Agenda item

The Leicester City CCG submits a briefing paper concerning medicines optimisation and third party ordering of repeat prescriptions.

Lesley Gant (Head of Medicines Optimisation) presented the report of the Leicester City CCG.

It was reported that the CCG had a team of experienced Clinical Pharmacists and Pharmacy Technicians that lead the Medicines Optimisation Agenda (also supporting GP practices to do so).  This team also looked at the value that medicines deliver, making sure they are clinically effective and cost efficient, and safeguards the best use of the prescribing budget for the CCG.  The report also defined the aims and importance of the Medicines Optimisation agenda at national, regional and local level.

Details of the current third party ordering and repeat prescription processes were reported including risks that had been recognised .  In response to this issue it was reported that the CCG had reviewed the whole process of repeat prescription ordering as well as the management and patient self-care around repeat medication and long-term conditions.

The CCG has put forward to practices a number of recommended actions, which culminates in changes to third party ordering of prescriptions, as follows:

• Practices will be encouraged to undertake a review of current processes of repeat prescription management. This involves general housekeeping to ensure current systems are safe, appropriate and follow national and local best practice.
• Practices are encouraged to further promote and support the use of online services for patients to order their repeat medication, where they are able to do so, and provide patient training to facilitate this.
• Support greater use of electronic transfer of prescriptions (EPS) and Electronic Repeat Dispensing (eRD) (batch prescriptions for consistent repeat orders).
• The final stage of this process would be a carefully managed implementation programme to reduce patient reliance on third party ordering across Leicester City taking account of learning from areas where this has already being implemented.

Lesley was thanked for presenting the report and Commission members were invited to ask questions and comment on the report and its findings.

Members referred to the concerns raised by constituents relating to the confusion they experienced, particular with the move to online services.  It was noted that many vulnerable and elderly patients experienced problems.  The issues concerning language gaps was also raised, it being noted that the support of some local pharmacies was crucial.

In response, reassurance was provided that paper prescriptions would continue to be available for vulnerable patients, and it was expected that the move to the electronic transfer would also benefit many vulnerable and elderly patients.  Initiatives including the availability of support packs to practices and increased mailshots to advise of the changes were reported and noted.  The availability of information printed in various languages was also recognised.

In respect of the consultation process and the number of respondents providing the sample information, it was noted that although 169 respondents seemed a low number, the CCG had been informed that this was a suitable level of response to help to inform future policy. 

Comment was raised on the numbers of complaints that had been received to date and the need to support those affected by the proposed changes was emphasised, including the concerns raised by pharmacies.  The CCG considered that the levels of comments and complaints were relatively low and that full consideration was given to the process in responding to and learning from comments.

The Assistant City Mayor (Health) was invited to comment.  Councillor Dempster referred to the need to ensure effective training to pharmacy staff and GPs.  She also expressed concern at the delays that may result in accessing the electronic system.

In reply it was reported that the training was provided as part of the national scheme and that many GPs and staff had supported the move to electronic services as it was in the practice interest to allow greater time for other patients.  It was also noted that the information held electronically would ensure that harm could not be caused with the wrong medication being prescribed.

It was reported an noted that a number of actions are now being taken to support practices with implementation, including a communications campaign, updates to the CCG website, social media accounts, messages displayed via GP practice TV screens, and traditional media.

There would also be continued full dialogue with the Local Pharmaceutical Committee to ensure that all community pharmacy and other third party providers are aware of

Scheme and support to member practices to help identify vulnerable patients who will still require help with ordering their prescriptions.

In conclusion, it was reported that the CCG had provided support from September 2019 and practices had been able to implement the initiative within their own timelines from October 2019, up until March 2020.

The Chair commented that members of the Commission would welcome any information on the proposed evaluation process before it was implemented.

AGREED: 

1)    That the report and update be noted.

2)    That a further report on the evaluation be submitted to the Commission following implementation to March 2020.