1 SystmOne® guide to eRD v1.0 April 2020

SystmOne® guide to eRD

Access patient record from the predetermined search on SystmOne®:

Clinical systems > General Practices > Medicines Optimisation Team > Pts aged 18+ on 1 item

(amlodipine, atorvastatin or levothyroxine)

Ensure the patient has a nominated pharmacy within a reasonable distance from practice and home

address. Ensure patient has a mobile phone number.

The patients in this search will be most likely suitable for eRD but must still have the below criterion

applied.

Exceptions:

Controlled drugs

Benzodiazepines

Hypnotics

Shared care drugs

Medication that requires frequent monitoring e.g. methotrexate, lithium

Unlicensed medicines

Does the patient have a nominated pharmacy?

YES

Likely to have or has had any medication changes in the previous/next 6

months?

NO

Are they on the list of excluded medicines listed

below?

NO

Does the patient have less than six months before

their mediciation review is due?

NO

Does the patient have any monitoring that is

overdue?

NO

Has the patient had any unplanned admisions in

the last six months

NO

SUITABLE FOR eRD

Not currently

suitable for

eRD

Review

periodically

for changes

NO

Yes

Yes

Yes

Yes

Yes

2 SystmOne® guide to eRD v1.0 April 2020

Ensure the repeat item(s) are dm&d and ETP compliant and amend if not.

If they have an item that is ‘as directed/PRN’ – click ‘amend’ and set this is an irregularly issued

template and set issue duration.

Note: untick the ‘patient can initiate issues’ box.

N.B. Where the patient is receiving 56 days’ supply of medicines, do not change this to 28 days but

keep at 56 days. This is to reduce the number of changes for patients, who may be used to 56 days

supply or may pay for their prescriptions or may be vulnerable and not able to easily collect their

medicines.

If the patient has met the criterion for eRD, you

can start the process.

Check the duration of the medications all

match up (i.e. levothyroxine 50mcg x 28 taking

1 a day = issue duration 28 days) – if not click

‘amend’ and change the amount they are

prescribed or the issue duration to match up

(see circled numbers)

If the numbers of issues are out of line you can

also amend these now – if you cannot see this

box, tick ‘Use maximum issues’ to trigger this

box (e.g. 28 tablets, 28 days issue duration, 7

issues = 6 months of medication triggering once

a month)

3 SystmOne® guide to eRD v1.0 April 2020

The medication you

want to issue should

still be highlighted (if

not highlight again –

remembering that any

MDU medication needs

to be on a separate

script, by itself), then

click the ‘RD’

button

Click OK and then you

have issued the

medication on

electronic repeat

dispensing – repeat as

necessary for MDU

items

Once all the repeat medicines

are aligned, highlight all the

medicines you want to set up

on eRD (you can hold Ctrl and

then click the ones you want)

then click the ‘re-authorise’

button and set the number of

issues (i.e. 28 days, 7 issues =

6 months – this will reset the

number of issues to 0, making it

clear on the record how many

issues the patient has had on eRD

4 SystmOne® guide to eRD v1.0 April 2020

Deferred start date of the first prescription

If you want to postpone the start of the repeat dispensing, this can be done whilst on the re-

authorise section, simply change the date to when you want the prescription to send to the

pharmacy.

1) Press for each individual drug and set the date as needed (so a week before the date

needed)

2) Ensure quantity and duration are correct

3) Ensure that max issues are unticked (ticking this can cause issues)

4) This process should reset the authorisation on the repeat template screen

5) Highlight all repeatble items and press the eRD button, at which point we can specify number

of repeats needed (to cover six months,7 issues for 28 day duration, 4 issues for 56-day

supply)

6) All other steps (reminder/read code/SMS) as normal

Example:

You have identified a suitable patient for eRD. You see that they have just collected this month’s

prescription from the surgery (1st April).

They have 28 days’ supply and will need a new prescription by the 28th April.

The medication start date will be seven days prior to the date that prescription is due to be collected

which in this is 21st April.

This gives the pharmacy seven days to prepare the prescription for the patient.

5 SystmOne® guide to eRD v1.0 April 2020

Adding a Read Code/SNOWMED CODE

Code this on the system as ‘On repeat dispensing system’ (Read Code: XaJus, SNOMED CODE:

414938004)

‘On repeat dispensing system’ will now appear on each individual electronic repeat dispensed

medicine and in the New Journal.

Add Reminder

Add Reminder/Alert to home page (Priority: Normal) this is found by scrolling down the clinical tree

and finding the ‘reminders’ icon, once open, click the in the top bar to add the note: “Added

to electronic Repeat Dispensing (eRD) during Covid-19 pandemic. Repeat prescriptions will be

automatically sent to nominated pharmacy every 28 or 56 days (based on issue duration) for 6

months from todays date”

Insert Read

Code/SNOWMED

code in search bar

and then click ok.

6 SystmOne® guide to eRD v1.0 April 2020

Sending an SMS text to the patient

First text message

“To streamline your medication during the coronavirus pandemic we have issued your repeat meds

as electronic Repeat Dispensing prescriptions for the next 6 months. Do not order your meds via the

GP practice; they will be dispensed by your nominated pharmacy as normal. More info at

https://bit.ly/3bsY1NH”

Second text message

“Please collect your electronic Repeat Dispensing prescriptions from your nominated pharmacy

around the date they are usually due. Your medication will not routinely be issued early. There is no

need to reorder from your GP until the final issue has been fulfilled as informed by your pharmacy.”

N.B. most practices will be using software such as ACCURX or MJOG to send messages to patient and

conduct e-consultations. Ask your practice about this and ask to be registered to use the text

message functionality.

Sending a text to the patient may be

different depending on your surgery.

1. Under the patient name,

DOB and address you may

see this icon

OR

2. If you do not see this icon,

click on the ‘Clinical’ tab on

the tree and send an SMS

from here instead. The text

you send can be similar as

the one-off script note.

N.B. text-messages are

limited to 306 characters.

7 SystmOne® guide to eRD v1.0 April 2020

Add a one-off script message

Select this icon to add a one-off script message for next script:

To minimise disruption to your medication during the coronavirus pandemic we have

issued your repeat prescriptions as electronic Repeat Dispensing prescriptions – your

nominated pharmacy can dispense your prescriptions for the next 6 months. You do

not need to order your medication through the GP practice – they will be dispensed by

your nominated pharmacy in line with how often you normally order your medicines.

For more info go to: https://bit.ly/3bsY1NH

This message can be set up as a pre-set to save time. Right click any repeat template and select

‘Amend’. Select ‘Presets’ and then the ‘+’ icon and enter the preset message.

Signing the prescription

Once you click SAVE, a ‘print issues’ message box will appear.

Warning: change the authoriser to usual GP/agreed GP/prescribing lead – confirm with the practice

You will be asked to Print/Sign& Send Now or Print/Sign & Send Later.

8 SystmOne® guide to eRD v1.0 April 2020

Select Print/Sign & Send Later

9 SystmOne® guide to eRD v1.0 April 2020

Appendix 1 Cancelling and ‘Syncing’ Prescriptions Even with robust processes for identifying patients suitable for Electronic Repeat Dispensing with stable medication regimes, some changes to medicines and doses will inevitably occur from time to time. If a change is necessary, either the individual item or the whole prescription must be cancelled and the correct medicines/quantities/doses prescribed. (Please note - it is not possible to amend an existing EPS prescription. It can only be cancelled and reissued.) Cancelling an item on an eRD prescription will also cancel that item from all future issues of the prescription that remain on the Spine. The prescribing system will be notified that these cancellations have been successful or if not, why any cancellation has failed. If a prescription has been downloaded by the pharmacy, but has not yet been issued to the patient, it cannot be cancelled automatically. In this case, the prescribing system will show all the prescriptions on the Spine that have had item(s) cancelled successfully and show one prescription that has not had the item(s) cancelled as being ‘With Dispenser’. The GP practice should then contact the pharmacy and request that the prescription is returned to the Spine for the cancellation to take effect. The amended eRD prescription can then be manually downloaded again by the pharmacy. There are two options for patients with multiple items on eRD: • Cancel ALL outstanding items on the Spine and replace with a new batch of all items including the new item. • Cancel the individual item(s) – check when the next issue of the existing eRD batch is due and generate a one-off prescription to cover until the date of the next issue. Then create a new eRD prescription, to start at the same time as the next issue of the existing eRD prescription, with enough issues so that all prescriptions end at the same time. “Syncing” prescriptions in this way aims to ensure that all the patient’s prescriptions are received by the dispenser on the same day to ensure patients receive all their medication at the same time and to support interaction checking (although it should be recognised that it is extremely difficult to achieve perfect synchronisation).

It is always good practice to communicate with the patient’s nominated pharmacy about any changes made to eRD prescriptions. Further Links: Skyline eRD resource page: http://skyline.wakefieldccg.nhs.uk/Interact/Pages/Content/Document.aspx?id=4658 eRD e-learning course:

https://learning.necsu.nhs.uk/nhs-digital-electronic-repeat-dispensing-elearning/

eRD cancelling prescriptions:

https://www.nhsbsa.nhs.uk/sites/default/files/2020-

03/Cancelling%20a%20prescription%20guide%20%28V0.1%29%2003.2020.pdf

eRD handbook:

https://www.nhsbsa.nhs.uk/sites/default/files/2020-

03/Electronic%20Dispensing%20Handbook_Digital_WEB_S.pdf