Questions and Answers

What is Hospital ePACT.net?
Hospital ePACT.net is a new service being offered to Trusts whereby they can receive electronic information about their prescriptions which are dispensed in the Community. This information is supplied with an analysis tool (Hospital ePACT.net) which will allow you to analyse your prescribing information.

What are the benefits of doing this ?
The benefits of receiving electronic information are:

• Prescribing information is received approximately 5 weeks after the end of the dispensing month instead of 16 weeks.
• There is improved financial monitoring as information arrives sooner.
• Improved performance management and monitoring of prescribing
• It allows identification of non formulary prescribing.
• It facilitates monitoring of particular drug areas e.g. high cost drugs guidance.
• Data builds up to 3 years.
• The electronic analysis package supports monitoring of trends and production of expenditure reports. It allows flexible manipulation of data to produce graphs, reports and comparisons.
• There is an improved ability to forecast future spend.
• There will be no need for a recharge provision.
• It assists with commissioning of services.
• All Trusts will receive pre-printed prescription forms thus saving resources within the Trusts as hand-stamping of forms is no longer required.
• From April 2004 only green forms can be ordered, thereby supporting the DH initiative to reduce the number of types of prescription forms in circulation.
• This supports the principles set out in Delivering 21st Century IT for the NHS which encourages the use of electronic rather than paper information.
• Chief Pharmacists' time is saved (one Chief Pharmacist stated that he can now do in a couple of hours what used to take him two days to achieve).

There is no charge to Trusts for this service.

How do I join the scheme ?
Contact Prescription Pricing Authority (PPA) helpdesk (tel: 0191 203 5050, e-mail: help@ppa.nhs.uk) and request a Hospital ePACT.net information pack.

Who has been using the system ?
The system has been used by 40 Trusts across the country, on average, for a period of at least 6 months. Ten trusts have joined more recently and 22 are preparing to join.

Codes

Why do I need to recode ?
The Organisational Codes Service (OCS) issue codes to be used by all NHS organisations. Recoding ensures that you can utilise the OCS standard whereby one code can be used to identify your organisation throughout the NHS.

How should I allocate codes within my Trust ?
The experience of the pilot sites and feedback from road shows has shown that prescribing codes should normally be allocated at speciality level for an acute Trust and by geographic site for mental health Trusts, to be most appropriate and practical.

Can I allocate a code to each consultant ?
Yes, this is possible, although the experience of the larger Trusts has shown that doing this will be onerous and difficult to manage, so it is not recommended. The pilot sites found that allocating codes at speciality level gave sufficient detail for analysis without providing an unacceptable burden in administering and storing pads. They also felt that if they had allocated codes to each consultant, this would significantly increase prescription wastage when consultants moved.

Can I reallocate the codes at a later date ?
Yes, however, the scripts containing historic data for the old codes cannot be "re-allocated" to the new codes. Consequently the two codes will be seen within Hospital ePACT.net making trends and analysis more difficult.

Forms

Are pre-printed prescription forms more expensive ?
If pads are ordered singly, then due to postage and packing costs, they will currently be more expensive. The overall cost of forms to the Trust will be greater if codes are allocated by consultant. The costs, however, are being reviewed as once all users move to "green" FP10s, the cost is likely to reduce as the volume of use increases. These pads of forms will be pre-printed thereby saving the Trust from having to hand stamp their prescriptions.

Can I have prescription forms suitable for printing by computer ?
Yes. These are FP10SSs and there is a formal accreditation process to ensure the overprinting of details onto the form is acceptable. Further details can be obtained from the PPA Helpdesk (tel: 0191 203 5050, e-mail: help@ppa.nhs.uk).

Is there a published date for the withdrawal of FP10HPs ?
The Department of Health has recently notified all Trusts that "orange" FP10HPs will be withdrawn from April 2004 and Trusts will no longer be able to order FP10HP pads from Astron from this date.

Will the PPA accept "orange" FP10HPs after April 2004 ?
Yes. The Department of Health advise that ideally no more than 3 months stock of any FP10 form should be maintained*. The PPA will continue to accept scripts up to 6 months after the change over.

How do I order the new forms ?
Forms can be ordered from Astron, as now. Contact details are: NHS Customer Services, Astron, Causeway Distribution Centre, Oldham Broadway Business Park, Chadderton, Oldham, OL9 9XD. Telephone: 0161 6832376

Fraud

If my prescriptions aren't returned, how do I monitor any fraudulent activity ?
Hospital ePACT.net will allow early identification of any prescribing outside that area of speciality, any abnormal trends of prescribing and show where the prescription was dispensed. If fraudulent activity is suspected, as with GP forms, the PPA will return suspect scripts for further investigation.

If I need my prescriptions returned, can I get them ? Will I be charged ?
Scripts will not routinely be returned. If fraudulent activity is suspected, the PPA will return suspect scripts for further investigation, as they do for scripts written by GPs. The PPA retains paper prescriptions for 14 months. It is currently not the intention to charge for the return of scripts although the level of returns will need to be monitored.

How will I know if the dose or quantity has been altered?
As with GP forms, if the script has been amended in any way, the PPA or the community pharmacist will refer the form back to the originator for further investigation.

Audit procedures within the Trust require documentation. How will I satisfy this without the scripts ?
Consultants should follow Trust procedures to record information in the patient's notes at the point of, or following, prescribing

Trust Procedures

If patients are treated who reside outside my PCT, how do I cross charge their PCT ?
Trusts involved in the pilot have identified a number of solutions including consideration within an SLA or reviewing internal systems to enable the capture/recording of relevant information e.g. treating scripts for patients outside their PCT in a similar way to private patients, which has allowed internal procedures to identify those patients who need to be charged elsewhere.

Will I have to pay 14 invoices in a 12 month period ?
The PPA will issue 14 invoices during the first 12 month period of the new arrangements. However, under resource accounting procedures, the costs will be attributed to the period in which they arise.

I am a Teaching hospital which uses the prescriptions to provide feedback on prescribing to my junior doctors, how will I do this ?
Hospital ePACT.net can be used to identify out of formulary prescribing or unusual trends at speciality level.

How can we record which drugs a patient has had prescribed and/or the dosage supplied? The Trust current systems have been set up to record this information when the script is returned to them.
Trust internal systems should be in place to record relevant information on prescribing including recording in the patient notes at the point of, or following, prescribing.

Hospital ePACT.net

Is there a charge associated with receiving Hospital ePACT.net ?
No.

Are there any training courses available?
Yes. There is a one day course run in Newcastle on a non-profit making basis (the cost you pay, £310, covers the cost of the tutor & refreshments). They are held in Newcastle to ensure the technology is guaranteed. It is recommended that these courses are attended by pharmaceutical and/or finance representatives. Please contact the PPA helpdesk (tel: 0191 203 5050, e-mail: help@ppa.nhs.uk) for details.

Who should use the system ?
It is primarily aimed at pharmaceutical and finance staff.

What technology do I need for the electronic analysis package ?
A connection to NHSnet is required. A standard PC with Internet Explorer Version 4 or above will run Hospital ePACT.net.

What will happen if I do not wish to join ?
The PPA will contact you with a list of your existing codes which will need to be replaced by Organisation Codes Service (OCS) new codes. Your scripts will not be returned from April 2004 dispensed prescriptions. You will continue to receive the paper reports as now for a limited period. Thereafter your information will be sent to you electronically in the same data blocks as now (i.e. by hospital). When you need to re-order prescription pads, they will be green (FP10NC) and will be pre-printed with your new codes and associated addresses. You will receive 14 invoices in the following 12 months as the information is processed quicker