ETP update

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ETP update
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Agenda

• 1. Overview
• What is ETP/EPS
• Where are we now
• 2. Implementation
• High-level implementation approach
• The GP approach
• The Pharmacy approach
• 3. Next steps
• The PCT impact

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1. Overview What is ETP/EPS ?
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The ETP Programme

• Our task is to create the Electronic Prescription
  Service and then to integrate it with with the
  NHS Care Records Service

Electronic Transmission ofPrescriptions Programme
Creation of the ElectronicPrescriptionService
Integrationof the Electronic Prescription
Service with the NHS Care Records Service
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Release 1
The Electronic Prescription Service
ELECTRONIC MESSAGING
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Release 2 additional features

• Electronic signatures
• Patient nominations
• Electronic repeat dispensing
• Cancellation of prescriptions
• Electronic reimbursement claim

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Release 2Using a nominated pharmacy
The Electronic Prescription Service
Prescription Pricing Authority
Electronic reimbursement request
Electronic prescription
ELECTRONIC MESSAGING
Optional paper token
Pharmacist
GP
Patient
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1. Overview Where we are now
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Where we are now

• ETP systems development
• Central spine systems developed and in place for
  Release 1
• Nearly all Pharmacy GP existing systems have
  achieved Rel. 1 compliance
• Compliance process supported by central ETP team
• Early systems deployment
• 6 Pharmacy over 75 GP sites live in 14 towns
  across England
• 120,000 live prescriptions issued
• An average of over 3000 electronic prescription
  messages are issued per day
• Initial implementers have been supported by
  central ETP team
• Moving into National deployment phase for Release
  1

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Release 2 timescales

• Technical specifications for Release 2 have
  already been published
• Systems suppliers are starting to plan
  development now
• Spine functionality will be delivered during 2006
• Introduction of Rel 2 will be managed differently
  due to nomination process electronic
  signatures. More information will be published in
  due course.
• Planning to complete roll-out of Rel 2 by end of
  2007

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Quotes from participants in the initial
implementations

• The system has been down from time to time, but
  when its down we really miss it
• We have noticed less labeling errors
• There has been no impact to patients
• Patient matching, especially for new patients,
  is helpful

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2. ImplementationHigh-level implementation
approach
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Implementation approach

• Two releases of software, comprising four
  overlapping phases

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Why 2 Releases? EPS Release 1 has no impact to
patients

• Patients
• Little impact still get paper prescription. The
  only difference is there is now a bar code.
• System suppliers
• Can develop roll out systems at different rates
• Adjustments can be made without impact to patient
  care
• GP practices
• Minimal impact to GP practices. GPs prescribe in
  exactly the same manner as usual
• Pharmacies
• Scanning use of dmd improves accuracy speed
• No competitive advantage for pharmacy until
  Release 2

• All users
• Enables them to become familiar with the system
  and any changes in SOPs, before changes affecting
  patients are implemented
• GP surgeries and pharmacies need to be brought up
  to the required standard technically (hardware,
  software and connectivity)
• ETP Programme
• Enables complete validation of the system whilst
  paper is still in use
• Enables critical mass to be reached before
  Release 2

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2. Implementationthe GP approach
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Where are we going
ETP R2
Pharmacy ETP R1 following demand
Upgrade existingGP CB sites
GP ETP R1 rollout in parallel with Choose and
Book
GP Tactical deployments
GP InitialImplementers
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Why are we implementing inparallel with CB now?

• EPS Release 1 will enable sites technically and
  assure the service before significant business
  changes are required for EPS Release 2
• Framework agreements are in place with EMIS,
  iSOFT and InPractice
• These allow the implementation of EPS Release 1
  for GP Practices at zero cost to PCTs that have
  implemented the integrated Choose and Book
  solution
• No additional infrastructure requirements are
  required for EPS over and above that required for
  integrated Choose and Book
• We are making best use of the resources already
  equipped to support the rollout of Choose and
  Book and EPS

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Implementing EPS at GP Practices

• Connecting for Health and system suppliers will
  support local implementation through
• A communication toolkit provided to all trusts
• Central co-ordination with GP and Pharmacy
  suppliers
• Managing the necessary changes to endpoint
  registrations
• Upgrading software (remotely where the Choose and
  Book integrated solution has already been
  implemented)
• Supporting awareness process for GP practices
• Training staff where implementation occurs in
  parallel
• Providing awareness material where EPS go-live
  occurs after Choose and Book

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ETP communications activity to support National
deployment

• A new website (www.cfh.nhs.uk/eps) which will
  continue to be expanded and updated
• Regular meetings with stakeholder groups
• SHAs PCTs
• User groups GP, Pharmacy, patient,
  implementation
• Frequent media briefings which have already
  started
• Printed information
• For patients, professionals, Trusts system
  suppliers
• Brief overview to detailed guidance on specific
  topics
• Support for communication at regional and local
  level

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2. Where are we goingthe Pharmacy approach
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Pharmacy considerations

• ETP-compliant systems
• N3 connectivity
• Training, user guidance ongoing support
• Planning monitoring
• Registration
• ETP Allowances

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ETP compliant systems implemented by suppliers
and pharmacies

• Most systems are compliant or are getting
  compliance now for Release 1
• Clinical safety case has to be done for each
  system at an initial implementer site
• Large multiples, supermarkets and some chains
  will manage their own implementations
• Others will be implemented by system suppliers
• Some might require hardware upgrades
• All will require scanners and Smartcard readers

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N3 connectivity

• All pharmacies will require N3 connectivity to
  access the spine
• However this does not mean a direct N3
  connection to every site
• Major multiples, supermarkets large chains will
  mostly have their own N3 corporate connection
  use their own branch networks
• We are working with a number of aggregators who
  will have their own N3 central connection and can
  provide secure connections for individual sites
• Aggregators mostly ordered through system
  suppliers as part of a bundled offering

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Training, user guidance ongoing support

• Multiples, supermarkets larger chains will
  undertake their own training support for users
• System suppliers will undertake training
  support for others
• ETP programme will
• Make generic guidance material available to all
• Offer to review training material to ensure
  consistency of message
• Monitor number of users trained, as far as
  possible
• NHS CFH will
• Provide help desk service management support to
  system suppliers

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Planning monitoring

• Working with GP systems suppliers to get their
  deployment plans
• Working with Pharmacy multiples, supermarkets
  larger chains to get their deployment plans
• Working with Pharmacy system suppliers to get
  their deployment plans
• Propose to update Tracking Database with all
  plans
• Can then report to PCTs on deployment plans to
  help with Registration planning
• Can also monitor go-live activity to monitor
  achievements

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Pharmacy registration

• New DH SRO of Registration appointed in October
  2005
• Considering options for Pharmacy registration
• PCTs will undertake registration process
• Sponsorship still under consideration but will
  probably be done by PCT staff
• On average, each (existing) PCT has about 30
  pharmacies
• Guidance for PCTs Community Pharmacy to be
  issued as soon as possible

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ETP Allowances

• Funding announcement made on 12th Oct. 2005
• Payments of 1300 to be made by PPA in Dec 2005
  and Feb 2006
• Payment of 200 per month per site once the site
  is enabled for electronic prescriptions
• For any issues/queries please use the Pharmacy
  helpline (operated for DH by Primary Care
  Contracting team) on compharm.queries_at_npdt.nhs.uk
  
• Or phone [phone]

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3. Where are we goingthe PCT impact
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PCT responsibilities for GP Practices

• PCTs will now need to
• Order communications toolkit (final version is
  available end of November)
• Engage with GP practices already enabled for
  Choose and Book
• Prepare other practices for parallel
  implementation

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PCT roles and responsibilities for pharmacy
Release 1

• Registration sponsorship card issuing
• Use Tracking database to anticipate timing of
  likely demand
• Communicate the implementation to the local
  pharmacy community, as required
• Monitor the implementation using the Tracking
  Database

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Next steps key points

• Moving into National Deployment phase for Release
  1
• Implementation in GPs is in parallel with Choose
  and Book
• No requirement for PCTs to manage pharmacy
  implementation
• Release 1 has little impact to patients and GPs
• Wed like PCTs to
• Order communications toolkit
• Engage with GPs now
• Register pharmacy staff guidance coming soon
• Target for full deployment is Dec 2007

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Questions?