Health leaders in Norfolk and Waveney have today revealed plans to develop a new service to support the most vulnerable and digitally excluded patients across our health and care system with their repeat medication requests.

The move comes following public feedback from local people who use the Prescription Ordering Direct (POD) service.  After listening very carefully to the views and feedback of local people who use the POD service and staff, NHS Norfolk and Waveney Integrated Care Board (ICB) will be closing the POD service this summer.

The ICB has been considering the future of the POD service as part of proposals to develop a new operating model in which it would no longer be a direct provider of services. This follows a letter from NHS England confirming that all ICBs nationally need to reduce their running costs by 30%.  

The current POD service allows patients to order repeat medications over the phone or online. As it stands, patients from only 18 of the 105 GP practices in Norfolk and Waveney are able to use the POD service, which means most people in Norfolk and Waveney order their medication in alternative ways, such as through their GP surgery website or the NHS App.

The service is mainly used by GP practices in the Great Yarmouth and Waveney area and a small number in West Norfolk, meaning that it is not a service that is currently offered equitably across our health and care system.

In October 2023 the ICB launched a survey for people to have their say on proposals to close the POD service. The ICB asked service users, their families and carers how they might be impacted if the POD service were to close, and what support they might need in the future.

The survey was available in local pharmacies, GP surgeries, libraries, printed in local newspapers, and available online and by phone. ICB staff were also consulted on the proposals over the summer. In total, 2,746 responses to the survey were shared with Healthwatch Suffolk, who produced a report to inform the ICB’s decision making.

Key themes can be found in the Healthwatch Suffolk report here.

These include concerns around the impact on people who are not comfortable with using or have access to digital tools, those with physical exclusion and disabilities, as well as praise for the current POD provision, concern to minimise the impact on primary care and to ensure that any future service is available equitably across the whole of Norfolk and Waveney.

Dr Frankie Swords, Executive Medical Director at NHS Norfolk and Waveney ICB said: “Thank you to everyone who has fed back as part of this important exercise and thank you to our staff for their ongoing work and commitment during what we recognise has been a very difficult time. We are also very grateful to Healthwatch Suffolk for their support with the analysis of the feedback from the public survey and the report.

“During this public engagement work we listened very carefully to people who use the POD service, their families and carers. We heard clearly about the difficulties faced by those who are vulnerable, such as those who are housebound, have limited mobility or access needs, those with learning disabilities and language and literacy needs and those who are digitally excluded. We heard that these groups who currently use the POD service would need more support to manage their medication requests moving forwards.

“We know that the POD service, along with its colleagues, is very highly valued, not just by the ICB, but by patients and those working in primary care. However, we must be mindful that repeat prescribing in Norfolk and Waveney needs to be offered equitably, and this currently isn’t the case, and neither is it financially sustainable longer term.

“We want to prioritise support for the most vulnerable and digitally excluded patients in our communities across Norfolk and Waveney to manage their repeat prescription requests. Our next steps will be to undertake detailed work with local authority digital exclusion teams and other local partners to develop a new service to support repeat prescription management for these groups moving forwards.”

The current POD team will be disestablished from 30 June 2024 and replaced by a smaller roving team of expert pharmacy technical staff who will support GP surgeries with prescription ordering across the whole of Norfolk and Waveney.

People who are able to use alternative methods of ordering their repeat prescriptions such as through their GP surgery website or the NHS App will be supported to transition across to these over the coming months. A core of specialist call handlers from the current POD team will temporarily stay on to support vulnerable and digitally excluded service users and their carers until plans for the new service have been developed.

Andy Yacoub, Chief Executive of Healthwatch Suffolk, said: “We have welcomed the approach of the ICB to ask people about their experiences, and to include local views in important decisions about this service. We recognise the challenges faced by the NHS, whilst also balancing this against the need for services that truly meet people’s needs.

“Naturally, people will be disheartened at the loss of what has been described as a valuable, unique, and helpful service. However, it is clear people’s experiences have been thoroughly considered and we are pleased that there are plans in place to continue to meet the needs of those who are most vulnerable. Such a continuation of advice and support will be critical to ensuring people have equitable access to medication, which we know is such an important part of people’s health and wellbeing.

“In doing so, the ICB is acknowledging the importance of taking a digital first, but not digital only, approach to ensuring people can access their medication and receive advice. This is critical for those who may not have the means, support or skills to be able to engage with digital services, and who have expressed genuine worries about their access to medication in the future. We encourage the ICB to involve people in co-producing the new service as much as possible. 

“It is only by listening and responding to people’s lived experiences that we can hope to create services that work for everyone now, and in the future.”

The ICB will continue to work closely with POD staff, patients, their families and carers, local GP surgeries and community pharmacies during the transition period, and further information for POD service users will be available in due course.

More information about the new service is expected in the autumn.