Repeat DispensingSue Carter Regional Tutor Hampshire and IOW

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Repeat Dispensing

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• At least two thirds of all prescriptions generated in primary care are for

patients needing repeat supplies of regular medicines

• Since 2005 repeat dispensing has been an Essential Service

Under the service pharmacies will dispense repeat dispensing prescriptions and

store documentation if required by the patient. They will ensure that each repeat

supply is required and seek to ascertain that there is no reason why the patient

should be referred back to their GP.

Utilisation

• There is significant variation in the proportion of prescriptions managed in this way, with some GP practices not making this service available to their patients at all

• The number of repeat items offered to patients in this way (as a percentage of all items) is currently just above 7% in England. However CCGs vary in their use of repeat dispensing from 0 to 37%

• Implementation of EPS2 will support practices in their roll out of repeat dispensing

Wessex

CCGs

Increasing use of the service – Contract changes from 1 March 2015

• Uptake has been very low – in part due to lack of engagement by GP

practices

• In order to increase the benefits gained by patients and the NHS from

1st March 2015 a new requirement in CPCF to give advice to

appropriate patients about the benefits of the repeat dispensing service

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National Activity

• NHS England – work with CCGs, LMCs, LPCs to encourage increased use of repeat dispensing by GPs.

• PSNC- encourage LPCs to support this local actvity

• NHS Employers – discuss with PSNC, General Practioner Committee of BMA what can be done to support an increase in repeat dispensing nationally

Actions for contractors

All pharmacies will be encouraged to work with LPC and other partners to support activities to increase uptake of repeat dispensing by prescribers in their area

• identifying and notifying prescribers of suitable patients• seeking transfer of patients already using managed repeats to repeat dispensing

Terms of service – 1 March 2015

Pharmacies to give advice to appropriate patients about the benefits of the repeat dispensing service

• verbally explaining about the service and its benefits to patients• providing patients with a leaflet describing the service when they are collecting a prescription

Appropriate is defined as

“ patients with long-term, stable conditions who require regular medicines and whose condition is unlikely to change in the short to medium term”

Benefits to patients

• Simplified process – one review can generate up to 12 months of prescriptions• Choose a pharmacy that convenient• Saves time as they only have to collect from pharmacy – don’t have to remember to order• Medicines ready to collect• Reduced risk of running out • If going on holiday can collect sufficient medicines• Safety • Can see the doctor at anytime for acute problems or if need review

Patients who use the service like it and want to carry on

Benefits to Practice

• Less prescriptions need to be generated• Reduced number of people coming into the surgery to order/collect prescriptions• Less queries face to face and via telephone• Reduction in need for urgent/ emergency prescriptions• Can link end of prescription to review

Benefits to Pharmacy

• Improved workload scheduling• Reduced queries• Reduced waste handling• Improved stock control• Reduced owings • Increase in repeat business• Increased patient contact, improving relationships and patient safety• Link to other Pharmacy services

Concerns of GPs

The prescriber determines whether the patient is suitable or not. They decide how long to prescribe for.

At each dispensing the service requires the pharmacy to check:• Patient still taking the medicines as intended by prescriber• Not suffering from side effects• Check whether any alterations made e.g. Hospital• Any changes in health needing referral• Taking any other medicines e.g. Herbal, OTCs

Benefits of EPS over paper based system

• Prescribers can cancel a whole prescription or an individual item off an electronic repeatable prescription with immediate effect- cancels item on all future prescriptions – confirmation from the spine

• Reduction in emergency supplies

• Easier to manage requests for holidays etc

• Easier to change nomination – and the remaining issues available on spine to new pharmacy

Identifying suitable patients

• Search PMR to identify a list of patients who would benefit

• Explain the benefits to appropriate patients during MURs

• Choose trigger medicines for pharmacy team to discuss benefits with patients

• Prioritise patients on managed repeats services for discussions about repeat dispensing, as they are used to coming straight to pharmacy to collect repeat medication

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Training – e learning and assessment

www.cppe.ac.uk

Free GPhC registrants

£10 Non GPhC registrants

https://www.cppe.ac.uk/programmes/l/repeat-e-01/

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CPPE Courses

Confidence in consultation skills All Day Events

4 June Holiday Inn Eastleigh Booking Reference 43917

30 June Holiday Inn Basingstoke Booking Reference 44002

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