ETP FOR WALES:

2-D BARCODED PRESCRIPTIONS (2DRx)

GUIDANCE NOTES

INTRODUCTION

Electronic Transfer of Prescriptions is an Essential Service under the Contractual

Framework for community pharmacy, agreed between the Welsh Assembly Government,

the Pharmaceutical Services Negotiating Committee (PSNC), Community Pharmacy Wales

(CPW) and the NHS Confederation.

BACKGROUND

1. Following a proof of concept and live trials in 2007, it was agreed by the national

community pharmacy IM&T programme board that the 2-dimensional barcoded

prescription ‘model’ (2DRx) was most appropriate for delivering an ETP service to

patients in Wales;

2. This approach received the endorsement of the Royal Pharmaceutical Society (Welsh

Executive) and CPW, as the key profession’s stakeholders of the national board;

3. Wales does not participate in the ‘EPS’ service being rolled out across England, as

Wales cannot connect its GP Practices and CP Practices to the English ‘Spine’;

4. Welsh GPs and CPs do not require the use of a ‘smartcard’ for controlled access to

the Welsh ETP service, as it does not rely on the NHS network for transferring the

prescription data in an electronic format between GP Practice and CP Practice.

Instead it uses a 2-dimensional barcode embedded on the prescription as the secure

carrier of data;

5. Since January 2010, all GP Practice systems in Wales have been generating barcoded

single sheet WP10SS prescriptions;

6. Since January 2010, some CP Practice systems have started the testing and piloting

of the scanning functionality of barcoded prescriptions.

WHAT HAPPENS NEXT?

1. Once the necessary upgrades have been completed to your PMR system, in order to

implement the 2DRx service in your pharmacy there will be a number of activities

you must undertake to become 2DRx-compliant and to ensure your staff are trained

in how to operate it;

2. This guidance outlines what you will need to do to implement 2DRx and what other

sources of information are available to you for further guidance;

3. The sequence in which activities are undertaken will vary depending on individual

circumstances. Your CP system supplier (or head office where applicable) will advise

you on the likely order of these activities. These activities, which are described in

more detail below include:

• Placing an order for your 2DRx-compliant PMR

• Installing hardware and upgrading software

• Training and communication

• Going live.

4. At the end of this guide are some frequently asked questions that will help to

address some of the queries you may have about the introduction of the 2-

Dimensional Barcoded Prescriptions service in your pharmacy.

DEVELOPMENT UPGRADES TO PMR

1. When the CP supplier’s system has passed NHS Wales compliance and accreditation

processes, the supplier will be given ‘Authority to Proceed’ with some early trials of

the system in a small number of pilot sites in Wales;

2. Once the system has been shown to be functional and effective, the CP system

supplier will be given ‘Authority to Proceed’ with phased rollout to all their Welsh CP

Practice sites.

ORDERING YOUR 2DRX-COMPLIANT SYSTEM

1. You will need to decide which CP system supplier you will use to deliver your 2DRx-

compliant system. In the first instance, we recommend that you should speak to

your current supplier to see what solution they can offer your pharmacy, taking into

account their current timescales for development;

2. There are a number of NHS-approved system suppliers to choose from, with some

offering an overall service package including the 2DRx software upgrade, hardware

advice and end-user training and support;

3. Your CP system supplier may need to conduct a site audit. Should this be required,

the main aims of this audit would be to:

• Assess the changes required to ensure the site meets the minimum hardware

specification;

• Confirm the operating systems and software already installed on site;

• Ensure there is an adequate provision of network cabling and power sockets to

support the required infrastructure;

• Agree the location of new hardware such as barcode scanners with the pharmacy

staff.

4. Once this audit has been undertaken, your system supplier is likely to have all the

necessary details to begin planning for the installation of hardware and software at

your pharmacy.

INSTALLING LOCAL HARDWARE AND SOFTWARE

1. Following the site audit (if necessary) and once authorised by NHS Wales, your CP

system supplier will be in a position to undertake any necessary hardware and

software upgrades. In terms of hardware installation, your system supplier will

provide and set-up a barcode scanner as well as enabling the software for operating

the 2DRx service, following their own system specific implementation process;

2. Checks will be made at each stage of hardware/software implementation by the

system supplier to ensure your system is operating correctly.

TRAINING AND COMMUNICATION

1. Your system supplier will be able to deliver any training on the use of the new

system. An explanatory leaflet entitled ‘2DRx – a guide for healthcare professionals’

has been produced by the NHS Wales to assist with staff briefing in parallel with any

system supplier guidance or training;

GOING LIVE

1. Once the above steps have been completed, you are ready to start using the 2-

Dimensional Barcoded Prescription service;

2. As GP practices in your area are already producing 2-Dimensional barcoded

prescriptions for their patients, you will now be required to process them using the

scanner(s) provided, so that the benefits of the system can be realised immediately;

3. Should you experience any difficulties with the operation of your scanner or the PMR

in general as a result of the upgrade to 2DRx, you must contact your CP system

supplier in the first instance, who can escalate to NHS Wales as appropriate;

4. Should you experience any issues with barcoded prescriptions from your local GP

Practices (for example, barcode misalignments), you must contact your CP system

supplier who will escalate to NHS Wales to contact the Practice.

FREQUENTLY ASKED QUESTIONS

WHAT CHANGES WILL 2DRX BRING TO THE DISPENSING PROCESS IN MY PHARMACY?

• When a barcoded prescription is issued to a patient by a Welsh GP Practice, the

main difference is that the WP10SS prescription form will have a 2-dimensional

barcode printed on it, an inch square and located in the ‘white box’ next to the GP

details;

• Once 2DRx is live in your pharmacy, you will have the capability to scan this

barcode to retrieve details of the prescription, rather than having to re-type it as

present. This is exactly the same as in England, except that the prescription details

are automatically collected from the barcode itself, rather than ‘pulled down’ over

the NHS network;

• The prescription data encoded within the barcode is a copy of what has been

printed on the prescription itself. Therefore, dispensers must be aware that any

poor quality in GP prescribing will also be reflected in the barcode and there will be

instances where you will have to overtype what was automatically populated from

the barcode (for example, dosage instructions/directions written in Latin or

shorthand);

• You may want to consider opportunities for improving your pharmacy workflow as

you introduce the scanning of prescriptions. The training provided by your system

supplier will cover this process in more detail.

HOW LONG WILL IT TAKE TO IMPLEMENT THE 2D-BARCODED PRESCRIPTIONS SERVICE

IN MY PHARMACY?

• The time it takes for your pharmacy to ‘go live’ will vary according to how much

progress your CP system supplier has made with development/implementation –

you should discuss this with your system supplier.

WILL I NOTICE ANY CHANGES WITH DISPENSING FROM 2D-BARCODED BARCODED

PRESCRIPTIONS RATHER THAN NON-BARCODED ONES?

• The implementation of 2-Dimensional Barcoded Prescription functionality has been

specified by NHS Wales to cause as little disruption to your dispensary as possible

by keeping, as far as possible, the same dispensing screens and processes;

• Once your pharmacy has ‘gone live’, you should be aware that, initially, barcode

scanning will slow up the normal dispensing time as you adopt this new

functionality and get used to the barcode scanner. This is normal when adapting to

any new technology, but over time the dispensing time will improve on traditional

keyboard entry;

• In addition, you should also be aware that there will be an initial period of ‘data

take-on’ for each patient who first presents with a barcoded prescription, while the

PMR reconciles existing patient information it holds against patient information in

the barcode. This may contribute to some of the initial small delay in dispensing

described above. However, for subsequent barcoded prescriptions per patient,

this process of reconciliation will cease, as patient matching will be against the

patient NHS number.

ONCE OPERATING THE SERVICE, CAN I STILL PROCESS WP10SS FORMS WITHOUT A

BARCODE?

• The 2-Dimensional Barcoded Prescription service has been developed to be flexible

enough that your system can still process prescriptions using manual keyboard

entry. For example, if the barcode is defaced, or if a patient with a non-barcoded

prescription (e.g. a dental prescription) attends your pharmacy, you can dispense

against the visible information on the prescription in the usual manner, by manual

keyboard entry.

WILL THIS NEW 2DRX SERVICE COST ME ANYTHING?

• Under the terms of the new contractual framework for community

pharmacy, contractors will already have received IT funding allowances to

offset the costs of upgrading their systems to support the Essential Service

requirements of the contract; namely, an appropriate ETP service as well as

an impending ETC (Electronic Transmission of Claims) service;

• The initial £2,600 allocation was towards baseline hardware replacements or

upgrades (phase 1) and the subsequent £1,000 payment was towards the

costs of ETP and ETC (phase 2). Details of all these payments can be found in

the current Drug Tariff.

FURTHER INFORMATION

• More information about the 2D-Barcoded Prescriptions service, updated

system supplier development status and additional FAQs is available online

at your normal website and by following the main link to ‘Community

Pharmacy Webpages’:

http://howis.wales.nhs.uk/wmss