NHS and IT/EPS
NHS and IT/EPS
The following is a high level summary of some key organisations involved with the delivery of NHS IT and EPS.
NHS Digital (previously Health and Social Care Information Centre (HSCIC) / Connecting for Health) manage the national infrastructure for a variety of NHS IT projects. From a community pharmacy perspective, the role of NHS Digital in managing the national infrastructure for the Electronic Prescription Service is the most high profile part of their service offerings. Their website address is https://content.digital.nhs.uk/home .
PSNC works closely with NHS Digital and NHS England to try to ensure that issues are addressed as quickly as possible. PSNC compiles a log of priority EPS issues. It is informed by the EPS feedback PSNC receives from pharmacy teams, LPCs, and Committee members.
NHS IT Operating Model
NHS England (formally known as the NHS Commissioning Board) are responsible for undertaking a range of tasks that support pharmacies in accessing and using national NHS IT applications.
The document – Securing excellence in IT Services: Operating model for community pharmacies, appliance contractors, dental practices and community optometry – sets out NHS organisational responsibilities in relation to IT.
Where there is a national policy directive for contractors to provide a service, including the Electronic Prescription Service, NHS England, through its local teams may either provide support functions itself or make arrangements for commissioning support units (CSUs) or any other IT provider to deliver them.
GP IT services will be managed by clinical commissioning groups (CCGs) on behalf of NHS England. A CCG may choose to provide support functions to GP practices itself or make arrangements to commission support from CSUs or another IT provider – whilst it is possible that in some areas, NHS England and CCGs will commission the same CSU to provide EPS support for pharmacies and GPs respectively, this may not always be the case
Local digital roadmaps
Clinical Commissioning Groups (CCGs) have developed Local Digital Roadmaps (LDRs) which set out how the local health system will increasingly use ‘digital’ to provide improved and more efficient healthcare.
This CCG work to produce LDRs has resulted from the agenda set out within the “Personalised Health and Care 2020” (PHC 2020) framework, which said that:
- clinicians should be increasingly paperless; and
- patients should expect that those caring for them have efficient access to relevant information.
The National Information Board (NIB) sets digital health priorities to increase the chances that the PHC 2020 objectives are achieved. NIB provided guidance for CCGs to help them develop LDRs, and to help them work with Sustainability and Transformation Partnerships to do so. LDRs are intended to be refreshed over time. The NIB said that CCG-led LDRs could support:
- an interoperable approach;
- procurement of the software and hardware technologies to support appropriate information sharing across systems;
- providing business change and training support regarding new technologies that help clinicians move towards paperless workflows; and
- the use of a robust delivery plan (CCGs could refer to NIB LDR guidance annex 4 and NHS England delivery plan guidance).
LDRs frequently include plans to boost:
- Electronic Prescription Service (EPS) utilisation;
- Electronic Repeat Dispensing (eRD) utilisation;
- online ordering of repeat prescriptions;
- NHSmail usage;
- e-discharge; and
- use of Summary Care Record (SCR) and other electronic health record-sharing.
To review the current LDR for your area, select your region from one of the four links below and then navigate to the LDR document which relates to your area:
Arrangements for distribution of Smartcards
NHS England through its local teams will be responsible for the issue of Smartcards. Given the business and patient safety critical nature of Smartcards, a Registration Authority (RA) needs to be in reasonable proximity to the pharmacies that it supports and have opening hours that properly reflect the realities of pharmacy practice. Contractors should report any concerns about the adequacy of local RA arrangements to LPCs. LPCs can escalate concerns to PSNC.
A copy of the operating guidance for Registration Authorities for 2013-4 can be accessed here (right click, and ‘save as’ Adobe Acrobat Reader is required).
A significant challenge to date has been inconsistency in local RA policies and in some areas, poor adherence to national guidance, for example refusal to issue the locum user role profile (FFFFF) where pharmacists have a legitimate need for it. As NHS England will ultimately be responsible for the provision of RA support, it is anticipated that there will be improved consistency in the application of RA policy.
Arrangements for distribution of tokens
On 1 September 2015, Capita took on responsibility for the delivery of NHS England’s primary care support services. The new name for the service is Primary Care Support England (PCSE). PSCE are responsible the delivery of tokens amongst other stationary items.
Arrangements for supervision of nomination functionality
NHS England have a duty to act on complaints about abuse of the service where the GP or pharmacy Terms of Service may have been breached. The NHS Digital will be providing the NHS with both summary and detailed reports about nominations to support the investigation of complaints.
Support with co-ordinating resolution of local issues arising in use of the service
For technical problems using the EPS service, system suppliers are currently and should continue to be a contractor’s first point of contact, the EPS Service model should be used to have issues escalated.
There may be a need to resolve operational issues that cannot be resolved directly between GPs and pharmacists, for example if inappropriate information is being included in electronic prescriptions for printing on the right hand side of dispensing tokens. Going forward, there may be a variety of organisations involved in supporting resolution of problems; this could include relevant leads at CSUs, CCGs or local NHS England teams.
General support for deployment
In some areas, local NHS England teams previously supported deployment by organising beneficial local awareness raising events or facilitating bringing together GPs and pharmacies to discuss business change. In many areas, this type of support will continue to be available, but in other areas, it may not. Support is available if LPCs want to independently organise events to provide support for contractors.
- Securing excellence in IT Services: Operating Model for Community Pharmacies, Appliance Contractors, Dental Practices and Community Optometry
- Operating Guidance for Registration Authorities 2013-14