Agenda item

Joint report of Andrea Green, Sue Davies and Ataz Dhanani, Coventry and Rugby Clinical Commissioning Group (CCG), who have been invited to the meeting for the consideration of this item. Fiona Lowe, Chief Officer, Coventry Local Pharmaceutical Committee (LPC) has also been invited to attend 

Further to Minute 33/18, the Board considered a joint report of Andrea Green, Sue Davies and Ataz Dhanani, Coventry and Rugby Clinical Commissioning Group (CCG) which provided a response to a letter sent by the Chair, Councillor Gannon requesting further information on the NHS Prescription Ordering Direct (POD) Service. Andrea Green, Sue Davies and Altaz Dhanani attended the meeting for the consideration of this item along with Dr Sarah Raistrick, Coventry and Rugby CCG, Fiona Lowe, Coventry Local Pharmaceutical Committee and Ruth Light, Healthwatch Coventry.

The report provided additional information on the following issues:

·  The cost of the Prescription Ordering Direct service

·  The business case and rationale for the POD

·  Why the business case and rationale had been removed from the previous report considered at the last Board meeting on 19^th December, 2019

·  The number of users each quarter since the service started

·  Whether there had been an increase in the number of NHS 111 calls as a result of the POD

·  Whether pharmacies had had to increase the number of emergency prescriptions

·  The lessons learnt from the summer.

Members were informed that during 2017/18 the cost of the POD service for each patient who could access the service was an annual cost of £7.14 per patient. The savings achieved had exceeded the investment by £1.4m and were achieved by reduction in wasted medication.

The report set out the rationale for introducing the service. The CCG held a Prescribing Waste Summit in July 2012 which identified the need to target waste from repeat medications. A Working Group was subsequently established to consider options to address this and the principle of the POD approach came from this group. The POD project was first tested as a ‘proof of concept’ with 2 GP practices. This was followed by a full pilot service involving 12 practices. The report detailed the results of the pilot using comparator data. The rationale was also based on patient feedback from a patient survey where 77% of patients who responded rated the service as excellent. Attention was drawn to the fact that in March 2016 there was a waiting list of practices wanting to join the POD as the additional benefits of the service became apparent from the Practices in the pilot.

The report highlighted the gradual increase in the number of users of the service in each quarter since 2015 with the number of calls rising from 6827 to 129856.

Andrea Green reported that evidence just received indicated that any increase in the number of NHS111 calls were not as a result of the POD. Evidence of this would be provided for members in due course

The report indicated that the CCG had not received any information to indicate an increase in the number of emergency prescriptions issued by community pharmacies since the introduction of the POD service. Fiona Lowe informed that the main issues related to requests for emergency prescriptions at weekends and bank holidays which were usually a result of patients not allowing enough time to have their prescriptions processed.

Lessons learnt from the summer 2017 were outlined. The service needed to improve the prediction of call volumes when adding new GP practices since the pace of take up of the service when a practice joined the scheme had increased. This had led to service users experiencing longer waits. In response the service had increased the pace of recruitment; advised patients of the busiest times and alternatives; improved access; implementing repeat dispensing; and providing reminders.

Dr Sarah Raistrick informed of the benefits of the service to her GP practice, emphasising that the POD service was only one of a number of ways that their patients could obtain prescriptions. 

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

·  Clarification and more information about the costs of the service

·  The details about the potential number of service users

·  How confident were the representatives that all GP practices provided a number of options for patients to obtain their prescriptions

·  What more could be done to ensure that GPs were promoting the POD service but also providing other opportunities for their patients to get their prescriptions

·  Concerns about the how the emphasis on partnership working within the new NHS ten year plan would conflict with any compulsory competitive tendering exercise

·  Further details about the evidence to support the benefit of the POD service

·  The importance of using digital technology

·  Concerns about the problems some patients face when using the telephone including ‘hard to pronounce’ medications

·  Concerns about elderly patients who would not be able to use digital services and the importance of engaging with such patients

·  A suggestion to hold an amnesty in the city affording residents the opportunity to hand over any unused medicines

·  Further details about the future of the service

·  Support for the Community Pharmacy Steering Group

·  The importance of having a consistent approach about the POD service offer and the importance of appropriate training for all employees including temporary staff.   

RESOLVED that:

(1) The contents of the report be noted.

(2) The information on the increase in NHS111 calls and the evidence that this is not related to the introduction of the Prescription Ordering Direct service be circulated to Members in due course.

(3) The details on patient satisfaction with the service be circulated to Board members.

(4) The Board endorse the partnership working being undertaken by Coventry and Rugby CCG and Healthwatch on the coproduction of the future system.