Iain Davidson, Chief Clinical Information Officer and Chief Pharmacist, Royal Cornwall Hospitals NHS Trust

Royal Cornwall’s implementation plan:A Chief Pharmacist’s perspective

13 April 2016

GS1atTheRoyalCornwallHospital

AChiefPharmacist’sPerspectiveIainDavidson

ChiefPharmacist&CCIO - RCHTApril2016

SomeFactsandFigures• TheNHSspendsaround£6.7bnperyearonmedicinesinhospitals(LordCarterreview)

• Between2003and2013,thenumberofprescriptionitemsperyearforanyonepersoninEnglandincreasedfrom13to19 (NICE)

• 5%to8%ofunplannedhospitaladmissionsareduetomedicationissues(NICE)

• £300mofmedicineswastedeveryyear(KingsFund)

• £200mstockholdingofacutehospitalpharmacydepartments(LordCarter review)

• £1investedinclinicalpharmacydelivers£5return (LordCarterreview)

• 55%ofpharmacyteam’stimeisspenton‘infrastructureservices’- aimis80%onclinicalservices(LordCarter review)

GS1AdoptionObjectives

• Improvedpatientsafety

• ReleasingtimetoCare

• ImprovedEfficiency

WhereDoesGS1AddValue?Pharma

Dispensing&Labelling

Robot

StockIssue

WholesalerHospitalPharmacyStores

DeliverytoWard

AdministrationtoPatientusingEPMA

PatientAdmitted

MedicinesPrescribedonEPMA

PatientDischarged

DRUGORDER

WardElectronicCabinets

WhereDoesGS1AddValue?Pharma

Dispensing&Labelling

Robot

StockIssue

WholesalerHospitalPharmacyStores

DeliverytoWard

AdministrationtoPatientusingEPMA

PatientAdmitted

MedicinesPrescribedonEPMA

PatientDischarged

DRUGORDER

WardElectronicCabinets

WhereDoesGS1AddValue?Pharma

Dispensing&Labelling

Robot

StockIssue

Wholesaler

WardElectronicCabinets

HospitalPharmacyStores

DeliverytoWard

AdministrationtoPatientusingEPMA

PatientAdmitted

MedicinesPrescribedonEPMA

PatientDischarged

DRUGORDER

GTIN&GLN

GTIN&GLN GTIN

GTIN&GSRN

GLN&GSRN

GLN,GTIN&GSRN

GTIN&GSRN

GTIN&GSRN

GTIN&GLN

GTIN&GSRN

GTIN&GSRN

WhereDoesGS1AddValue?Pharma

Dispensing&Labelling

Robot

StockIssue

Wholesaler

WardElectronicCabinets

HospitalPharmacyStores

DeliverytoWard

AdministrationtoPatientusingEPMA

PatientAdmitted

MedicinesPrescribedonEPMA

PatientDischarged

DRUGORDER

GTIN&GLN

GTIN&GLN GTIN

GTIN&GSRN

GLN&GSRN

GLN,GTIN&GSRN

GTIN&GSRN

GTIN&GSRN

GTIN&GLN

GTIN&GSRN

GTIN&GSRN

We’veGotAlltheGear!

Wejustneedtolinkitupbetter…..

GS1GS1

GS1GS1

GS1

Whyisthisimportant?

RefBobWachter presentation https://vimeo.com/157611617

Examples

RoyalCornwallHospitalsTrustScan4Safety

RCHT - Electronic Drug Ordering

Scan4Safety

‘GSRN’‘GTIN’

‘GLN’

RCHT - Electronic Drug Ordering

Scan4Safety

PercentageofWorkload Dispensed before10.30am

Pre-implementation (Oct13) 23%Post-implementation (March14) 35%

RCHT - Electronic Drug Ordering

Scan4Safety - safer and more efficient

MissedDosesCriticalMeds

0,00%

0,20%

0,40%

0,60%

0,80%

1,00%

1,20%

Jan/14

Feb/14

Mrt/14

Apr/14

Mei/14

Jun/14

Jul/14

Aug/14

Sep/14

Okt/14

Nov/14

Dec/14

Jan/15

Feb/15

Mrt/15

Apr/15

Mei/15

Jun/15

Jul/15

Aug/15

Sep/15

Okt/15

MedicationUnavailable

MedicationUnavailable

Lineair(MedicationUnavailable)

RCHT - Electronic Drug Ordering

Scan4Safety

SunderlandRoyalHospitalRodBeard- DirectorofPharmacy

LinkingePrescribing toRoboticDispensing

LinkingePrescribing toRobotics

SunderlandExperience• Fourstaffwerereleasedforre-deployment

• £500,000instockholdingefficiencyabovethatsuggestedbythebusinesscasewasidentified

• Productsdispensedbytheelectronicprescribing- robotsystemproducedzerodispensingerrors

• Thespeedofdispensingincreasedalso,astheelectronicprescribing- robotcombinationpermittedalmostinstantaneousdispensingfromthepointofadoctorenteringaprescription

IsleofWight- StMarysHospitalGillHoneywell- ChiefPharmacist

LinkingePrescribing,WardStockandDispensing

EPMA-EDC-Robotlink

• 11%reductioninwarddrugspend

• 83%reductioninmisseddoses

• Reducedlengthofstay

• Freesupnursing‘timetocare’

• Robustfinancialaudittrail

• ReturnonInvestment- 3years

GS1- CanitDeliver?

• Improvedpatientsafety

• ReleasingtimetoCare

• ImprovedEfficiency

GS1- CanitDeliver?

• Improvedpatientsafety

• ReleasingtimetoCare

• ImprovedEfficiency

WhatDoWeNeed?

WorkwithOurSuppliers

NHSBenchmarkingData2015

HowDoesitFitAllTogether?Unique Identifier ProductLevel

DM&D Product level

GTIN Product,Supplier &BatchLevel

FMD Product, Supplier,BatchandBoxLevel

TimelineforInitiatives

2011

2019(2016+3)CompleteFMDImplementation

Feb2016Publicationof

FMDDelegatedActs

July2011PublicationofFMD

36Mon.

20182015 2017

June2017Implementationof

NHS dm+d

2016

2016ImplementationofGS1andPEPPOL

2019

May2014PublicationofDHeProcurement

strategy

June2015LordCarter's review

ofefficiencyinhospitals

June2016Introductionof theconceptof“AModel

Hospital”

TimelineforInitiatives

2011

2019(2016+3)CompleteFMDImplementation

Feb2016Publicationof

FMDDelegatedActs

July2011PublicationofFMD

36Mon.

20182015 2017

June2017Implementationof

NHS dm+d

2016

2016ImplementationofGS1andPEPPOL

2019

May2014PublicationofDHeProcurement

strategy

June2015LordCarter's review

ofefficiencyinhospitals

June2016Introductionof theconceptof“AModel

Hospital”

Co-Ordinated&Collaborative