores:

  1. Patient data (Personal Demographics Service PDS)
  2. Patient clinical information (Personal Spine Information Service PSIS), summarised as the Summary Care Record SCR

Supports programmes including:

  1. SCR/ PSIS access (access limitation programs)
  2. Choose and Book/Electronic Referrals
  3. GP2GP
  4. Secondary Uses Service (SUS)
  5. Electronic Prescription Service (EPS)
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6
Q

what is NHS smart cards

A

workers specific

NHS smartcards are required by all staff to access the NHS Spine and EPS.
Allows access to NHS spine
Personal property – The pin should not be shared, and the smartcard should not be left for others to use.
Issued by NHS (NHSE)
Different levels of access to NHS patient information for different staff.
Specific to one or more pharmacies (uses ODS codes)
Electronic certificate renewed every 2 years
Locums?

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7
Q

what is the development of EPS

A 
1999 onwards- development of the dm+d
2002 onwards NHS Spine and EPS release 1 
2014 EPS release 2-full rollout
2014-15 NHS Spine 2
2019 Schedule 2 and 3 CDs and EPS4
2021 rollout of Phase 4
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8
Q

what is EPS - release 1

A

FP10 prescriptions with:

barcode down the righthand side
signed by prescriber

Need NHS smartcard, Spine access, barcode reader

Read the barcode: patient, prescriber and medication details inserted into PMR.

Rx representation on screen.

Agree or change details (especially dosage)

Endorse and send for pricing as with paper Rx

Can be dispensed like a normal FP10 Rx (not using barcode)

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9
Q

what is the advantage and disadvantage of EPS release 1

A

Useful as:
Reduces data input error (?)
Adds accurate patient data record with NHS number
Used to test the Smartcard system/move to EPS2

Drawbacks
More complex PMR entry needed
Data input error not reduced
Have to send off paper prescriptions for pricing at month end

Still used but reducing in numbers (especially with the national roll of of phase 4)

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10
Q

EPS-R2 and Nominations

A

The patient chooses a dispensing site for their GP practice to send a prescription electronically for EPS2

Patients can nominate:
A pharmacy (including an internet pharmacy)
A dispensing appliance contractor
A dispensing GP practice (if eligible)

Nomination process requires access to the Spine
GP practices/ pharmacies can set up the nomination.
Patients can change their nominated dispenser at any time.
Written permission not required but nomination must be auditable.
Does not expire

Full electronic system-prescriber digitally signs prescriptions formatted like FP10

Prescriptions sent electronically from GP to nominated pharmacy

Nominated pharmacy:
Prints off electronic Rx on a Dispensing Token and accesses electronic Rx by scanning barcode OR scans Prescribing Token barcode to access electronic prescription
Dispenses and checks medication and endorses electronically (Drug Tariff rules apply)
Supplies medication to patient
Sends notification of dispensing to Spine
Check endorsements/claim for fees/medication cost electronically from NHSBSA

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11
Q

what are the types of NHS electronic prescriptions

A

Repeat prescriptions including Schedule 2 and 3 CDs
Acute prescriptions (urgent care often on Prescription Token or EPS4)
Electronic repeat dispensing service – eRD (batch prescriptions)

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12
Q

what types of prescriptions are not on EPS

A

Not on EPS

Non dm+d coded items

FP10MDA (yet)

Private prescriptions – Non NHS private prescriptions can be signed electronically but not sent to the pharmacy using the NHS spine.

Private Schedule 2 or 3 controlled drugs – must be printed on FP10PCD

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13
Q

how does eRD work?

A

day 1 - Gp signs eRD and uploads onto spine
pharmacy downloads and prepare medication
patient collects
pharmacy sends dispense medication

day 21 - second issue is downloaded automatically and have 7 days to prepare
day 28- patient collects
pharmacy sends dispense notification

day 49 - third issue is downloaded and automatically and have 7 days to prepare
day 56- patient collects
pharmacy sends dispense notification

…..

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14
Q

what happens to patients without a nomination

A

How can a GP write prescriptions for patients without a nominated pharmacy?

Get a patient to nominate a pharmacy, which they can change later (one off repeat)

Paper FP10 or EPS-R1

Use EPS4

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15
Q

what is EPS phase 4 and how does it work?

A
  1. GP issues a prescription
  2. non nominated EPS R2 prescription can be issued if no nomination is present and a paper prescription is not requested by patient
  3. X medication is added to the NHS spine
  4. the spine holds the rx ready for pulling down once the patient presents tehir paper to their chosen pharmacy
  5. patient takes their token to the pharmacy
  6. pharmacy scans token =dispenses = discuss if nomination needs to be set
  7. patient collects Rx from pharmacy
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16
Q

what is EPS tracker

A

Used to find the status of an EPS prescription

Enter a barcode or search by patient NHS number/date range, to find where a prescription is in the process:

left the prescribing site (been signed off)
reached the Spine
reached a dispensing site
been fully processed and claimed

Is the prescription at another nominated pharmacy?

Which prescription type the prescription has been written in i.e. phase 1 - 4?

You cannot see what items have been prescribed at this point.

17
Q

what is the benefits of EPS tracker

A

GP Practice and pharmacy can check the current status of an Rx

Pharmacies can ‘copy and paste’ a barcode into their system to retrieve a prescription

Pharmacies can double check claiming

Pharmacies can check if the following prescriptions have been written:
- EPS1 barcoded paper prescription
- EPS2 electronic prescription
EPS4 electronic prescription and can download electronic Rx (not EPS1)

18
Q

EPS2 vs EPS4

A

Scanning an EPS4 token may cause the PMR to print an identical token on FP10DT (white)

EPSR2 sent to the nominated pharmacy automatically – the prescription is usually already being processed or ready!

If a patient/representative cannot collect the EPS4 token, will they know all the appropriate information for the pharmacy to find that patient?

If the patient can not collect a prescription from their surgery the pharmacy team can find and dispense and EPS4:
GP sends email to patient with barcode of Rx or Rx ID number
Search the EPS tracker e.g. using NHS number of patient
Can be done for an EPSR2 if the nominated pharmacy can return it to the spine

19
Q

what are problems with EPS

A

Drug field details in instructions field
Instructions for use in Latin code
Multiple copies of eRD prescriptions generated concurrently

20
Q

what are the advantage and disadvantage of using EPS for patient

A

A:
Faster service-goes straight to pharmacy

Convenience-only visit GP surgery for medical appointments, not to collect Rx e.g. via ordering online and/or using eRD

Freedom of choice-can collect Rx anywhere, even if on holiday in a different part of England

D:

Timescale expectations not met

Sometimes Rx hard to find at the pharmacy as so many different systems in operation (complaints)

EPS2-renomination on receipt of Rx by distant pharmacy

Patient unaware of Rx if on eRD

21
Q

what are the advantage and disadvantage of using EPS for GP surgery staff

A

A:
Less work
Less staff needed to process Rx= cost savings=more profit
Greater control (Rx cancellation)

D:
Not all items allowed (non dm+d), FP10MDA
Training staff
Problems with writing correctly
Difficult for locum doctors
22
Q

what are the advantage and disadvantage of using EPS for pharmacy

A

A:
Streamlined workflow-staff can download prescriptions when they have free time
Fewer collections of Rx from GP surgeries
Aids development of new dispensing models e.g. internet/ distance selling
Easier month end processing
Reduced errors?
More accurate claims and fewer Rx lost in transit

D:
Extra work: printing DTs, sending dispense notifications, electronic endorsements, claims for payment, searching for Rx on the tracker

Interact less with GPs

Threat of internet pharmacies to community pharmacies

Paper Rx and DTs (non-age exempt) still submitted

Technical issues- wrongly written prescriptions, ‘quick dispense’ and ‘batch’ submissions problematical.

No flagging system for urgent Rx

Most errors are picking errors

Prescription switching/payment exemptions, electronic Rx out of date prior to claim esp 28 day expiry Rx (Schedule 2, 3 and 4 CDs)

23
Q

Paper FP10 (signed in ink)

EPS1 (barcoded FP10 signed in ink)

EPS2 (signed, sent and claimed electronically) linked to nominated dispenser site

Prescription Tokens (printed by GP) and Dispensing Tokens (printed by pharmacy)

eRD

CDs Schedule 2 and 3

EPS4 (signed, sent and claimed electronically) NOT linked to nominations

A

part 3d (21 decks)

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