Welcome to the latest issue of our monthly newsletter where we bring you industry insights using NHS data. This month is focusing on changes to the Electronic Prescription Service and how these may affect your business.
Industry Overview - Items
In the NHS data released to December, items for the month were down 0.9% compared to December the previous year. The familiar trend of the Online charge is evident with a boost of 25% item growth in the last month compared to December last year.
Industry Overview - Services
The average MURs per branch done from April to December was 212. This is indicative of the total MURs for this year being closer to target than last year. Independents and small groups are struggling a little to keep up. The monthly average of NMS is increasing slightly with an average of 7 done per pharmacy in December. With the average target per month at 38 it still seems to be a challenge to maximise this service.
Changes to the Electronic Prescribing Service
- EPS R4 Pilots & Addition of Schedule 2 & 3 CD’s
Schedule 2 and 3 drugs can now be prescribed electronically by the majority of GP practices across England. That means the amount of electronic scripts you’ll be handling with the narrow 28 day turnaround to claim for payment, is going to increase massively. We’d encourage you to take a look at the guidance available on the NHS Digital site HERE. But in the meantime here are what we see as the pro’s (and otherwise) for your business:
1. Less Green Scripts!
Savvy operators will take the opportunity to get nominations from this sizeable pool of patients. Remember though, you’ll still need to capture a patient signature on the back of a dispensing or prescription token and this needs to be sent to the NHSBSA the same month the claim is made.
3. Patients in Branch
We’re going to list this as both an opportunity and a threat. Since a patient or their representative will still need to sign for CD’s, there’s no opportunity for online pharmacy to fulfill these scripts. Incidentally, if you are concerned about the threat of online pharmacy to your business why don’t you reach out to us for your FREE NHS dashboard which will show you at a glance how online pharmacies are affecting your local area?
1. Exemptions and Compliance
There’s a training piece here to ensure your staff know how to correctly process these scripts. As with any other exempt script you’ll need to ensure the exemption is valid and matches what is on the spine (unless the patient is exempt on age grounds). You also have obligations to ensure compliance with the Misuse of Drug Regulations. In addition to capturing a physical signature you’ll also need to decide a method of marking the prescription at the time of supply. Dispense notification works for this, but physically marking the FP10T does not comply. Talk to your PMR system provider to see if they have a process you can use to record the date with an electronic audit trail.
2. 28 Day Window to Claim
Up until now a bit of leakage for unclaimed EPS scripts for CD’s falling past the very short 28 day window might have been okay. That pipe is about to burst though with Schedule 2 and 3 now shifting a vast number of CD scripts over to EPS. Your processes for claiming need to be absolutely watertight or you could face a very big hit. RWA’s decision support solution already has this functionality bedded in and we’ll be providing this service to all our UK pharmacy clients from the get go, but if you’re not yet with us you’ll need to do a full review of your checks and procedures – or better yet feel free to call us for a bit more information on what exactly this means for your pharmacy.
3. Patients have to be in Branch
We said we’d list this as both an opportunity and a challenge, and this is for anyone out there sending a dispense notification before the medicine is in a patient’s hand. There is no opportunity to deliver these meds, so you are relying on the patient to get into the branch within a 28 day period of a dispense note being sent to the spine.
4. And One To Watch For
Watch out for oral liquid methadone with a packaged dose endorsement! If you receive an EPS prescription for this and want to claim the PD fee for each separate container you’ll need to go back to the prescriber to request an FP10 (if you don’t need/want to claim this fee you can submit a claim).
EPS R4 – Impact to your pharmacy
Currently only around 64% of prescriptions nationally are EPS, making cardboard boxes stuffed full of green scripts are a familiar part of any pharmacists working environment. With phase 4, electronic prescribing will become the default – so as much as 95% of scripts will now be processed electronically. Aside from less boxes to trip over there should be some real benefits for the way you do business:
- Less administrative time for your staff means more patient-facing time.
- There’s less room for error on a digital script, reducing the risk of your patients receiving the wrong medicine.
- Fewer reimbursement queries due to electronic prescription endorsement.
- Taking a longer term view, anything digital makes integration alongside other NHS service providers more straightforward. If the future is all about joined up care this capability is a must.
Should you like any clarifications, or if you’d like to explore any of these areas further please let me know.
Business Development Manager
Call: 0808 1890 617
Mob: +353 86 043 4094