In order to improve efficiency and appropriateness of repeat prescription ordering, Dudley Clinical Commissioning Group (CCG) operates a Prescription Ordering Direct (POD) Service across eight GP practices, led by the CCG’s Pharmaceutical Public Health team. Led by a desire to extend coverage and improve usage, the service needed support to improve its infrastructure, review communication and engagement, and develop its workforce.
As a result of the support provided by Arden & GEM’s experienced transformation team, the service will have a new telephony system and office space in place in January 2019, improved operating processes and procedures, and a series of implementable recommendations to improve usage, putting the POD in a prime position for expansion.
The Dudley CCG POD, which was established in January 2017, was developed by the CCG’s Pharmaceutical Public Health Team. Based on the original Coventry POD model it provides pharmaceutical expertise and leadership to reduce the need for medicines and prescribing related queries to be dealt with at practice level. It enables patients at eight participating GP practices to request and receive regular prescription medicine via a telephone service, removing the need for unnecessary visits to the surgery.
The telephone service is manned by a team of operatives and includes a pharmacist, who can support any requests that require a clinical review or questions that the operatives cannot answer. The POD had an intention to extend the service to all the practices in Dudley through a phased rollout. This would require a gradual increase in the number of call handlers working within the POD, which would impact on office space and utilisation of the telephony system.
There was also a need to demonstrate service capability and resilience, as part of the expansion, with an updated business continuity plan and a programme of regular audits.
In order to quickly and effectively deliver the improvements required for expansion, the POD needed project management expertise to:
By working closely with POD stakeholders, the CSU was able to quickly identify requirements and appraise the options for a new telephony system. One of the service transformation team’s experienced project managers supported the procurement of a preferred supplier. Approval of the new system by the CCG’s relevant governance groups was also facilitated and mobilisation of the new solution was overseen. The project manager was also able to identify appropriate office space and equipment in readiness for the team’s expansion.
Developing processes and workforce
As part of the POD’s standard operating procedures a programme of regular audits should be taking place. Arden & GEM designed and tested an audit process and completed a handover with the service’s manager to ensure these are now being undertaken on a regular basis. Through liaising with the service and the IT provider, a finalised business continuity plan is also in place to ensure patients and practices are assured of a high quality and consistent service.
A review of usage revealed that current GP surgeries had different levels of engagement with the POD service. By visiting practices with the lowest usage and working in partnership with the CCG’s communication team, the CSU was able to make a series of recommendations that would improve promotion to patients and ultimately service use.
A new cloud based telephony system is being mobilised, ready for implementation in January 2019. It will deliver a range of benefits to the service including:
While the new office space is ready to accommodate up to 15 new operatives in line with a rolling recruitment programme which was initiated in November 2018.
Robust and regular audit processes are in place and initial audits have already highlighted potential improvements in standard operating procedures, for example, requiring call handlers to note completion of synchronisation of medicine ordering.
A number of useful tools have also been created following the usage review, including a communications and engagement checklist which can be utilised when launching the new telephony service and expanding the service to new practices.
This package of current and potential improvements will support the POD to successfully expand coverage across all Dudley GP practices, benefiting patients, practices and commissioners.
Arden & GEM has provided the Dudley CCG Pharmaceutical Public Health team with a valuable steer during a time of growth for the POD, enabling the clinical and operational teams leading and supporting the POD to focus on service delivery whilst delivering on the production of a robust business continuity plan, sourcing a new and competent telephony system and liaising with facilities teams to ensure the site is fit for purpose and expansion. The project manager was a pleasure to work with and kept us on track.
Clair Huckerby – Consultant Pharmacist Primary Care Medicines Optimisation at Dudley CCG
My practice reviewed the list of highest risk stratified patients against our own list of patients at risk of unplanned admissions. We found 27 patients who had a risk of 75% or greater of a hospital admission in the next 6 months who were effectively ‘off our radar’. We have now added these patients to our proactive care list.