EPS Phase 4 (EPS non-nominated) awareness session

EMIS Web - GP

Aims of session

You are aware of:

• what is EPS phase 4

• local processes that may need to be modified

• the resource materials available to support

you and your staff

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Why EPS is important to COVID-19 response?

• Supports work flows to avoid patients having to travel to their surgery

• Supports the outcomes of the increased use of remote consulting

• Provides a safe, secure and traceable mechanism for transferring prescriptions

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Overview of Phase 4

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Phase 4 of EPS allows prescriptions for patients without an EPS nomination to be signed, sent and

processed electronically

1. If Patients* continue to nominate their EPS pharmacy to receive their prescriptions (as with the

current service) – No change continue as normal

2. If no nomination is in place, or the patient chooses not to use their nominated pharmacy, patients must

be provided with a token with a barcode to take to a pharmacy who will scan it and “pull down” the

prescription from the spine

*If Patients are registered or flagged as Dispensing patients - then No change. The prescriptions will print as FP10s

GMS and PMS regulation amendments:

https://www.legislation.gov.uk/uksi/2018/1114/contents/made

2019/20 GMS Contract guidance:

“It is already a contractual requirement that, once EPS Phase 4 has been installed at a practice, practices must use electronic prescriptions if

they are satisfied EPS is working properly and apart from some specific exemptions, where clinical need is identified.

After piloting, EPS Phase 4 will be rolled out across England during 2019/20 and use of electronic prescriptions will become mandatory, with

paper prescriptions used only by exception”

What does a Phase 4 EPS token Look like?

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Phase 4 EPS Token

Nominated EPS

Token

COVID-19 - Exception workflow

As the collection of a paper token may not be appropriate to current work flows

during the pandemic, exception workflows may need to be used:

– Is a temporary nomination viable?

– The token barcode number could be provided to the patient i.e. via text

for them to present to the pharmacy to enter into their pharmacy system.

– The patient may be given their NHS number to present to the pharmacy

who can then trace Phase 4 prescriptions using the EPS tracker

https://digital.nhs.uk/services/electronic-prescription-service/using-eps-in-remote-consultations

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Where to find the prescription barcode number?

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Key benefits

• almost all prescriptions will be processed and signed

electronically (est. >95%). One main process for prescriptions will

lead to a more efficient, faster and secure service (GPs,

Pharmacy, NHS BSA)

• if a patient without a nomination loses their token, it can be easily

reprinted, no duplicate issuing / signing

• it is also possible to track more prescriptions using the EPS

Prescription Tracker

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Processes in Practice

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Processes changes in Practice

• Admin/ Prescription Clerk Issuing

• Ordering Processes remain the same – F2F, Online, pharmacy etc.

• EPS nomination / no nomination – both sent to EPS signing queue this will be signed as per EPS2

• The phase 4 token is only printed after signing the electronic task

• GP or other signing prescriber Issuing

• Prescription raised as normal

• Prompt for EPS smartcard PIN to sign

• Prescription signed and a token will print locally unless selected to print later.

• Printing for patients at branch surgeries

• COVID-19 exception process for informing patient of the prescription ID number or NHS number.

• Non-prescribing clinician Issuing (nurse, paramedic etc.)

• Prescriptions will be issued to the prescribers EPS signing queue

• Need to review current processes if prescriptions are required immediately for patient

• Token print routing

• Options to configure where tokens are printed (post signature) 10

Printer Routing Preferences

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Phase 4 Token

Printing

Acutes

Terminal Printer -

Consultation room

Bulk Signing – Meds Mngmt workflow

Terminal Printer- Consultation room

Network Printer - Admin, Other,

Remote/branch site

EMIS Store function

(print later)

Phase 4 token must be

printed for patient to present

at pharmacy

Or patient provided identifier

during COVID-19 exception

process

Printer Configuration option for medicines management signing tasks

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Finding from pilot

sites recommended

printer Offset

x-8

y-8

Other printers can be selected for

individual signing tasks

‘Issuing a ‘One off’ Phase 4 scripts for patients with a

nomination - EMIS

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EPS – Any Pharmacy will now

revert the prescription to a Phase

4 signing task – removing the

patient nomination for the

individual script, if present.

Unexpected FP10s

When might an FP10 print? Non dm+d items

PDS mismatch

No smartcard

Border patients

Instalment prescribing

Personally Administered (screenshot next slide)

If an FP10 is printed unexpectedly please question why???

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Please ensure that all practice colleagues are aware that if EPS could

be used for a prescription then it should be used.

EMIS Personally Administered (PAs)

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• If PA box is ticked = FP10 printed

• If PA box unticked and Nomination set = EPS script sent to Spine

• If PA box unticked and non-Nominated = EPS4 token printed

Printing FP10s – In exceptional circumstances!

• Paper FP10s can still be printed – but manual override is

required for each individual script

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NHS Printed Script (non- EPS)

will override EPS/Phase 4 and

print an FP10 paper script

‘FS’ Prescriber Endorsement

• Introduction of a new prescriber endorsement ‘FS’ for 'free supply of

sexual health treatment' to enable prescribers to endorse prescriptions for STIs to indicate to dispensers that the patient should not be charged.

• ‘until the EPS can be amended, prescribers are advised to prescribe STI treatment on paper FP10s, adding the FS endorsement and signature by hand next to each item prescribed for an STI’

• https://www.nhsbsa.nhs.uk/changes-fp10-nhs-prescription-form

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Prescriber Type – check local configurations

• Non-Medical Prescribers

– Independent nurse prescribers

– Pharmacist prescribers

Can these prescribers currently sign EPS prescriptions?

• Non-prescribing nurses

– Prescriptions will now be sent to the EPS prescribing queue

• Locums

– Can be configured using local prescriber PPAID

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Post dated prescriptions in Phase 4

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Post-dating

• EPS prescription is not released to spine until post date is

reached

• The Phase 4 token is printed on date signed – explain date to

patient

• Pharmacy – check for validity/date on token

Electronic Repeat Dispensing (eRD) in Phase 4

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EPS nomination is recommended

• Current paper RD will remain active until next issue is due.

• If no nomination – when phase 4 live; a new regime will be prescribed as eRD

with an phase 4 token.

• Patient takes Phase 4 token to pharmacy each time

• Pharmacy must check dispense history – EPS tracker, script date + issue

number

Wessex AHSN ERD support : https://wessexahsn.org.uk/projects/120/electronic-repeat-dispensing

Processes in Pharmacy

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Processes in Pharmacy

• Tokens instead of FP10s

• All tokens the same – green/white

• No need to print a white dispensing token in addition to the green

• COVID Exception processes – Inform local Pharmacies of intended policy

https://psnc.org.uk/our-news/covid-19-guidance-for-prescribers-using-eps-remotely/

• Scan phase 4 tokens as per R1 FP10s

• Make sure scanners work / barcode quality

• Once scanned down, all processes as per EPS R2

– Returns to spine / token to patient

– Cancellations / NDs

– Exemptions and endorsements

– Virtually all claims via EPS - claim regularly!

– Token submissions – (green and white)

• Keep nominating regular patients 22

Patient key messages

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• Little change for patients

• Poster must be displayed to comply

with GDPR

• Still get a ‘paper copy’ of prescription

to take to pharmacy

• More safe and secure, seen only by

the same people

Resources

• NHS digital website https://digital.nhs.uk/services/electronic-prescription-service/phase-4

• EMIS detailed system guidance

https://www.emisnow.com/csm?id=kb_article&sys_id=bdca0ae31b3b77006062620e6e4bcbd8

EMIS COVID-19 news: https://www.emisnow.com/csm?id=kb_article_view&sys_kb_id=b675b75a1b54d050acae2f06bd4bcb5c&spa=1

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Phase 4 Checklist

• Checklist for CCG to assure

practice readiness to go live

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Patient Comms Materials

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EPS Prescription Tracker

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• Ensure all colleagues can

access the Prescription

Tracker

• Provides a detailed

prescription event history of

electronic prescription

https://portal2.national.ncrs.nhs.uk/prescription

sadmin/prescriptionsearch

Issue Management

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• Issue reporting and escalation

• Patient communication

• Alert services:

http://nww.hscic.gov.uk/servicemanagement/status/

http://nww.hscic.gov.uk/servicemanagement/status/

How to go live with EPS Phase 4

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Preparation

– Checklist – Staff awareness

Activation Activation request form on EMISnow (user request). EMIS will active within 2 days of request (note: activation will occur overnight) EMIS have communicated this directly to practices (14th April 2020) Links also on NHS Digital website: https://digital.nhs.uk/services/electronic-prescription-service/phase-4/clinical-commissioning-group-information

Local Contacts

Please use normal EMIS service desk routes for any system issues or

queries.

Oxfordshire:

Todd Davidson

email: todddavidson@nhs.net

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Any more questions?