Key Challenge 3
Business Transformation

To transform the organisation by reengineering our business processes, creating the capacity to accommodate growth and complexity in a changing business environment.

Key Outcome for Stakeholders
We will transform our business to create the capacity and flexibility to meet the current and emerging needs of users. We will maximise the efficiency of our service delivery by reengineering our core processes to receive unambiguous script data electronically and to process it automatically.

Introduction
The number of prescriptions and items processed by the PPA grows annually. Those prescriptions now come from a greater number of diverse prescribers. There is demand for richer information services to support prescribing and dispensing management in Primary Care. We must consider radical solutions to the skills and technology that will allow us to improve our efficiency and cost effectiveness to meet the demands of an increasingly connected healthcare economy.

Our involvement in the development of Electronic Transmission of Prescriptions (ETP) pilots has enabled us to contribute to the shape of a future National Prescriptions Service, delivering an electronic solution within the framework of an integrated electronic healthcare record.

National Prescriptions Service
Creating a National Prescriptions Service is a key component of the Government's information strategy for the NHS. This strategy supports the Government's general aim that all dealings with Government should be deliverable electronically and the specific commitments to pilot ETP contained in Pharmacy in the Future.

This information strategy will facilitate further developments both of information flows and of data handling, which will enable us to optimise the benefits of our reengineering programme.

Reengineering our Business Processes
In order to generate the organisational capacity we need to deal with the growth in prescription numbers and the increasing complexity of those prescriptions, we will reengineer our internal business processes.

Reengineering will be shaped by the national model for ETP, but is not solely dependent upon it. We aim to enable our reengineered processes to receive and automatically interpret the content of electronic messages and to automate the validation of prescription data to an agreed rule set.

This reengineering effort will require a transformation of our existing workforce, skills and capacity over the next five years. We must re-evaluate the relationship between the core staff skills we develop in the organisation, the infrastructure for processing work and the buildings we occupy. We will handle this transformation sensitively with the aim of ensuring that we have the right number of people and that they possess the appropriate skills to enable us to deliver reengineered services.

Simplification of the Reimbursement and Remuneration Rules
The reimbursement and remuneration rules we currently operate under are very complex. The achievement of a high level of automation is only possible if the rules to be applied can be simplified.

The simpler the rule set is, the more achievable the objective of increased pricing automation becomes. We will continue to work on options for simplified implementation of the rules and seek to influence their adoption by the DH and by contractors and their representative groups.

NHS Primary Care Drug Dictionary
We have developed a Drug Dictionary to provide common descriptions for individual medicinal products that are available in the UK for the treatment or alleviation of discomfort in human patients. The range of data included in the dictionary enables it to be used in the environments of primary care prescribing and dispensing, drug administration, clinical decision support and reimbursement and remuneration. Universal adoption of standard dictionary identifiers throughout primary care will significantly reduce the complexity of communicating relevant information between prescribers, dispensers and the PPA. We will work to promote the use of the PCDD in GP and Pharmacy systems to enable this.

We will work with database providers within the existing supply-chain to drive the rollout of PCDD into Primary Care and its adoption in GP and Pharmacy IT systems, as the first phase of the United Kingdom Clinical Products Reference Source (UKCPRS).

The Dictionary will replace our existing drug master file and, when it is in comprehensive use across primary care, will remove the present ambiguity between prescribing and dispensing information, which has contributed to the complexity of the reimbursement and remuneration rules.

The successful implementation of this project throughout primary care prescribing and dispensing, will assist us to achieve our aim of maximising the automation of the process of validating prescribing and dispensing information.

Realisation
This large and complicated change programme involves many independent interests. We will vigorously promote the benefits of the whole programme and champion those elements within our control. By working with others across the NHS, we aim to contribute significantly to the successful integration of the DH's priorities for primary care prescribing, community pharmacy, improved administration of patient care pathways and the electronic delivery of services.

Our programme of reengineering will contribute significantly to realising the benefits of a national prescriptions service. This will provide a data source for many of the interactions patients have with the NHS, at the core of the Integrated Care Record Service (ICRS).