Scenario
Since 2005, patients have been able to use online services for booking appointments, ordering repeat prescriptions, and viewing information their GP practice holds about them in their patient record. This has helped to enhance the quality of care and increase choice and convenience for patients. Proxy access was developed to allow on behalf of the patient to access and manage parts of their GP online services account. The proxy is given their own online access account (rather than using the patient’s login details). When staff in the care home are given proxy access by the GP practice, they can order monthly repeat prescriptions and include a note to the GP.
The process for ordering medication without proxy access is via paper records which are delivered to the GP practice and uploaded into individual patient records. This is a time consuming process for the GP practice and the limitations include not being able to check the accuracy and status of a prescription order. A national target of 25% of Care Homes to be signed up for Proxy Access was set in 2020.
Solution
Communication and engagement with both GP Practices and Care Homes to promote the benefits was undertaken to encourage uptake of this digital initiative. We reviewed the national guidance and developed proxy access documentation in collaboration with the Primary Care DPO.
Since July 2021, we have fully supported 90 Care Homes to order medication electronically via proxy access and are actively working with many other interested Care Homes and 46 GP practices.
The Digital Health and Social Care team train Care Homes and GP Practices to ensure the transition from paper-based medication ordering to the electronic proxy access ordering process is as smooth as possible.
Within the past year, we have supported Care Homes getting proxy access with over 500 1-1 support calls, visits, emails and follow ups to ensure all processes have been followed.
The Digital Health and Social Care Team have also conducted over 50 1-1 training sessions with GP practices via Teams or in person. This is to not only to train GP practice staff how proxy access will work with the Care Home and themselves, but to also show them how to accurately configure the clinical system going forward for other aligned Care Homes.
Benefits
GP practices and Care Homes have both seen the benefits of electronic ordering via proxy access, as there has been a reduction in phone calls and overall time spent on processing Care Home medications.
As part of successful implementation of proxy access for ordering medications the team work collaboratively with PCN colleagues and the ICB Medication Optimisation Pharmacy Service to continually evaluate best practice throughout the project cycle.
- Fewer errors and queries (e.g. missing items, what has been ordered/collected from pharmacy)
- Fewer risks and issues associated with ordering, issuing, collecting, and dispensing repeat medications
- Improved clinical safety with an improved, easy to access audit trail
- Easier and faster access, as Care Home staff can order at any time of the day or night
- Improved data security due to Care Home staff having their own username and password
- Better communications and partnership working between Care Homes and GP Practices
Feedback
“I think proxy access is really good. It’s going to help the surgery a lot by reducing phone calls. The training was brilliant and it wasn’t as complicated as I thought it would be. I know if I have got any problems I can contact the Digital Health and Social Care Team and they’re always available.” – PCN Pharmacy Tech
“The dispensary team are well chuffed! We had the first lot of online requests on Friday, and it’s really simple and easier than a load of phone calls!” – Practice Manager
“We logged in and it seems really easy to use and understand. We’ve placed an interim order and are really pleased with it so far.” – Care Home Registered Manager
“It is a real benefit to work with the Digital Team on Proxy. They have been really supportive and help the Care Homes. I love that they have a real life understanding of working in Care Homes which I think gives the staff reassurance”. ICB Medication Optimisation Pharmacy Service