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

1. 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

2. GS1 at The Royal Cornwall Hospital
A Chief Pharmacist’s Perspective
Iain Davidson
Chief Pharmacist & CCIO - RCHT
April 2016

4. Some Facts and Figures
• The NHS spends around £6.7bn per year on medicines in hospitals (Lord Carter review)
• Between 2003 and 2013, the number of prescription items per year for any one person in England
increased from 13 to 19(NICE)
• 5% to 8% of unplanned hospital admissions are due to medication issues (NICE)
• £300m of medicines wasted every year (Kings Fund)
• £200m stockholding of acute hospital pharmacy departments
(Lord Carter review)
• £1 invested in clinical pharmacy delivers £5 return (Lord Carter review)
• 55% of pharmacy team’s time is spent on ‘infrastructure services’-aim is 80% on clinical services
(Lord Carter review)

5. GS1 Adoption Objectives
• Improved patient safety
• Releasing time to Care
• Improved Efficiency

7. Where Does GS1 Add Value?
Pharma
Dispensing
& Labelling
Robot
Stock Issue
Wholesaler
Hospital
Pharmacy
Stores
Delivery to
Ward
Administration to
Patient using EPMA
Patient
Admitted
Medicines
Prescribed
on EPMA
Patient
Discharged
DRUG ORDER
Ward
Electronic
Cabinets

8. Where Does GS1 Add Value?
Pharma
Dispensing
& Labelling
Robot
Stock Issue
Wholesaler
Hospital
Pharmacy
Stores
Delivery to
Ward
Administration to
Patient using EPMA
Patient
Admitted
Medicines
Prescribed
on EPMA
Patient
Discharged
DRUG ORDER
Ward
Electronic
Cabinets

9. Where Does GS1 Add Value?
Pharma
Dispensing
& Labelling
Robot
Stock Issue
Wholesaler
Ward
Electronic
Cabinets
Hospital
Pharmacy
Stores
Delivery to
Ward
Administration to
Patient using EPMA
Patient
Admitted
Medicines
Prescribed
on EPMA
Patient
Discharged
DRUG ORDER
GTIN &
GLN
GTIN &
GLN
GTIN
GTIN &
GSRN
GLN &
GSRN
GLN, GTIN
& GSRN
GTIN &
GSRN
GTIN &
GSRN
GTIN &
GLN
GTIN &
GSRN
GTIN &
GSRN

10. Where Does GS1 Add Value?
Pharma
Dispensing
& Labelling
Robot
Stock Issue
Wholesaler
Ward
Electronic
Cabinets
Hospital
Pharmacy
Stores
Delivery to
Ward
Administration to
Patient using EPMA
Patient
Admitted
Medicines
Prescribed
on EPMA
Patient
Discharged
DRUG ORDER
GTIN &
GLN
GTIN &
GLN
GTIN
GTIN &
GSRN
GLN &
GSRN
GLN, GTIN
& GSRN
GTIN &
GSRN
GTIN &
GSRN
GTIN &
GLN
GTIN &
GSRN
GTIN &
GSRN

11. We’ve Got All the Gear!

12. We just need to link it up better…..
GS1
GS1
GS1GS1
GS1

13. Why is this important?
Ref Bob Wachter presentation https://vimeo.com/157611617

14. Examples

15. Royal Cornwall Hospitals Trust
Scan4Safety

16. RCHT - Electronic Drug Ordering
Scan4Safety

17. ‘GSRN’
‘GTIN’
‘GLN’
RCHT - Electronic Drug Ordering
Scan4Safety

18. Percentage of Workload Dispensed before
10.30am
Pre-implementation (Oct 13) 23%
Post-implementation (March 14) 35%
RCHT - Electronic Drug Ordering
Scan4Safety - safer and more efficient

19. Missed Doses Critical Meds
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
Medication Unavailable
Medication Unavailable
Lineair (Medication Unavailable)
RCHT - Electronic Drug Ordering
Scan4Safety

20. Sunderland Royal Hospital
Rod Beard - Director of Pharmacy
Linking ePrescribingto Robotic Dispensing

21. Linking ePrescribing to Robotics

22. Sunderland Experience
• Four staff were released for re-deployment
• £500,000 in stockholding efficiency above that suggested by the
business case was identified
• Products dispensed by the electronic prescribing - robot system
produced zero dispensing errors
• The speed of dispensing increased also, as the electronic
prescribing - robot combination permitted almost instantaneous
dispensing from the point of a doctor entering a prescription

23. Isle of Wight - St Marys Hospital
Gill Honeywell - Chief Pharmacist
Linking ePrescribing, Ward Stock and Dispensing

24. EPMA-EDC-Robot link
• 11% reduction in ward drug spend
• 83% reduction in missed doses
• Reduced length of stay
• Frees up nursing ‘time to care’
• Robust financial audit trail
• Return on Investment -3 years

25. GS1 - Can it Deliver?
• Improved patient safety
• Releasing time to Care
• Improved Efficiency

26. GS1 - Can it Deliver?
• Improved patient safety
• Releasing time to Care
• Improved Efficiency

27. What Do We Need?

28. Work with Our Suppliers
NHS Benchmarking Data 2015

29. How Does it Fit All Together?
Unique Identifier Product Level
DM&D Product level
GTIN Product, Supplier & Batch Level
FMD Product,Supplier, Batch and
Box Level

30. Timeline for Initiatives
2011
2019 (2016+3)
Complete FMD
Implementation
Feb 2016
Publication of
FMD
Delegated Acts
July 2011
Publication of FMD
36
Mon.
20182015 2017
June 2017
Implementation of
NHS dm+d
2016
2016
Implementation of
GS1 and PEPPOL
2019
May 2014
Publication of DH
eProcurement
strategy
June 2015
Lord Carter's review
of efficiency in
hospitals
June 2016
Introduction of the
concept of “A Model
Hospital”

31. Timeline for Initiatives
2011
2019 (2016+3)
Complete FMD
Implementation
Feb 2016
Publication of
FMD
Delegated Acts
July 2011
Publication of FMD
36
Mon.
20182015 2017
June 2017
Implementation of
NHS dm+d
2016
2016
Implementation of
GS1 and PEPPOL
2019
May 2014
Publication of DH
eProcurement
strategy
June 2015
Lord Carter's review
of efficiency in
hospitals
June 2016
Introduction of the
concept of “A Model
Hospital”

32. Co-Ordinated & Collaborative