Agenda item

Report of Sue Davies, Coventry and Rugby Clinical Commissioning Group (CCG)

Jenni Northcote, Coventry and Rugby CCG has been invited to the meeting for the consideration of this item 

The Board considered a report Sue Davies, Coventry and Rugby Clinical Commissioning Group (CCG) which provided an update on the development of the NHS Prescription Ordering Direct (POD) service; an overview of patient feedback; and details of the actions taken by the service to address issues raised by patients and Healthwatch Coventry. Sue Davies, Altaz Dhawani, POD Service manager, Ruth Light, Healthwatch Coventry and Fiona Lowe, Coventry Local Pharmaceutical Committee attended the meeting for the consideration of this item. Councillor Abbott, Cabinet Member for Adult Services also attended.

The report indicated that the NHS POD was introduced in Coventry in June 2015 to support a reduction in medication waste. Additional benefits included convenience for patients from reduced visits or telephone calls to their GP surgery and the reduced demand on GP reception staff and GP time. The service was a telephone/ online service which took orders for repeat medication from patients registered with participating GP practices. The repeat orders were transmitted to the GP Practice for approval, electronically, and then sent on to a community pharmacist of the patient’s choice for dispensing.

The Board were informed that the service operated 5 days a week managing an average of 1,800 calls a day from patients. The average wait time was currently 59 seconds. There had been some variability where the wait was longer. The service had been able to reduce stockpiling and waste of unneeded medications. The service currently covered 40 practices with 276,000 registered patients using the service. Additional practices were joining the service in January/ February 2019. The service currently employed 45 trained call handlers on a mix of full time and part time contracts.

The report highlighted the benefits for patients, the CCG and GP practices. There were potential financial savings of around 8% of the prescribing budget (when all practices were covered), approximately £6m. The financial savings for the first three years of operation were set out.

The Board noted that the Service had received both positive and negative feedback from patients, which was logged and used to inform improvements to the service. One of the themes received from callers was that they did not like having to ring every month for their medication. To address this the POD was trialling repeat dispensing for patients with medications that were taken regularly. The POD was also addressing concerns that medication requests were taking longer to be processed by community pharmacies following contact with the POD.

The service had been working with Healthwatch Coventry to develop additional materials which would support patients to understand and get the most out of using the POD. Healthwatch had reviewed the service in 2016/17 and identified the following themes of improvement:

i) Opening hours for phone calls to the POD

ii) Information provision for users of the service and future users

iii) Ensuring that users and future users of the service with hearing impairment and or memory issues could use an alternative means of reordering medication via their pharmacy or GP practice since the POD was not appropriate for them.

The responses from the service to these concerns were detailed.

Since June 2018 there had been a 16% increase in the number of calls to the POD service which had resulted in an average wait time of 3.46 minutes and an abandoned call rate of 35%. Complaints had been made to the CCG. To address these concerns, improvements had been made to the call back service and an additional 14 staff had joined the service since August. In September the average wait time had reduced to 59 seconds and the abandoned call rate was down to 8.72%.

The next steps for the service were to continue to expand to cover as many GP practices under the Coventry and Rugby CCG as possible; to increase the uptake of electronic repeat dispensing; and to continue to work with community pharmacies to provide timely reminders to patients to order their repeat prescriptions.

Members raised a number of issues in response to the report and responses were provided, matters raised included:

·  The percentage of patients who were eligible to use the POD service

·  Why weren’t all the GP practices signed up to the service

·  Information about the option of electronic requests rather than patients having to rely on making telephone calls to the service

·  Additional information on the trial for repeat dispensing for patients with medications that were taken regularly

·  Clarification about how communications about the service were being improved

·  Concerns about the lack of a response to issues raised by Healthwatch including the draft patient information

·  A request for information about the costs of providing the service and the cost savings for GP surgeries

·  How could the service be improved to be ‘outstanding’

·  Information about the lessons learnt from the experiences of the service over the summer

·  Where were the savings from existing users compared to those when new patients joined the service

·  Concerns about language barriers which could result in patients not getting their correct medication

·  Concerns that the response time was longer than the average wait time of 59 seconds

·  Concerns about the lack of information about the POD service provided to patients by their GP surgeries   

·  Details of the implications for the local pharmacists

·  Concerns that patients prefer to use their GP surgery for prescriptions as this was a quicker service

·  The potential option for hospital consultants to be able to prescribe to the service

·  Concerns about the closure of community pharmacies.          

RESOLVED that:

(1) The progress to date and the action to address patient feedback be noted.

(2) A further report be submitted to a future meeting of the Board in the New Year, with Andrea Green, Chief Officer, Coventry and Rugby CCG and representatives from the local GPs being invited to attend.