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How our CCG tried a new repeat prescription approach

By Diar Fattah
22 January 2019

The traditional repeat prescription ordering process presents challenges for the NHS, says Diar Fattah, associate director of medicines optimisation at Dartford, Gravesham and Swanley (DGS) CCG. 

The current repeat prescription process flags several issues for the NHS; it’s complex, time-consuming, costly, and can even have implications for patient safety. A great deal of money is spent every year on repeat prescriptions in the NHS, presenting an area that could be improved through better ways of working.

At DGS CCG the volume of repeat request is high, in fact 77 % of the medicine dispensed in our community is repeat medication. However each month a great deal of waste is generated through items ordered on repeat prescription. Undeniably the traditional process of managing, ordering and collecting repeat prescriptions creates inefficiencies for everyone; GP surgeries, community pharmacies, our CCG, and the patients.

To combat the difficulties faced, our medicines optimisation team launched a telephone prescription ordering direct (POD) scheme last year, where a team of trained medicine coordinators from our medicine optimisation team review the requests from patients, which minimises the wastage accumulated from patients ordering more than needed.

Significant improvements were achieved and the scheme was an early success; an achievement which we were keen to build on. In order to take it to the next stage and secure greater benefits, we recognised that technology was a key enabler. As part of our plans to expand the POD service across our whole catchment area, our target outcomes could only be achieved through using innovative technology.

Patients in our region can now use our Healthera mobile app, an app available from the NHS Apps Library, on their smartphones to order repeat prescriptions directly to our POD, and track and manage medications from their selected local pharmacy. The app was chosen because it already works with a network of pharmacies which suited our collaborative approach within the community.

Prior to adopting patient-facing technology, our POD service covered 10 surgeries and generated cost savings totalling £650,000. With an estimated three million every year in medication wastage within our CCG, our target is to increase efficiency so that more savings can be realised.

Expanding our service in this way has simplified the process enormously. By processing requests through the app as an alternative to the phone, it is replacing some of the labour-intensive calls. Requests come with all patient details and order history, which can be processed by staff in less time, and uniformly throughout the day.

This approach has resulted in saving our staff an estimated 72 hours per week. Since October and the launch of the Healthera app, we have increased the coverage from 80,000 patients to 140,000, processing 1,500 requests per week.

Part of our vision at DGS CCG is to be an innovative commissioning organisation, ensuring that our healthcare system works better for patients with a focus on the right care, at the right time, in the right place; a vision which cannot be delivered in isolation, and instead requires working in collaboration with key stakeholders.

Our collaborative approach has enabled real benefits for the GP surgeries in our locality and the community pharmacies. Clinicians often spent considerable time entwined in the paper repeat process, and by automating this aspect, time is now spent with patients on clinical duties as opposed to administration; a much better use of time both quality-wise and financially.

Patients can choose to collect medication from more than 60 pharmacies within our area. Our community pharmacies now have two-way communication via the Healthera app allowing them to provide advice and answer any questions; which supports pharmacies to play an ever greater role in patient healthcare.

Our aim for patients is to enable greater individual control over their health. By providing a free app, patients have more choice and convenience, it eliminates the need to visit their GP or pharmacy every time supplies run low, and enables active self-management of medication.

Currently 16 GP surgeries use our new system, it’s available to 140,000 patients and our ambition is to scale this further to encompass all 31 GP surgeries in the region, which will open up the service to more than 265,000 people living in our area. By doing this and managing repeat prescription orders more efficiently we are reducing wastage and saving valuable NHS funds.

At DGS CCG being innovative with the repeat prescription process is having a real impact on our organisation; any initiative to reduce the millions of pounds wasted from public funds every year is a welcome improvement, and I believe CCGs are in the position to make a real difference here.

Diar Fattah, associate director of medicines optimisation at Dartford, Gravesham and Swanley (DGS) CCG

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