Evaluation EPs Repeat Dispensing Pilot North Manchester Greater

Evaluation EPs Repeat Dispensing Pilot North Manchester Greater

Evaluation EPs Repeat Dispensing Pilot North Manchester Greater Manchester LPC Introduction North Manchester Clinical Commissioning Group (CCG) and Greater Manchester Local Pharmaceutical Committee (GM LPC) have been working in collaboration to deliver a Repeat Dispensing Project across North Manchester. The project intended to support the wider health system through better use of the community pharmacy network using the Electronic Prescription Service as part of Repeat Dispensing. Current Issues Current prescribing issues were identified that eRD may be able to positively impact and improve Workload and transaction costs for GP practices Patient safety potential risk patients will be without medication Patient convenience Professional working relationships and primary care collaboration Medicines waste Process All 36 GP practices in North Manchester are included in the pilot, along with the 52 neighbouring pharmacies. Each GP practice nominates an eRD Champion, ideally their current EPS

lead. eRD Champions and pharmacies attend training sessions to learn more about repeat dispensing using EPS and to ensure integration between GP practices and neighbouring pharmacies. Each pharmacy nominates their 10 most suitable patients, in line with the standard operating procedure and training documents provided by the Project Lead and the training session they have attended. The GMLPC Project Lead visits each GP practice and spends 3-4 hours implementing eRD for suitably identified patients. This includes setting up the computer system and training practice staff. KPIs following implementation 1. 100% of community pharmacies actively identifying suitable patients 2. 75% of community pharmacies identify 10 suitable patients 3. 5% of North Manchester patients on eRD 4. 75% of GP practices demonstrate reduction in repeat prescription workload 5. 75% patients feel they can manage their prescriptions better on eRD 6. 75% patients feel community pharmacy is best place to manage repeat medication. Status 27 38 GP practices visited and live by September 2017. Pharmacies attended eRD training in February 2017. 511 811 Patients implemented on eRD

by January 2018. Patients nominated for eRD by January 2018 Pharmacies There are 52 pharmacies in the North Manchester pilot area. 38 attended the eRD pharmacy training in February. Furthermore, some pharmacies that did not attend training are engaged and nominating patients. GP Practices The project lead has visited 27 of the 36 North Manchester GP practices Face to face in-house training was provided to 97 members of staff (Including GPs, Practice Managers, Nurses) This training took 92 hours in total. Patients 844 Patients were selected for eRD So far 511 patients have been implemented. KPIs following implementation 75% of community pharmacies identify 10 suitable patients Achieved 811 patients were nominated, this equates to 15 per pharmacy on average. 511 patients have been implemented, this equates to 9.8 per pharmacy on average. It was difficult to capture the data as Pharmacies submitted patients direct to the GP, some practices reviewed the lists provided by community pharmacies prior to implementation and some were deemed unsuitable. The number of nominated and implemented patients has therefore been captured by GP practice rather than pharmacy. Anecdotally the project leads reported that many pharmacies nominated patients for eRD prior to or on the day of implementation, and were engaged with the service. KPIs following implementation 5% of North Manchester patients on eRD in progress According to data published by NHS Digital 3.5% of patients in Manchester CCG

locality were on eRD in March 2018. It has not been possible to break this down to North Manchester due to the merger of the CGGs and the way the data is presented, we do not have access to data that can be split. Feedback from Patients Feedback was received from 113 patients. Demographics Male: 42% Female: 58% Age. 25-44: 2.78% 45-64: 32.41% 65-74: 30.56% 75 or older: 32.41% Ethnicity. White: 92.86% Asian: 2.67% Black: 2.68% Q. Had you heard of repeat dispensing prior to this service? Yes 61.47% Feedback from Patients KPIs following implementation 75% patients feel they can manage their prescriptions better on eRD - Exceeded 90% of patients said that they feel they can better manage their medication as a result of the service. 75% patients feel community pharmacy is best place to manage repeat medication. - Exceeded 93% of patients said that they feel their community pharmacy was the best place to manage their repeat medication. Feedback from Patients Positive Outcomes 94% said they are happy with the current process for ordering their repeat prescriptions. 95% said they feel this is a better way of ordering and looking after their medication. 91% said that through this service, they have not received anything they did not order / need. 94% said that during the service they did not run out of any medication which

resulted in a call to the out of hours service. 89% said that they felt the service gave them better control of their medication. Feedback from Patients Opportunities Q. How would you improve the service? 37 open responses Positive response/no improvement needed: 16 Receive medication quicker/on time: 6 Improve communication between GP and Pharmacy: 5 Improve patient information: 3 Other (general): 8 None, its excellent Happy with the service Feedback from Patients Opportunities Q. Please add any general comments: 46 open responses Positive response: 28 Issues experienced: 7 Delays experienced: 3 Improve communication between GP and Pharmacy: 1 Improve patient information: 2 Other (general): 5 I am pleased with the way the service is conducted Excellent service that is patient focused Thank You

Feedback from Patients Opportunities Reduce Delays 68% of patients said they feel they received their medication with undue delays compared to before joining the service. 16 respondents highlighted in the comments that they had experienced some issues with the service, 9 of which mentioned issues with delays or their medication not being ready on time. Patient: Ensure repeat prescriptions are ready for me to collect every 28 days (in my case) without fail. No delays, no missing items. Feedback from Patients Opportunities Improved communication between pharmacy and patient 78% said that they received adequate information about the service. However 61% said that no one from the pharmacy team checked/contacted them about which medication they needed before dispensing. In the comments 6 patients recommended an improvement in communication from the pharmacy. Patient: Contact before regular delivery to just check supply to cut back on duplicate orders and prevent build up 50% of patients said this service prevented a build-up of medication at their house. Feedback from Pharmacies and GP Practices To assist the evaluation of the pilot GMLPC sent a questionnaire to all the GP practices and pharmacies involved. 32 Responses were received from pharmacies and 32 responses were also received from GP practices, this allows for the answers provided to be evaluated comparatively. Feedback from Pharmacies and GP Practices Q. What is your role? Pharmacy

GP Practice Awareness prior to service 93.75% of pharmacies and 68.75% of GP practices were aware of repeat dispensing prior to the service starting. 84.38% of pharmacies and 67.74% of GP practices were aware of electronic repeat dispensing prior to the service. Feedback from Pharmacies and GP Practices Q. Did your pharmacy/GP practice use repeat dispensing as part of your prescription management? Pharmacy GP Practice Benefits of repeat dispensing 96.88% of pharmacies said that the majority of their team are aware of the benefits of repeat dispensing and 80.00% of GP practices said that the majority of their prescribers are aware of the benefits of repeat dispensing. Feedback from Pharmacies and GP Practices KPIs following implementation 100% of community pharmacies actively identifying suitable patients - Ongoing 90.63% of pharmacies said they have been able to continually identify patients suitable for electronic repeat dispensing. 70.97% of GP practices said they felt the patients selected by community pharmacies are appropriate for electronic repeat dispensing. Feedback from Pharmacies and GP Practices KPIs following implementation 75% of GP practices demonstrate reduction in repeat prescription workload Data not available The questionnaire asked if electronic repeat dispensing had impacted on the prescription work flow and the time taken to process repeat prescriptions but did not ask if there had been a reduction, so this data is not available. This would need to be edited for future use to ensure it is captured. 45.16% of GP practices said that electronic repeat dispensing had an impact

on the prescription workflow and 43.33% said that it had impacted on the time taken to process repeat prescription requests. In comparison 74.19% of pharmacies said that electronic repeat dispensing had impacted in the prescription workflow and 77.42% said that it had impacted on the time taken to process repeat prescription requests. Feedback from Pharmacies and GP Practices Positive Outcomes 67.74% of pharmacists said they feel this service has improved their stock control for these patients. 87.10% of pharmacists said they feel they could better manage requests for early prescriptions, for example if the patient is going away on holiday. 70% of pharmacists said this service enabled them to better highlight medication related issues for the patient. 87.5% of pharmacies and 80.65% of GP practices said that the majority of their team/prescribers are aware that unused/not needed items can be cancelled at any time by the practice. Feedback from Pharmacies and GP Practices Opportunities Awareness of the EPS tracker 100% of pharmacies said they are aware of the EPS tracker and that they know how to use it, of these 96.88% said that they feel confident using it and 87.5% said that they use it regularly. In comparison 62.50% of GP practices said that they are aware of the EPS tracker and 54.84% said they know how to use it. This suggests that there is an opportunity to develop awareness and understanding at GP practices of the EPS tracker. Feedback from Pharmacies and GP Practices Opportunities Making use of Information in MURs 83.87% of pharmacies said that the majority of their team are aware that not dispensed items are flagged up on the Patient Medication Record. 65.52% said they feel their local practice(s)

use this information as part of their medication reviews with patients. In comparison 41.94% of GP practices said that the majority of their prescribers are aware that not dispensed items are flagged up on the Patient Medication Record. 60.00% said their clinicians use this information as part of their medication reviews with patients. Feedback from Pharmacies and GP Practices General comments Pharmacist: Positive impact particularly for dosette patients Its a good service GP: Only small amounts of patients on repeat dispensing not enough to have any impact. Good Our practice hasnt really embraced electronic repeat dispensing mainly due to lack of training and the length of time changing each item. Need more training. Struggling with updating repeat prescriptions. Feedback from Pharmacies and Patients Opportunities Improved communication between GP and pharmacy Only 56.25% of pharmacies said they felt repeat electronic dispensing has reduced the number of phone calls made to local GP practices. Pharmacist: Although EPS repeat dispensing has reduced Adminit has increased queries for ussome items missinghaving to phone surgery. 6 patients also added comments suggesting that communication between the pharmacy and GP could be improved. Patient: Medical centre and pharmacy dont seem to communicate in a manner that is beneficial to the patient KPIs following implementation Conclusion

1. 100% of community pharmacies actively identifying suitable patients In progress 2. 75% of community pharmacies identify 10 suitable patients Target achieved 3. 5% of North Manchester patients on eRD In progress 4. 75% of GP practices demonstrate reduction in repeat prescription workload Data not available 5. 75% patients feel they can manage their prescriptions better on eRD Target exceeded 6. 75% patients feel community pharmacy is best place to manage repeat medication Target exceeded Financial Overview The project has kept within its budget of 17958. The table below sets out the spending during the 5 different phases of the project. Project Spend 5,000.00 4,537.90 4,500.00 4,189.04 4,000.00 3,537.95 3,500.00 3,000.00 2,681.55 2,500.00 2,000.00 1,556.25

1,500.00 1,000.00 500.00 0.00 e as Ph 1 - g in op c S d an i ce rv e S s De ig n e as Ph 2

rm ha P - ac i st ai Tr ng ni e as Ph 3 P -G Im e pl m ti ta en on as

Ph e 4 d ue n ti on -C rt po p su as Ph e 5 -E va ati lu on Financial Overview The table below displays how the budget has been spent throughout the project. Comms and Engagement Support Printing and mailing

281.25 539.04 Clinical Lead Room Hire Business Support Manager Admin Support Project Lead 2,375.00 590.80 1,200.00 4,401.00 7,115.60 Conclusion The project has been successful and provided a platform for supporting further implementation. The project has shown improved communication and better patient perception for their repeat management. Some scoping work to understand barriers of implementation, impact on waste reduction and ensuring a seamless service between practices and pharmacies would be beneficial. This would support development of further training/ implementation support which could be beneficial to the pilot area and facilitate the project being rolled out to other areas. Pharmacies Trading Name

Address of Contractor 1 Address of Contractor 2 Address of Contractor 3 Postcode Telephone number Asda Pharmacy Asda Sport City, Alan Turing Way Bradford Manchester M11 4BD 0161 230 3520 Asda Pharmacy North City Shopping Centre Harpurhey Manchester M9 4DJ 0161 205 8941 x 319 Blackley Village Pharmacy Unit 5, 73 Old Market Street Blackley

Manchester M9 8DX 0161 795 2787 Boots 11-13 Piccadilly City Centre Manchester M1 1LY 0161 834 8244 Boots 32 Market Street City Centre Manchester M1 1PL 0161 832 6533 Boots Unit 5, Piccadilly Station City Centre Manchester

M1 2BN 0161 228 2059 Boots 3A The Circus Portland Street Manchester M1 4RL 0161 236 7254 Boots Collegiate Medical Centre 407 Cheetham Hill Road, Cheetham Manchester M8 0DA 0161 205 3475 Boots 103 Crumpsall Lane Crumpsall Manchester M8 5SR 0161 721 4086

Boots Cheetham Manchester M8 8EP 0161 832 6623 Boots Cameolord Pharmacy Manchester Fort Retail Park, Cheetham Hill Road 65 Victoria Avenue 16 Oxford Street Blackley City Centre Manchester Manchester M9 0RD M1 5AE 0161 740 2137 0161 236 1445 Cheetham Hill Internet Pharmacy 460B Cheetham Hill Road Cheetham Hill Manchester

M8 9JW 0161 795 2781 Cohens Chemist 861A Ashton New Road Clayton Manchester M11 4PA 0161 370 9227 Cohens Chemist 22 Swan Street Ancoats Manchester M4 5JQ 0161 834 5410 Cohens Chemist Breightmet Health Centre Collyhurst Manchester M40 7QH

0161 205 1451 Cohens Chemist 407 Queens Road Collyhurst Manchester M40 8RL 0161 205 5480 Cohens Chemist 287 Cheetham Hill Road Cheetham Hill Manchester M8 0SN 0161 203 5060 Cohens Chemist 244 Cheetham Hill Road Cheetham Hill Manchester M8 8UP 0161 205 1678 Cohens Chemist

102 Church Lane Harpurhey Manchester M9 4NH 0161 205 1670 Cohens Chemist 664 Rochdale Road Harpurhey Manchester M9 5TT 0161 205 1864 Cohens Chemist 55 Victoria Avenue Blackley Manchester M9 6RA 0161 740 1014 D & K Chemist 380 Moston Lane

Moston Manchester M40 9LX 0161 681 2296 DocPharma Pharmacy 1st Floor, 84 North Street Cheetham Manchester M8 8RA 0161 819 5024 Drugs 4U Pharmacy 1st Floor, 311a Moston Lane Moston Manchester M40 9NL 0161 222 8287 Haven Chemist 6 Medway Walk Miles Platting Manchester

M40 7HS 0161 205 2174 Pharmacies Trading Name Address of Contractor 1 Address of Contractor 2 Address of Contractor 3 Postcode Telephone number Higher Crumpsall Pharmacy 248 Middelton Road Higher Crumpsall Manchester M8 4WA 0161 740 4774 K'S Chemist Ancoats Primary Care Centre Old Mill Street, Ancoats Manchester M4 6EB

0161 273 5721 Lloyds pharmacy 109 North Road Clayton Manchester M11 4NE 0161 223 2131 Lloyds pharmacy Wellfield Medical Centre 53 - 55 Crescent Road, Manchester M8 9JT 0161 740 2378 Lloyds pharmacy Unit 1, Burgess House North City Shopping Centre, Harpurhey Manchester M9 4DH 0161 205 2164

Manchester Pharmacy Unit 4, Hoyle Ind Estate Hoyle Street Manchester M12 6HG 0161 274 4442 Mediward Ltd 227 Hill Lane Blackley Manchester M9 6RG 0161 795 7572 Newchem Pharmacy 55 Old Church Street Newton Heath Manchester M40 2JN 0161 681 2928 Peak Pharmacy

Unit 11, Lime Square. 1221 Ashton Old Road Higher Openshaw Manchester M11 1DA 0161 301 2940 Pharmaco 84 - 90 Stanley Street Higher Openshaw Manchester M11 1LE 0161 301 5896 Rowlands Pharmacy 400 Alan Turing Way Beswick Manchester M11 3BE 0161 223 0112 Rowlands Pharmacy 4 Windcroft Close

Beswick Manchester M11 3SN 0161 223 0932 Lloyds Pharmacy In Sainsburys 170 Heaton Park Road West Higher Blackley Manchester M9 0QS 0161 251 8728 Superdrug Stores 7 - 9 Piccadilly City Centre Manchester M1 1LY 0161 834 6091 Tesco In-Store Pharmacy Cheetham Hill Road Cheetham

Manchester M8 5DP 0161 602 8946 Tesco In-Store Pharmacy Victoria Avenue East Blackley Manchester M9 6HP 0161 602 1055 Tims & Parker Pharmacy 85 - 87 Moston Lane East New Moston Manchester M40 3GP 0161 681 4128 Tims & Parker Pharmacy Valentine Medical Centre 2 Smethurst Street, Blackley Manchester M9 8PP

0161 202 4366 Well 139 - 141 Droylsden Road Newton Heath Manchester M40 1NT 0161 681 1110 Well 9 Old Church Street Newton Heath Manchester M40 2JL 0161 682 3311 Well 183 - 187 Victoria Avenue Blackley Manchester M9 0RB 0161 740 1902

Whitemoss Pharmacy 247 Charlestown Road Blackley Manchester M9 7BD 0161 740 3762 Wilkinson Pharmacy 384 Hollinwood Avenue New Moston Manchester M40 0JD 0161 681 1321 Wilkinson Pharmacy 203 Lightbowne Road Moston Manchester M40 9DD 0161 681 3006 Wilkinson Pharmacy 321 Moston Lane

Moston Manchester M40 9NL 0161 205 4351 Wise Pharmacy 376 Cheetham Hill Road Cheetham Hill Manchester M8 9LS 0161 740 7573 Crumpsall GP Practices Practice Address THE AVENUE MEDICAL CENTRE THE AVENUE MEDICAL CENTRE, 51-53 VICTORIA AVENUE, BLACKLEY, MANCHESTER, M9 6BA THE NEVILLE FAMILY CENTRE THE NEVILLE FAMILY CENTRE, 25 OLD MARKET ST,BLACKLEY, MANCHESTER, M9 8DX CHARLESTOWN MD CHARLESTOWN MD, CHARLESTOWN RD, BLACKLEY, MANCHESTER, M9 7ED ST GEORGE'S MEDICAL CENTRE ST.GEORGES DRIVE MED CTR, ST.GEORGES DRIVE, MOSTON, MANCHESTER, M40 5HP WHITLEY ROAD MEDICAL CENTRE WHITLEY ROAD MEDICAL CTR, 1 WHITLEY ROAD, COLLYHURST, MANCHESTER, M40 7QH SIMPSON MEDICAL PRACTICE SIMPSON MEDICAL PRACTICE, 361 MOSTON LANE, MOSTON, MANCHESTER, M40 9NB MP VICTORIA MILL VICTORIA MILL HEALTH CTR, 10 LOWER VICKERS STREET, MANCHESTER, LANCASHIRE, M40 7LH

FLORENCE HOUSE MEDICAL PRACTICE HGR OPENSHAW PCC, 1344 ASHTON OLD ROAD, MANCHESTER, M11 1JG LIME SQUARE MEDICAL CENTRE LIME SQUARE, ASHTON OLD ROAD, OPENSHAW, MANCHESTER, M11 1DA THE SINGH MEDICAL PRACTICE THE SINGH MEDICAL PRACT, 1 CHURCH LANE,HARPURHEY, MANCHESTER, LANCASHIRE, M9 4BE DROYLSDEN RD FAMILY PRACTICE 125 DROYLSDEN ROAD, NEWTON HEATH, MANCHESTER, M40 1NT HAZELDENE MEDICAL CENTRE HAZELDENE MEDICAL CENTRE, 97 MOSTON LANE EAST, NEW MOSTON, MANCHESTER, M40 3HD PARK VIEW MEDICAL CENTRE PARK VIEW MEDICAL CENTRE, 66 DELAUNAYS ROAD, CRUMPSALL, MANCHESTER, M8 4RF CITY HEALTH CENTRE CITY HEALTH CENTRE, 2ND FL, 32 MARKET ST, MANCHESTER, LANCASHIRE, M1 1PL CONRAN MEDICAL CENTRE CONRAN MEDICAL CENTRE, 77 CHURCH LANE, HARPURHEY, MANCHESTER, M9 5BH Date visited Number of staff trained? 0 4/7/717 5 0 11/07/2017 1 18/07/2017 4 0 18/07/2017 6

25/07/2017 6 0 0 01/08/2017 3 01/08/2017 3 29/08/2017 4 0 26/09/2017 4 GP Practices Practice Address BEACON MEDICAL CENTRE BEACON MEDICAL CENTRE, 156 VICTORIA AVE,BLACKLEY, MANCHESTER, M9 0FN DAM HEAD MEDICAL CENTRE DAM HEAD MEDICAL CENTRE, 1020 ROCHDALE RD,BLACKLEY, MANCHESTER, M9 7HD JOLLY MEDICAL CENTRE THE JOLLY MEDICAL CENTRE, 72 CRESCENT RD, CRUMPSALL, MANCHESTER, M8 9NT CHEETHAM HILL PRIMARY CARE CENTRE CHEETHAM HILL PCC, 244 CHEETHAM HILL RD, MANCHESTER, M8 8UP QUEENS MEDICAL CENTRE CHEETHAM HILL PCC, 244 CHEETHAM HILL ROAD, CHEETHAM HILL, MANCHESTER, M8 8AU BROOKDALE SURGERY BROOKDALE SURGERY, 202 DROYLSDEN ROAD, NEWTON HEATH,MANCHESTER, M40 1NZ

NEWTON HEATH MEDICAL CENTRE NEWTON HEATH HEALTH CTRE, 2 OLD CHURCH STREET, NEWTON HEATH, MANCHESTER, M40 2JF FERNCLOUGH SURGERY UNIT 1, TAVISTOCK SQUARE, HARPURHEY, MANCHESTER, LANCASHIRE, M9 5RD WILLOWBANK SURGERY 1 WILLOWBANK, CHURCH LANE, MANCHESTER, M9 4WH ARTANE MEDICAL CENTRE ARTANE MEDICAL CENTRE, 1 MIDDLETON ROAD, HIGHER CRUMPSALL, MANCHESTER, M8 5DT WELLFIELD MEDICAL CENTRE WELLFIELD MEDICAL CENTRE, 53 CRESCENT RD, CRUMPSALL, MANCHESTER, M8 9JT CORNERSTONE FAMILY PRACTICE CORNERSTONE CENTRE, GRAHAM STREET, BESWICK, MANCHESTER, M11 3AA FIVE OAKS FAMILY PRACTICE FIVE OAKS FAMILY PRACTICE, 47 GRAHAM STREET, BESWICK, MANCHESTER, M11 3BB NEW COLLEGIATE MEDICAL CENTRE NEW COLLEGIATE MED.CENTRE, 407 CHEETHAM HILL ROAD, CHEETHAM, MANCHESTER, M8 0DA ALEESHAN MEDICAL CENTRE 3 SHIRLEY ROAD, CHEETHAM HILL, MANCHESTER, M8 0WB DR MOKASHI CLAYTON HEALTH CENTRE, 89 NORTH ROAD, CLAYTON, MANCHESTER, LANCASHIRE, M11 4EJ EASTLANDS MEDICAL CENTRE CLAYTON HEALTH CENTRE, 89 NORTH ROAD, CLAYTON, MANCHESTER, LANCASHIRE, M11 4EJ THE MAZHARI & KHAN PRACTICE CLAYTON HEALTH CENTRE, 89 NORTH ROAD, CLAYTON, MANCHESTER, LANCASHIRE, M11 4EJ ANCOATS URBAN VILLAGE MEDICAL PRACTICE ANCOATS PRIMARY CARE CTRE, OLD MILL STREET,ANCOATS, MANCHESTER, M4 6EE NEW ISLINGTON MEDICAL CENTRE ANCOATS PRIMARY CARE CTRE, OLD MILL STREET,ANCOATS, MANCHESTER, M4 6EE VALENTINE MEDICAL CENTRE VALENTINE MEDICAL CENTRE, 2 SMETHURST ST, BLACKLEY, MANCHESTER, GREATER MANCHESTER, M9 8PP Date visited 04/04/2017 Number of staff trained? 4 04/04/2017

3 25/04/2017 5 25/04/2017 3 25/04/2017 3 02/05/2017 3 02/05/2017 6 0 0 16/05/2017 3 16/05/2017 3 23/05/2017 4 23/05/2017 3

30/05/2017 1 30/05/2017 2 0 06/06/2017 5 06/06/2017 2 13/06/2017 3 13/06/2017 4 20/06/2017 4

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