CP ITG has five workstream areas:

1. Interoperability and security: Ensuring information about people’s health and care can be safely and securely accessed, wherever it is needed. (WS1a-1d)
2. Reducing burden: Use of digital to reduce the burden on pharmacy teams, so they can focus on patients, and appropriate infrastructure for the task. (WS2a)
3. Good use of digital: Support the use of digital within pharmacy to improve health and care productivity, improve patient safety outcomes and improve cooperation between pharmacy teams and the health and care system. (WS3a-3c)
4. Patient and pharmacy tools: Support enabling patients to be able to choose digital tools to access medicines information and pharmacy services directly, so they can receive the best outcomes, recognising the need to also remain inclusive for all patients. (WS4a)
5. Set out roadmap priorities: Development and promotion of a wider community pharmacy digital roadmap / vision. (WS5a)

Those areas have some alignment with NHSX missions. See downloadable PDF version of the full: CP ITG workstreams.

These sections below set out updates related to these workstreams based on the most recent pharmacy IT bulletin.

CPCF/CPCS IT

General

• CPCS IT systems are currently funded centrally by NHSE&I. This arrangement was originally due to end in April 2021 but was extended up until the end of September 2021. CPCS contractors will be responsible for purchasing their own solutions from October 2021 onwards.
• The group has been supportive for guidance and benchmarking that assists the selection of pharmacy contractors’ CPCF/CPCS system supplier and has noted that some contractors will be considering contracts and contract length given that October 1st 2021 is approaching. CP ITG and PSNC have supported for continued work but also have fed back to NHSE&I and the CSU at previous and recent meetings that six to twelve months’ notice should be provided ahead of such developments. This time is to allow pharmacy contractors to consider options, agree contracts and train with the new systems. Suppliers also request this period of notice to assist with their allocation of programming resource and to help them with fitting in this work around their other roadmap items.
• Suppliers’ software solutions will need to meet CPCS IT standards set by the NHS. These standards will be reflected in the CPCS Technical Toolkit (which NHSE&I plan to publish in draft format during June 2021 and to iterate it over time as needed). The document incorporates past comments from CP ITG and suppliers.
• Four CPCF IT suppliers are expected to be ready for 1st October 2021: Cegedim, PharmOutcomes, Positive Solutions and Sonar. Other suppliers may come on board later. Suppliers are currently being supported by NHS Digital and NHSBSA to meet the minimum requirements in the CPCS Technical Toolkit. See also: CPCS IT system selection and IT support arrangements.

GP CPCS IT pilot

NHSE&I has been working on the GP CPCS piloting and rollout since 2020 and provided a further update about recent progress:

• The pilot relates to eight London community pharmacies with the Sonar system and four GP practices.
• CPCS connects patients who have a minor illness or need an urgent supply of a medicine with a community pharmacy. CPCS was extended to include referrals from GP practices from 1st November 2020. Pharmacies which are already registered to provide CPCS do not need to re-register to receive referrals from GPs, as this is an extension to the existing Advanced service (previously referrals came only from NHS 111).
• There are a significant number of scenarios in which the GP could refer the patient to the pharmacy.
• NHSE&I have engaged with the LPCs with pilot pharmacies within their areas including with LPCs within Pharmacy London.

GP CPCS IT principles and standards

• When the GP makes a referral to a community pharmacy, this could be done using different types of GP IT (e.g. accuRx or Doctorlink). Contractors have requested common GP CPCS IT standards so that the messages appear seamlessly in pharmacy CPCS IT systems. LPCs have also requested a principle for GPs to have access to a form of IT that enables CPCS referrals to be reported in the appropriate way even for those patients who do not visit the GP practice in person to make it easy for GP practices to divert patients to pharmacy via GP CPSC, where appropriate.

IT policy updates

Integrated Care Systems (ICS) and local digital priorities

• NHSE&I published Designing ICS (June 2019) and Integrating care… (November 2020) setting out plans to increase the importance of ICS within the NHS. PSNC published a summary of the key points. ICS were in place by April 2021 (or before in many areas) and ICS have a statutory footing from 2022, subject to legislative change. ICS evolved from Sustainability and Transformation Partnerships. ICSs are to: enable cooperation between the NHS and councils; run services in a coordinated way; agree system-wide priorities; and plan collectively how to improve patients’ day-to-day health. There are around 40 ICS and each of them services populations of between 300,000 and 3 million.
• ICS have been tasked with developing data and digital as one of several key goals (“to drive system working, connect health and care providers, improve outcomes and put the citizen at the heart of their own care”). IT ICS priorities as set out by NHSE&I are as follows: developing Local health and shared care records (LHCRs); preparing digital transformation plans for their area; developing a roadmap for patient-centred digital channels; enabling collaboration including shared appointment booking and referral management and task sharing; publishing statistics; and supporting remote monitoring to allow patients to stay safe at home for longer. Many ICS are forming digital boards and employing digital leads. Local Pharmaceutical Committee Chief Officers have expressed interest with taking on board CP ITG national priorities to support their work with ICS on local digital priorities.
• The group, LPCs and contractors accessing LHCRs are encouraged to attend a Virtual LHCRs/ICS Event: for LPCs and CP ITG (1st July noon-1.30pm).
• Local digital priorities based on feedback received by PSNC and on the national CP ITG digital priorities list have been prepared into documents: Local pharmacy digital priorities (prose) and Local pharmacy digital priorities slides. Comments on these documents can be made to it@psnc.org.uk by the end of June 2021.
• Examples of LHCR or local digital priority papers should be sent to it@psnc.org.uk by 30th June 2021.

New CP ITG IT infrastructure survey

• Contractors and others can promote the newly launched survey using template wording. Please can pharmacy contractors and teams also submit an IT arrangements survey response within June. The results will help inform IT policy of system suppliers and the organisations which attend CP ITG.

NHSX and NHS Transformation Unit working to develop a new strategy

• NHSX and NHS Transformation Unit discovery work is continuing to enable the later creation of an NHSX digital strategy for pharmacy, optometry, dentistry, ambulance and community services (PODAC). NHSX are working closely with NHSE&I and other stakeholders to build on the opportunities already taken to accelerate transformation in these areas over the next three to five years.
• Many from within the group volunteered their time to feed into two workshops. PSNC and pharmacy teams also fed in via one-to-one interviews with the project team. The project team have explained that some extra system supplier feedback will be captured later. PSNC has reported that capturing supplier feedback is also critical.
• Those who have not yet fed in can contact it@psnc.org.uk to be sighted on developments and feedback opportunities.

Pharmacy IT Gantt chart draft template

• System supplier feedback has indicated that multiple projects and objectives are contributing towards severe capacity challenges. Suppliers asked whether the group could explore documenting the multiple projects which are ongoing or forthcoming within the NHS; a draft chart template has been prepared. See: Gantt Chart (slide) and Gantt Chart (spreadsheet). The chart can be set to relate to ‘all contractors’ or can be used as a template by an individual system supplier. Comments about the work may be sent to it@psnc.org.uk.

COVID-19 vaccination programme IT

• More than 600 community pharmacy sites are currently being used to provide vaccines. Contractors have used Point of Care systems such as those provided by Outcomes4Health and Sonar.
• NHSE&I and NHS Digital are supporting the use of the National booking service (NBS) and the wider vaccination programme. NBS enables people to book COVID-19 vaccination appointments at vaccination centres and community pharmacies across England. The national booking service is made up of three parts: (1) an online booking service available to the public on the NHS website – the Book a coronavirus vaccination service; (2) an appointment management system for staff working at vaccination centres and community pharmacies offering vaccinations (Q-Flow); and (3) an app for checking people in to their appointments when they arrive at vaccination centres.
• More than 500 pharmacy-led vaccination sites have administered over five million vaccines across England (as of June 2021). Further pharmacies are being onboarded into the programme.
• Pharmacy teams involved with vaccine supply are encouraged to feed into NHS Digital by registering interest at http://bit.ly/NHS-vaccination-user-research so an NHS Digital team member can get in contact. The user research team are especially interested to hear from those who do activities such as data input or reporting, or those who use computer systems as part of their role.

Other IT policy updates

• The group’s Terms of Reference will be added to the CP ITG webpage during July 2021. The Terms of Reference can be seen here. If you would like to comment on these, please contact it@psnc.org.uk.
• The group’s PMR system wishlist has been further updated during June 2021 and priority and feasibility rankings added. Community pharmacy teams or the group can contact it@psnc.org.uk to take part with further developing iterations to the list.
• CP ITG published a previous progress update, and its quarterly round-up following its last main event.
• Community Pharmacy Digital Group discussed NHS Digital Academy accepting applications during April 2021 (for courses starting from Sept 2021).

Integrated Care Systems and digital technology

• NHSE&I outlined the importance of data and digital in fulfilling plans to progress ICS.
• Derbyshire ICS signed a 10-year shared records deal with Orion Health.
• With ICS set to be put on a statutory footing by 2022, Mala Mawkin says that now is the time to get personal and share stories of integration success.
• net published an opinion piece written by a healthcare lawyer putting forward that “putting ICSs on a statutory footing could encourage similar levels of digital maturity across regions if the right funding and governance was in place”, and “success depends on ‘baseline’ digital maturity across organisations”.
• NHSE&I board papers illustrate NHSE&I hopes digital and data will help drive system working as well as connecting health and care providers.
• Infinity Health published an opinion piece about “What the new NHS Integrated Care Systems need to do to be successful” including the expansion of Shared care records, and more proper digital transfers of care.

IT policy updates

• Simon Bolton replaced Sarah Wilkinson as interim chief of NHS Digital.
• The NHSX CEO, explored the digital future of the NHS, including the speculation surrounding NHSX and looked over the work and lessons NHSX has been involved with since it’s set up in 2019.
• NHS Digital improves e-Referral Service (e-RS) further following feedback.
• co.uk reported that NHSE&I is to create a ‘transformation directorate’ merging NHSX with others from NHSE&I. Timothy Ferris was appointed Director Of Transformation for NHSE&I.
• Matt Hancock set out Five mission critical areas of digital health technology.
• DHSC launched a review to highlight how health data can be used for research and analysis.
• Government and healthtech bodies backed a campaign to showcase UK digital health.
• NHSE&I highlighted patient stories of digital primary care in a pandemic.
• Simon Eccles (NHSX CCIO) reflected on the IT leadership survey of 2020 and its findings such as IT Leaders responses demonstrating: more video consultation, a reduction of dissatisfaction with hardware, a shift in attitudes to health data, upgrades being made to records systems and improved online triage becoming more available.

A May 2021 joint Lancet and London School of Economics (LSE) report on the future of the NHS called for a re-evaluation of digital health and for new areas of focus. The suggested focus areas are as follows:

1. Deliver integrated electronic health records past commitments (with access for patients, carers, and health and care providers across multiple settings).
2. Improve the usability and interoperability of IT systems to reduce staff errors and burnout.
3. Address security, privacy and governance concerns.
4. Develop easy-to-use platforms for those at risk of digital exclusion.
5. Collate datasets to support policy and planning, service delivery, and the precision medicine and public health agendas.
6. Invest in IT leadership, training and development of the existing workforce, and the creation of new roles such as data scientists and clinical informaticists
7. Understand AI/robotics benefits but as complementary to pre-existing roles and to reduce the burden on staff.

Interoperability and records

Work to update the Pharmacy information flows standard

• The Professional Record Standards Body (PRSB) provided an update at the group’s last meeting and invited CP ITG to a multi-disciplinary workshop, and suppliers to a January 2021 workshop. PRSB pharmacy flows standard developments work was highlighted by PSNC. A dedicated pharmacy call with CP ITG and PRSB took place in February 2021. PSNC will consider endorsing the dataset after its Service Development Subcommittee have reviewed the latest version of the dataset (which is expected to be available within June 2021). PSNC will feed back to PRSB and RPS.

Local health and shared care records (LHCRs) and records update

• Updates about LHCR arrangements have been included within previous progress updates. LHCRs are sometimes referred to as ‘Shared care records / ShCR’.

LPCs and/or local contractors can continue to take steps to gain pharmacy access such as:

• identifying the LHCR project team from the List of records systems;
• learning about case studies such as: Dorset Care Record LHCR pharmacy access case study;
• contacting the LHCR project team and other local partners to find out how to get involved;
• using the ‘Planning pharmacy access briefing’ and frequently updated LHCRs webpage; and
• reviewing the December 2020 PSNC/RPS LHCRs/SCR letter to NHS orgs about records access.

Other updates:

• CP ITG pharmacy reps and LPCs will be invited to a Virtual LHCRs Event: Shared care records meeting for LPCs and CP ITG (1st July noon-1.30pm).
• PSNC and the Royal Pharmaceutical Society (RPS) called for LHCR standards and continued pharmacy access to Summary Care Records with Additional Information (SCRs with AI) following the COVID-19 pandemic. Read the letter in full here.
• A researcher published their findings on the use of electronic health records (EHRs). They identified benefits but also usability challenges.
• Child health records are set to be digitised earlier than planned (April 2023 instead of a year later) under government plans to give families greater access to their children’s data.
• NHSX plans to launch a new framework for digital social care records.
• net published a special report on Local health and shared care records (LHCRs) which argues that the continued growth and development of LHCRs means “the NHS is actually beginning to catch up with what many people think is happening already”.

Other interoperability updates

• DHSC reported that £16 million will be used to introduce digital prescribing across 16 hospitals.
• InterSystems (IT system supplier) expressed the view that interoperability could be key when it comes to unlocking the success of healthcare IT companies.
• Digital health expert Wachter (and author of ‘Using tech to improve the NHS’) believes the world will shortly enter ‘a golden era’ of health IT.
• NHS App e-Referral Service reduces patients who ‘did not attend’ by half.
• Electronic notifications were introduced for pharmacies and GP practices using Sonar and EMIS Web, following the service launch with PharmOutcomes and TPP SystmOne.
• NHS Digital published information on ethnicity recording in the NHS to aid planning and research for COVID-19.
• Amazon progressed further into the US health sector with use of its online pharmacy in the US.
• NHS Wales commits to adoption of GS1 barcode standards.
• PRSB publishes guidance for prescribers using genetic information.
• The group previously agreed to support the capability for anonymised data to be accessible, so that pharmacy teams’ interventions can start to be auditable, and the value of community pharmacy can be better demonstrated. If PMR systems were to be adapted to allow such data sharing, it would require the development of a roadmap and a standard approach to data provision, which may benefit from use of SNOMED CT clinical terms. A PSNC-drafted dataset was prepared and a dataset for the Community Pharmacist Consultation Service could be added. If you would like to help progress this work, please contact it@psnc.org.uk.

NHSmail

• NHSmail support pages outline the benefit with the NHSmail Teams “Virtual Visits” patient consultation platform – it enables appointment booking and video consultation. The NHSmail team provided a demo to PSNC and CP ITG representatives. At present, pharmacy team members do not have the ability to ‘switch on’ the functionality and the NHSmail team have advised that an update will be provided later about whether a pharmacy process for accessing this can be added.
• PSNC has been working with the NHSmail team to check that pharmacy contractors have the correct revised naming format: ODScode@nhs.net (e.g. not the incorrect format nhspharmacy.ODScode@nhs.net). Contractors who do not have their address within the expected format can raise a ticket with the NHSmail pharmacy admin team.
• PSNC has published a factsheet to support escalation of an NHSmail ticket.
• IT case study: Pharmacy and GP practice co-working with NHSmail: Community pharmacy contractors and GP practice staff in Widnes are collaborating more than ever after digitising their communications through a local NHSmail initiative.

IG, identity and security

NHS Digital’s Care Identity Service 2 (CIS2) program

• CIS2 is a future enabler for login to NHS systems without a physical Smartcard for more health and care settings.
• CIS2 (formerly called NHS Identity) is an authentication system. Some newer associated CIS2 integrations are being piloted with health and care professionals in England to prove their identity when accessing national clinical information systems e.g. Summary Care Record (SCR) access on iPads via fingerprint identification by Care Home staff and paramedics.
• Authentication in the future may be via: a specified mobile device correctly set-up and with the right software; or a Smartcard (or virtual equivalent) with or without a direct HSCN connection. However at the present time, Smartcards do require a HSCN connection. There is a piece of work in the pipeline to enable Smartcards to be used on the internet and so remove the reliance on a connection to HSCN.
• At present EPS and the associated authentication being used (CIS1) is limited to Microsoft Windows.
• CIS2 has a series of advantages compared with CIS1: it works with iPads/Windows tablets/laptops, and cross-platform keys, it also works with Google Chrome and Apple Safari instead of just via the Microsoft internet browser.
• Paramedics using CIS2 have found benefits including speedier authentication when compared to older systems.
• Some older CIS1-related technologies will be reaching end-of-life, and NHS Digital and PSNC will be communicating about this to suppliers within June 2021.
• Pharmacy contractors, teams and CP ITG have expressed interest in being able to break away from needing to use physical Smartcards, in favour of signing-in on a mobile device and using EPS.
• At some point, CIS2 may be able to create scenarios in which personal mobiles are used for authentication.
• The ongoing work between Entrust and NHS Digital on other ‘Entrust virtual Smartcard certificates’ is separate from CIS2 developments. Work is ongoing to coordinate and align the two projects.
• NHS Digital authentication/CIS2 team have been engaging with each of the pharmacy EPS system suppliers and will continue doing so, and plan to do so further via the EPS Next Generation work and  the ongoing NHS Digital / PMR service calls. System suppliers which wish to further understand how to speedily begin the CIS2 integration work should fully explore the NHS Digital CIS2 webpages, continue any PMR/CIS2 team talks which have already begun or contact the CP ITG secretariat (it@psnc.org.uk) who will link you to the CIS2 supplier onboarding team. Suppliers may also contact the CIS2 supplier onboarding team directly.

Data Security and Protection Toolkit (DSPTK)

• PSNC has issued communications and guidance relating to the completion of this year’s Toolkit.
• PSNC has again worked closely with NHS Digital and contractor testers to keep the workload manageable but the data security protections appropriate. The key differences this year include: new mandatory questions and improvements to the wording for all the questions.
• PSNC updated its Data security and information governance hub during April 2021 to support Toolkit completion and published new guidance for the 2020/21 Toolkit submission: Toolkit completion: Five steps to complete the Toolkit (overview); Toolkit completion: Question-by-question guidance (mandatory questions).
• Data security templates were all updated and new ones added: psnc.org.uk/dstemplates. These templates are also now organised both by template number and alphabetically.
• A revised training option was added: Pharmacy data security (for induction or refreshment).
• PSNC also hosted meetings with the PMR suppliers and NHS Digital, to help the PMR suppliers with their preparation of PMR-specific guidance for contractors.
• If you would like to feed into the development of the proposed 2021/2022 question set, please email it@psnc.org.uk.

Other updates about data security

• Tributes paid to National Data Guardian Dame Fiona Caldicott who passed away in February 2021. Caldicott passed away at the age of 80 following a career dedicated to seeking the balance between the protection of patient information and the sharing of information to improve care.
• Nicola Byrne has been appointed as the new National Data Guardian (NDG) for Health and Social Care for the next three years. Byrne published an introductory blog and her statement about the reasoning for taking on the role.
• NHS Digital has announced plans to replace the General Practice Extraction Service (GPES) with a new General Practice Data for Planning and Research (GPDPR) service. This new service is intended to make it easier for NHS service planners and researchers to have access to de-personalised data from GPs.
• NHS IT leaders believe Covid has changed attitudes to digital for the positive.
• PSNC submitted a consultation response regarding the draft NHSX Records Code. NHSX has closed its consultation and published its Records Management Code of Practice 2020.
• PSNC has updated guidance about: Antivirus; Backups; Data handling and Data roles.
• The Irish health service was impacted by a serious cyber-attack during May 2021.
• A cyber security expert summarised some of the increased cyber risks during the pandemic.

Promoting good IT, and user research opportunity

NHS Service Finder enhancements and user research

• NHS Service Finder is a free tool that provides access to information from the Directory of Services (DoS) and the NHS website. It is not accessible by the public, but it does allow pharmacy teams, LPCs and other healthcare professionals to search for service information quickly. The NHS Service Finder team added new enhancements during March 2021 including: restyled search results, quicker searches, and improved filtering options. PSNC has been requesting such changes and will continue to provide input to the NHS Service Finder team based on contractor feedback it receives. A YouTube video was published to highlight the benefits for pharmacy team members.
• NHS Digital user researchers are conducting a round of user interviews to help develop the NHS Service Finder tool further. Please take part by emailing it@psnc.org.uk.

Digital tools research by NHS Digital: pharmacy volunteers required

• NHS Digital and NHSX are running research to help identify what community pharmacists and service leads need most from the digital tools and systems that pharmacy teams use on a daily basis at work. They are also looking to identify what information and data pharmacists and service lead staff need in their daily tasks to make informed decisions and best carry out their role. PSNC have fed inputs into the project team.
• The user researchers are also looking to speak to pharmacists and service leads, most particularly those working in: regional/local multiples; distance selling pharmacies; and large multiples. They have already spoken with many independent pharmacy contractors. The interviews will take around 45 minutes and can be scheduled at a time that works best for the pharmacy team member.
• NHS Digital user researchers are conducting user interviews to help develop the NHS Service Finder tool further. If you’d like to take part email it@psnc.org.uk with ‘digital tools’ in the subject title.

Other updates: reducing burden

• The group previously identified going paperless as a priority – within its Digital Priority List and Views on the next generation of EPS However, pharmacy teams continue to report considerable use of paper and printing for reasons such as enabling prescription information to move around the dispensary given limited space for PMR terminals. Following work with the group and the paperless sub-group a new ‘Going paperless’ webpage has been published on the PSNC website for pharmacy teams.
• PSNC published an IT case study in which a Pharmacy in Sheffield went paperless.
• The Government temporarily suspended the requirement for patients (or their representatives) to sign the back of NHS prescription forms or EPS tokens from 1st November 2020 until at least 30th June 2021. PSNC continues to discuss with the Department of Health and Social Care (DHSC) the remaining need after this point, for the regulatory requirement that requires the patient or representative to sign a declaration on a prescription form or EPS token when they pay an NHS prescription charge.
• 30,000 iPads will be issued to ambulance crews in England.
• PSNC reported on dm+d viewer suppliers welcoming views on new dm+d browsers from pharmacy team and other users: new NHSBSA dm+d browser is in testing mode; NHSBSA’s legacy dm+d browser (available for a limited period); OpenPrescribing dm+d viewer; Unilexon dm+d browser; and East Kent NHS dm+d browser.
• PSNC published a new factsheet to explain the EPS tokens ordering and escalation process.
• Case study: How one NHS trust moved to virtual outpatient appointments.

EPS and RTEC

EPS statistics

• NHS Digital EPS and eRD utilisation rate statistics (for the March 2020 dispensing month) are set out on the right, and 95.6% of GP practices were Phase 4 ready at this time. NHSBSA continue to publish EPS dashboards and other data.
• NHSBSA confirmed at the June CP ITG meeting that over 95% of those community pharmacy prescriptions being processed by NHSBSA are now EPS ones. Other statistics at NHSBSA and NHS Digital websites indicate more than 90% of prescriptions are EPS taking into account other dispenser types.

Other EPS and electronic prescribing updates

• NHSBSA’s NHS EPS endorsement guidance has been updated (to version 7.6), pages 13-14. The SSP endorsement can be used from June 2021. The current ‘NCSO workaround’ is being phased out and is scheduled to no longer be allowed to be used from October 2021 dispensing.
• EPS SSPs went live within the June 2021 Drug Tariff with a transition period in which NCSO will be allowed. System suppliers have received guidance from NHSBSA.
• Suppliers may be revising their SSP system-specific guides and PSNC offered to comment on drafts.
• NHSBSA and PSNC have clarified EPS old patient charge rate processes near the boundary of a new financial year (the patient prescription charge rate typically increases from April 1st each year). If EPS prescriptions are submitted in the March dispensing month, they are processed as ‘old patient charge rate’ and if they are submitted within the April dispensing month they are processed as ‘new patient charge rate’ (i.e. for the new financial year).
• PSNC revised its Dose area EPS-related guidance.
• The Welsh government continues to consider an electronic prescription system. Matt Armstrong is feeding into this project on behalf of the CP ITG.

 NHS Digital work on EPS Next Generation

• NHS Digital have continued working with NHSX, NHSE&I and others on preparing a newly developed ‘EPS prescribing API / message format’ and EPS Fast Healthcare Interoperability Resources (FHIR) standards. The initial implementation is into secondary care and in relation to homecare providers. The EPS team has rebuilt the existing service using modern standards and technology. It is now available for secondary care and GP suppliers to develop against. It is anticipated that pharmacy system suppliers can start developing from late June 2021 at the earliest.
• The EPS team’s 2021-22 ‘Next generation’ work plan includes progressing a first-of-type within summer 2021 for EPS outpatients and homecare suppliers, and working with suppliers to start the transition and deliver some new EPS features. The 2023-24 the work plan currently includes: identification of further features; building new features; working with suppliers and ideally decommissioning the older HL7 EPS R1 and R2 technology by March 2024.
• NHS Digital have updated several webpages including the following: EPS developer guide, FHIR implementation, FHIR API and signing-in apis.
• One of the main reasons EPS has moved to FHIR is so that there is the ability for EPS suppliers to align with the standard dosage standard – something long campaigned for by the CP ITG’s outgoing Chair.
• The Next Generation EPS features that are being looked at include a range of features, including EPS instalment dispensing for methadone (EPS FP10 MDAs) and EPS antibiotic prescriptions.
• The EPS team would like to be able to work on other EPS wishlist items including: Personally Administered (PADM) items, improvements to cancellation options, removal of the 4-item limit (line item prescribing), extending nomination choices, EPS Tracker APIs, private prescriptions, prescribing and dispensing ‘services’ within directories, customised prison EPS forms, improved eRD (Electronic Repeat Dispensing) and improved dispensing statuses (enabling patient-facing messages via apps etc). Enhancement business cases will be made on a feature-by-feature basis.
• PSNC will continue feeding into NHS Digital. The EPS team will also be welcoming more detailed pharmacy team inputs about specific EPS enhancements being worked on such as via upcoming user research events which the group will be made aware of.
• If you work within community pharmacy and would like to feed into the CP ITG’s EPS future list or NHS Digital’s work and events contact it@psnc.org.uk with ‘EPS future’ in the subject title.

Real Time Exemption Checking (RTEC)

• NHSBSA has led the RTEC project since January 2020. CP ITG and PSNC have been supportive of its continued roll-out. Read more on RTEC, its phases and continued piloting of Department for Work and Pensions (DWP) RTEC at five pharmacies using PSL at: RTEC. Feedback from RTEC users (PSL/EMIS/Cegedim/Titan systems) has continued to be very positive. Use of RTEC reduces the exchange of paper between pharmacy teams and patients, assisting infection control.
• NHSBSA met with two PMR suppliers across late 2020 to discuss the new data sharing arrangements necessary between NHSBSA and those suppliers. Deployments for pharmacies with those systems had to pause for several months. RTEC deployments relating to those two system suppliers recommenced immediately after the group’s November 2020 meeting, after additional work by NHSBSA and PMR suppliers. Contractors are now being encouraged to register for RTEC and more than three quarters of pharmacy organisations have now done so.

Apps, wearables and technologies (incl videocon)

NHS App

• Details about the NHS App have been explored in past IT progress updates. The NHS App is available on the Google Play store and the Apple App store.

The NHS App team are working on further features including:

• Online consultations integration: The first supplier was made available through the NHS App in 2020 initially with eConsult and Patient Knows Best. The NHS App team is using open standards to help suppliers who provide forms-based triage systems integrate them.
• Push notification capability: The NHS App team have built the ability to allow users to receive broadcast or targeted push notifications and messages relating to their care. This could include reminders for referral appointments, reminders for online consultations, and screening invitations, via services integrated into the app. Suppliers are being onboarded.
• NHS Electronic Referral Service (NHS e-RS) integration: The NHS App team integrated the NHS booking system for hospital appointments, NHS e-RS Manage your referral. This enables patients to book their first hospital appointment when their GP refers them to a specialist.
• Personal Health Records (PHRs) integration with NHS App: The first supplier, Patients Know Best, was made available in the NHS App from April 2020 and more are expected to go live in spring 2021.

Apps and tools

• NHS website launched Flu vaccine finder for patients as reported by PSNC.
• An app reviewing firm (for trusts) reported that 80% of apps reviewed do not meet NHS standards.
• Open Access Gov set out the data potential of wearable health technology readings.
• A study recommends that fitness apps should be prescribed to improve physical health, having found that users of wearable fitness trackers walk almost an extra mile a day.
• Push Doctor has relaunched private video consultations via its app after increased demand for it.
• ORCHA reported on a health app download ‘explosion’: a 25% rise in health app downloads since the start of the pandemic – a rise of roughly one million, up from four to five million downloads per day.
• Herefordshire and Worcestershire launches its own health apps library.
• National Institute for Health and Care Excellence (NICE) issued health technologies guidance.

Video consultation, artificial intelligence (AI) and robotics

• GP online reported: Hancock believes GPs should do 45% of consultations remotely post pandemic.
• NHSX has set up an online community to encourage the adoption of robotic process automation (RPA) in health and social care.
• NHSX reported on a year in the life of the NHS AI Lab
• The Scottish government announced an AI strategy for Scotland, including the creation of the Scottish AI Alliance, which will include representation from across society.

IT policy updates

Integrated Care Systems (ICS)

• PSNC published a one-page ICS and healthcare IT factsheet.
• Integrated Care Systems will be required to have digital and data platforms in place by April 2022.
• The requirement for all of England to be covered by an Integrated Care System (ICS) was introduced to parliament.

IT policy: lessons from the pandemic

• A more “systematic” approach to data collection and sharing is needed to better prepare for future pandemics, according to a report from the G7 summit.
• Richard McEwan, Lead Technical Architect, explains the infrastructure behind one of the world’s largest national COVID-19 vaccination programmes and how it has helped over 35 million people and counting get their life-saving jabs.
• A new study has revealed the majority of the UK’s leading health providers are accelerating their digital transformation plans this year in response to the Covid pandemic.
• NHS Digital received an award for statistical work to identify those patients most vulnerable to COVID-19 so that their care was prioritised. NHS Digital’s Chief Technology Officer considered How data shielded the vulnerable.

IT policy: changes to the landscape

• Digital Health Network’s Advisory Panels elected new members.
• Tributes were paid to NHS Digital’s deputy CEO Pete Rose also serving as the organisation’s chief information security officer (CISO) who passed away in August 2021.
• Digital Health reported on Amanda Pritchard’s appointment as NHS England’s new CEO.
• New interim chief executive of NHS Digital Simon Bolton outlines his main priorities including to further improve working relationships between NHS England, NHSX and NHSD.
• Digital Health opined on the biggest tech challenges for health secretary Sajid Javid.

CP ITG IT infrastructure survey

• Contractors and others can promote the newly launched survey using template wording. Please can pharmacy contractors and teams also submit an IT arrangements survey response within October. The results will help inform IT policy of system suppliers and the organisations which attend CP ITG.

dm+d code changes and synchronisations

• PSNC received system supplier and pharmacy contractor feedback about changes to dm+d codes impacting on the use of EPS.
• Pharmacy contractors should report actual or potential clinical impacts using the Learn from patient safety events (LFPSE) process outlined at the dm+d webpage reporting guidance section.
• NHSBSA dm+d team are reviewing their scope to provide notifications ahead of changes and have already started to introduce some communications earlier than usual via the Technology Reference data Update Distribution communications route.
• Supplier comments have proposed that if dispensing and prescribing systems targeted aligned synchronisation dates this would reduce the risk that pharmacy contractors received problem prescriptions for items which have had changed dm+d entries. However, there are challenges given that some prescribing suppliers reportedly synchronise less often compared to pharmacy system suppliers and additionally whilst the drugs database update may be made available monthly for prescribers, it may take two to three weeks after the update for it to reach all GP practices using that system. Pharmacy system suppliers will contact the CP ITG secretariat within October 2021.

IT policy key updates

• PSNC published a one-page ‘Reshaping how health and care data is used’ factsheet about DHSC proposals in their Data saves lives paper.
• World Health Organisation (WHO) forecasts global 13 million shortfall of health workers by 2035.
• Medical Futurist reports on Google’s plans in the health and care sector.
• Kings Fund published a long read about the impact of NHS administration processes on patients.
• NHS Digital calculated a digital revolution in social care might have £127m in future benefits.
• King’s Fund considered the journey towards a smarter hospital within an integrated landscape.
• Hospitals expected to begin testing electronic prescribing systems from autumn 2021.
• CP ITG published its previous Pharmacy IT quarterly round-up after the last CP ITG meeting.
• Microsoft announced Windows 11 plans.
• BT say Public Switched Telephone Network (PSTN) phonelines will all be disconnected within four years. Pharmacy contractors will need to ensure they connect their phones into an internet connection (Voice Over Internet Protocol (VOIP)) and consider contingencies if internet is lost.

Innovation

• Digital Health London launched Innovation Directory for London to help accelerate digital change.
• An openaccessgovernment.org opinion piece argued that innovation can resolve NHS challenges.
• AHSN Network published an innovation in healthcare study.
• NICE and AHSN have announced a two-year agreement to support the use and promotion of innovation in the NHS.

Digital capabilities

• Health Education England selects new consortium to deliver NHS Digital Academy programme.
• Health Education England published a Digital Capabilities in the Pharmacy Workforce
• UK Parliament reported on the extend of digital literacy amongst citizens. Data suggests around a fifth of the population do not have “essential digital skills” for life as defined by the UK Government – impacting their ability to access services, get employment and healthcare.
• The US core pharmacist curriculum has had additional Genomics content added.

Inclusion

• Local Government Association (LGA) has launched a Digital Pathfinders Programme with a promise of support of up to £20,000 each for a number of projects led by local authorities aiming to improving digital inclusion, connectivity in their communities and cyber security.
• NHSX and others published a factsheet for digital project teams to consider digital inclusion as part of their work.
• NHSX plans to further develop an NHS Account to simplify patient access to digital services.
• Emma Stone, Director of Design, Research and Communications at the Good Things Foundation, explored the implications of increased use of digital health services on the digital divide.

Healthwatch reported on how some patients had been excluded by remote GP appointments

Interoperability and records

Shared Care Records (ShCR) update

Updates about ShCR arrangements have been included within previous meeting papers and discussed at past meetings. ShCRs were previously called ‘Local health and shared care records (LHCRs)’.

LPCs and/or local contractors can continue to take steps to gain pharmacy access such as:

• identifying the ShCR project team from the List of records systems;
• learning about case studies such as: Dorset Care Record ShCR pharmacy access case study and the recently published East London Patient Record (eLPR) pharmacy case study.
• contacting the ShCR project team and other local partners to find out how to get involved;
• using the ‘Planning pharmacy access briefing’ and frequently updated ShCRs webpage; and
• reviewing the December 2020 PSNC/RPS ShCRs/SCR letter to NHS orgs about records access.

CP ITG pharmacy reps and LPCs took part in the Virtual ShCRs event (1st July 2021). PSNC continues to work with NHSX and other relevant stakeholders on the actions decided at this meeting. More information about these actions is available here: minutes and outputs for the Shared Care Record (ShCR/LHCR) summer 2021 event.

Records

• NHS Digital launched a Data Uses Register tool so patients can see which organisations access certain data (also reported by Digital Health).
• NHSX is looking at how new IT could allow pharmacy teams to add notes to patient records.
• NHSX launched procurement framework for digital social care records.
• NHS England and NHSX plan to invest £52 million into online maternity records.
• Royal Marsden Hospital announced a partnership with Great Ormond Street Hospital to deliver a new digital health record powered by the supplier, Epic.
• Clinical and system leaders from Greater Manchester presented a virtual September 2021 event about the progress with use of the ShCR ‘Greater Manchester Care Record’.
• Genetic test results for urgent cancer patients can now be accessed digitally across Wales.
• North Tees and Hartlepool Hospital integrated into the Great North Care Record.
• A case study explored how to manage healthcare data volumes in health care records (e.g. more high-resolution images).

Other updates about interoperability

• Enovacom launched a FHIR: everything you need to know (short factsheet) about Fast Healthcare Interoperability Resources.
• The Royal Wolverhampton NHS Trust has extended its partnership with Babylon.
• NHSX Blueprinting Steering Committee said that Blueprints are important for delivery of digital capabilities within the NHS. The committee considers blueprints a knowledge asset and a product of a structured approach to learning, from projects that have taken place. The committee is overseeing the development of hundreds of new blueprints.
• NHS Digital announced the first providers had begun taking part in the national data alignment programme between the NHS and private sector.
• At a previous meeting, CP ITG agreed to support the capability for anonymised data to be accessible, so that pharmacy teams’ interventions can start to be auditable, and the value of community pharmacy can be better demonstrated. If PMR systems were to be adapted to allow such data sharing, it would require the development of a roadmap and a standard approach to data provision, which may benefit from use of SNOMED CT clinical terms. A PSNC-drafted dataset was prepared and a dataset for the Community Pharmacist Consultation Service (CPCS) could be added. If you would like to help progress this work, please contact it@psnc.org.uk.

NHSmail

NHSmail support pages outline the benefit of the NHSmail Teams “Virtual Visits” patient consultation platform – namely, this platform enables appointment booking and video consultation. The NHSmail team provided a demo to PSNC and CP ITG representatives. Pharmacy contractors that would like to pilot this can contact it@psnc.org.uk with their name, ODS code and telephone number and ‘Virtual Visits pilot’ within the email subject title.

IG, identity and security

Data Security and Protection Toolkit (DSPTK)

• PSNC and NHS Digital are currently updating the Data Security and Protection Toolkit (DSPTK) and related tips. Additional user testing is also planned. If you would like to get involved with this user testing, please contact it@psnc.org.uk.
• NHS Digital may update contractors about the availability of the initial Toolkit version. However, we strongly recommend that contractors hold off accessing the Toolkit until the planned improvements have been finalised and PSNC releases its updated guidance. Contractors will still have adequate time to complete the Toolkit before the submission deadline on 30th June 2022. We will keep contractors informed of any developments.

Data security key updates

• PSNC and NHSX published a joint Cyber security tips IT factsheet for pharmacy teams.
• The implementation date of September 1st 2021 of the GP Data for Planning and Research (GPDPR) programme was The proposed changes will apply only once criteria is met.
• World Health Organization published a report to help national health systems protect data.
• The Irish government confirmed it was aware that health data could have been stolen during a major cyber-attack and that data may potentially may be abused by criminals. Davey Winder, cyber security expert gave his thoughts on the Irish incident.
• Moorfields Eye Hospital in Dubai was subject to an IT security incident.

Promoting good IT, and user research opportunity

NHS Service Finder enhancements and user research

• NHS Service Finder is a free tool that provides access to information from the Directory of Services (DoS) and the NHS website. It is not accessible by the public, but it does allow pharmacy teams and other healthcare professionals to search for service information quickly. The NHS Service Finder team published user survey results in August 2021.
• NHS Digital user researchers are conducting a further round of user interviews to help further develop the NHS Service Finder tool. If you’d like to take part email it@psnc.org.uk.

Discovery work about patient digital authentication

• Discovery work about patient digital authentication: PSNC and CP ITG are feeding into DHSC who are carrying out related discovery work and must explore: the best way to capture digital authentication in community pharmacies; main challenges in implementing digital authentication; and main benefits in implementing digital authentication (for pharmacies/patients).
• Contractors may submit further information into a survey at: https://forms.office.com/r/VYUw5geidT by 20th October 2021. CP ITG and PSNC will collate further feedback such as via survey and will share the output to DHSC.

Key reducing burden updates

• CP ITG previously identified going paperless as a priority – within its Digital Priority List and Views on the next generation of EPS However, pharmacy teams continue to report considerable use of paper and printing for reasons such as enabling prescription information to move around the dispensary given limited space for PMR terminals. Following work with CP ITG and the paperless sub-group the ‘Going paperless’ webpage has been further updated.
• More than half of contractors were using MYS for end-of-month submission by August 2021.
• The Government temporarily suspended the requirement for patients (or their representatives) to sign the back of NHS prescription forms or EPS tokens from 1st November 2020 until 30th August 2021. PSNC reported on the end of this temporary suspension.
• PSNC published a factsheet that explains how pharmacy team members can check if they have an older NHS Smartcard needing replacement in case it is reaching ‘end-of life’ this calendar year.
• NHS Digital previously added the multi-site ‘FFFFF’ Smartcard code and SCR rights onto Smartcards with the pharmacist or pharmacy technician role, because of the COVID-19 pandemic. The initiative was supported by PSNC and NHS England and NHS Improvement. NHS Digital have confirmed to PSNC that assignment codes will be further extended until 31st March 2022.
• Medical Futurist explored how Drones may be used to support the delivery of health and care.

Development of pharmacy systems

Use of pharmacy systems for CPCF services

• DMS was introduced as an Essential service in early 2021. NHSE&I and PSNC were keen for suppliers to be given information on the service, IT implications and dataset requirements. Supplier briefings occurred in October 2020, February and May 2021. Contact persons on the project introduced themselves to CP ITG There is an objective to progress the specification work further during autumn, and for a ‘go-live date’ ideally by late 2021. PSNC is continuing to push for this work to be completed at the earliest opportunity. Updates will be published at: psnc.org.uk/itrequirements and psnc.org.uk/dms.
• NHSE&I announced that a national procurement model would be in place to support community pharmacy contractors with the delivery of the Community Pharmacist Consultation Service (CPCS). This was scheduled to terminate on 1st October 2021, but was extended to the end of March 2022. Contractors are recommended to start considering which CPCS IT supplier they want to choose well in advance of the next change. From the autumn, contractors will be able to transition to their own contractual arrangements with one of the four assured IT providers: Cegedim; Positive Solutions; Sonar Informatics; or PharmOutcomes.
• NHSE&I has published a CPCS IT Provider ‘Switching’ guide and additional buyers guidance and an NHSE&I CPCS IT webinar is expected shortly on Thursday 14th October, from 7.00-8.30pm.

EPS and RTEC

EPS

• Since the last meeting, PSNC has restructured and revised the webpages within its EPS website section. PSNC has also updated its EPS totals reconciliation guidance (EPS totals) guidance and reported on EPS script volumes exceeding 95% of total items.
• EPS Serious Shortage Protocols (SSPs): The current ‘NCSO workaround’ is being phased out and it is recommended that all contractors and system suppliers ensure they are using the EPS SSP endorsement instead of NCSO as soon as possible. NHSBSA is issuing some guidance and support to system suppliers implementing the EPS SSP feature. Suppliers also have some flexibility as to the extent to which they will support pharmacy team members for example, by asking users to complete any missing or incomplete SSP endorsement information if the required endorsements are not present or not in the specified format. NHSBSA has received examples of invalid/incorrectly endorsed SSP claims submitted via EPS. PSNC tips explain how to avoid submitting invalid SSP claims.

Real Time Exemption Checking (RTEC)

• NHSBSA has led the RTEC project since January 2020. CP ITG and PSNC have been supportive of its continued roll-out. Read more on RTEC, its phases and continued piloting of Department for Work and Pensions (DWP) RTEC at five pharmacies using PSL at: RTEC. Feedback from RTEC users (PSL/EMIS/Cegedim/Titan/Lloyds/RxWeb systems) has continued to be very positive. Use of RTEC reduces the exchange of paper between pharmacy teams and patients, assisting infection control.
• Contractors are now being encouraged to register for RTEC and more than three quarters of pharmacy organisations have now done so.
• NHSBSA, DWP and the RTEC steering group plan to allow the expansion of the DWP RTEC functionality to additional pharmacy contractors shortly.
• PSNC published an RTEC benefits case study (CP ITG Vice Chairman, David Broome).

Apps, wearables and technologies (incl videocon)

NHS App

• NHS App has reached more than 10 million users and become the UK’s most popular app with over 6 million new users since the COVID-19 vaccination status service was added on 17th May 2021. The NHS App is available on the Google Play store and the Apple App store.
• The NHS App team are working on further features including: Personal Health Records (PHRs) integration with NHS App: The first supplier, Patients Know Best, was made available in the NHS App from April 2020 and more are expected to go live in late 2021.

Tool quality and tool frameworks

• NICE is consulting on its plans to amend health technology evaluation. This plan is intended to enable quicker innovation of personalised medicine and digital health technologies.
• Digital Health explored the clinical and regulatory factors of Mobile messaging platforms.
• British Medical Journal (BMJ) analysed over 20,000 mobile health apps on the Google Play Store the majority of which did not properly explain how data was being protected.
• Davey Winder, data security expert explored the design and use of health-related apps.

Apps and tools

• NHS website launched newly designed public-facing profile for pharmacies. The new pharmacy profiles aim to better meet the needs of patients, feature improved support for mobile devices and meet modern accessibility standards.
• ORCHA (the Organisation for the Review of Care and Health Apps) published ‘Digital Health in the UK, National Attitudes and Behaviour Research’, after surveying those who use health apps and those who do not, to provide a snapshot of app use across UK regions and across demographics. Medtech News reported on the related findings.
• Digital Health reported on the launch of NHS Digital Weight Management Programme.
• NHS Test and Trace app expected to be used into 2022, contracts suggest.
• The Government launched COVID Pass Verifier app for businesses to more easily verify the vaccination status or offer proof of a negative test.
• Over three million records were uploaded to the Welsh COVID-19 passport service on launch day.
• A digital physiotherapy tool may save over £1m annually in Wales, pilot results suggest.
• BT reported digital transformation in healthcare, 97% of people who’ve communicated with the health service since the beginning of the pandemic have done so digitally. And 80% of UK health providers believe the need to deliver better remote care is a main driver of digital transformation.
• Combining consumer technology and clinical needs will make health information universally accessible, the vice president of Google Health said.

GP tools

• Babylon announced plans to become a public company following a £2.9bn merger.
• GP at Hand hit a new milestone of 100,000 patients on their GP practice list.
• Over 120 GP practices in London and Manchester have deployed a telephony solution from X-on.
• A GP practice in Milton Keynes has partnered up with Livi to offer video consultations for patients which includes weekend and evening appointments.

Artificial intelligence (AI) and robotics

• HeartFlow tech company explored how gender inequalities might be tackled with help from AI.

• NHS Shared Business Services (SBS) has issued a tender calling for intelligent automation (IA) vendors that supply “off the shelf” automation solutions which would ease NHS administrative task work. The 48-month framework will allow NHS organisations to purchase IA services from pre-approved suppliers, streamlining the process of implementing IA in the health service.
• Pulse reported that NHSX and NHS England are considering the viability of a wider roll out of an AI triage model based on that used by Babylon.
• NHS AI Lab’s “AI in Health and Care Award” backed a further 38 projects with £36 million of funding. These will be backed by NHSX and Accelerated Access Collaborative (AAC).

• The UK’s medicines watchdog has vowed to improve interoperability and collaboration across the health system through smart solutions such as AI.
• AI has been used to predict the structures of almost every protein made by the human body. The development could help the discovery of new medicines.
• The pandemic has shifted views on AI and data use across industries including within the NHS.
• Robotics & Autonomous Systems (UK-RAS) published the report, Preparing the Workforce for 2030: Skills and Education for Robotics & Autonomous Systems.

NHS Digital Clinical Safety Strategy

• NHSX, NHS Digital and NHS England and NHS Improvement (NHSE&I) recently published a Digital Clinical Safety Strategy. It aims to improve the safety of digital technologies, now and in the future, with its recommendations including:
  1. Understanding of, and planning for the clinical impacts if IT technologies have downtime.
  2. The Learn from patient safety events (LFPSE) service (which replaced the NRLS service) to have a greater emphasis on digital systems and technologies.
  3. Other reporting mechanisms to align to the LFPSE service – reporting digital clinical safety incident information into the LFPSE should be accessible via all standard incident reporting platforms.
  4. LFPSE mandatory questions will ask reporters if an event is related to an IT or software system, and follow-up questions will ask about the nature of the IT or software problem.
  5. System-wide learning and response related to digital technologies.
  6. IT help desk queries, system downtime reports and, when possible, patient, and public stories should be considered in a triangulated way.
  7. IT suppliers are recommended to produce a clinical safety case report (CSCR) which contains a hazard log that details mitigations and additional controls. This is to be maintained throughout the life cycle of the health IT system and its use and sharing is critical to system-wide learning.
  8. Necessary information will be relayed from LFPSE to NHS Digital and NHSX.
  9. Clinical Risk Management Training such as that equivalent to the relevant Health Education England (HEE) module to be promoted to additional groups working at the intersections of digital clinical safety, including those working in industry and patient safety professionals and health and care workers.
  10. The Clinical Safety Forum to continue to enable sharing of ideas and lessons.
  11. Digital clinical safety to be embedded within future policy and regulatory documents.
  12. A central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation.
  13. Digital products and services may be assessed against the NHS Service Standard.
  14. A National Digital Clinical Safety Board will be established with responsibility for strategy implementation. It will include policy makers, patients, and suppliers of digital technologies.

Integrated Care Systems (ICS)

• NHSX confirms 37 of 42 ICSs have ShCR. Five systems missed the national target to establish ShCR by the end of September 2021.
• ICSs are expected to deliver ‘fully costed digital plan by March 2022’.

Innovation

• Digital Health Rewired 2022 called for speakers who can present their digital journeys.
• NHSX has announced that it is to fund and support 14 new projects across the country to help half a million people receive care at home using digital technology.
• Innovation Agency, described how the AHSN Network has been created to make innovation in the NHS easier to implement.
• A Digital for Boards programme working with trusts across the NHS, and a representative provided advice about building innovation by focussing culture rather than tech and that “Digital leaders looking to foster innovation should find out the names of the people involved in innovation programmes and work with them, or create their own programme. Focus on smaller problems first and ensure staff were well supported when using new technology.”
• InterSystems argued the airline industry and healthcare can learn from each other.

IT policy: lessons from the COVID-19 pandemic

• NHSX CEO shared digital lessons learned during pandemic.
• The Welsh Clinical Portal team considered the role of technology during the pandemic.
• net explored whether there is some linkage between GP burnout and the increased use of digital services and online consultation platforms since the start of the pandemic.

Digital clinical safety

• An NHSX clinical advisor set out Why digital clinical safety matters to everyone.
• NHS Digital Deputy Clinical Director explained how NHS Digital systems and services keep people safe and clinical safety processes.
• Industry leaders shared their views on the Digital Clinical Safety Strategy from NHSX.

IT policy: other updates

• Before the group’s March 2022 meeting, a sub-group meeting will review the group’s IT vision documents considering recent NHS strategy documents and updates to the Community Pharmacy Contractual Framework (CPCF). If you’d like to join the workshop, please email it@psnc.org.uk.
• CP ITG published its Pharmacy IT quarterly round-up after the group’s previous meeting.
• NHSX published a ‘What Good Looks Like’ framework for good digital practice, which highlights the importance of senior level leadership and ownership of digital transformation.
• NHSX announced funding opportunities for developers that could make appropriate cases to reduce health inequalities and promote sustainability towards a greener NHS.
• uk published guidance about how to evaluate a digital health product.
• Government Office for Science published a report on Harnessing technology for the long-term sustainability of the UK’s healthcare system. This report presents recommendations aimed at creating system change to improve outcomes for patients and support health care professionals.
• The health and social secretary Sajid Javid called for the UK to ‘level up’ digital health inequalities.
• A new open-source collective has been launched to enable the reuse and co-funding of digital health solutions across the health and care system
• Charlotte Clayton, a digital champion midwife opined on ‘Why there is such a slow uptake of digital technology?’
• The chancellor announced £2.1billion for NHS technology for more ‘connected’ hospitals.
• com argued about the importance of clinicians and patients understanding more about machine learning.
• NHSE&I’s Director of Transformation spoke on digital transformation: “Digital change is ‘really difficult’ but ‘essential’”.
• Eric Topol and AI expert Kal-Fu Lee released a podcast about “How machines bring humanity back to medicine”.

NHSX published the ‘Who Pays for What’ framework

• NHSX published the ‘Who Pays for What’ framework to clarify how ICSs and other relevant parties now and in the future can apply for access to IT funds.
• This framework set out that for 2021-2022 national funding for specific transformational technological projects would be consolidated into a single fund – the Unified Tech Fund (UTF). UTF seeks to simplify and consolidate the process for accessing technology funding. The UTF will no longer be taking applications after 22nd March 2022, but some funds close well before this date. Individual ICSs or collaboratives of ICSs can apply for ShCR funding to support Shared Care Records progress. Applications must meet the criteria set out within the UTF prospectus. Several funds were added later, and some have had their close date extended.
• NHSX proposed that for 2022-23 onwards ICSs will be expected to fund the delivery of their tech plans from their own budgets, the total funding envelope available to ICSs and their constituent organisations. They will be given control of more resources with which to do so. National funding will continue to cover national products such as the NHS App; national infrastructure; pilots linked to the NHS Long Term Plan commitments in advance of national scaling; and things that need to be done across multiple ICS areas
• NHSX expect to move away from central funding of frontline tech.
• Views about the ‘Who Pays for What’ framework can be sent to wpfw@nhsx.nhs.uk.

Interoperability and records

NHS Profile Manager

• A new tool, NHS profile manager is scheduled to replace both the DoS Updater and the NHS website editor in early 2022.
• During November 2021, NHS Digital will review all the existing users of the NHS website profile editor and any users who are not using an email address ending with nhs.net will receive email instructions on how to update their login details.
• This will help all contractors to ensure that they are prepared for the launch of the new NHS profile manager in early 2022.
• Group members are encouraged to use example communications copy to update their networks post meeting; invited to see a demo of the new system during a CP ITG subgroup call (scheduled for late November 2021) and provide feedback on it.
• NHS Digital will update multiples about the plans concerning the NHS website and DoS Application programming interface (API), during a late 2021 call which is being facilitated by PSNC.

Interoperability and NHSX strategy

• NHSX recently published an update on interoperability which included five shared priorities/goals:

1. A new end-to-end process and governance model for standards development.
2. A standards and interoperability strategy to be published.
3. An open-source playbook which will provide guidance to providers and commissioners looking to adopt and implement open-source solutions.
4. A long-term roadmap for standards and interoperability, this will include a timeline for moving from one version to another and will assist vendors, providers and commissioners with planning and development.
5. A standards portal, registry of standards used across health and care. Standards may be arranged by use case and easily searchable. The portal will be supported by community features to enable greater collaboration and sharing around standards development, maintenance, and adoption.

• NHSX can be contacted regarding this programme of work via standards@nhsx.nhs.uk.
• Collated feedback will be shared with NHSX.

NHSBSA/NHSE&I update on pharmacy services API work

• NHSBSA are to update the group.
• NHSBSA are to invite CP ITG PMR/CPCF suppliers and relevant persons to a dedicated call on the topic.

Closure of the Shielded Patient List

• NHS Digital previously added a ‘Shielded Patient Flag’ to the NHS Summary Care Record (SCR), this included patients who were on the Shielded Patient List. This enabled community pharmacy teams using the SCRa application to see an alert when viewing the SCR of such a patient.
• Following Government announcements regarding the end of national shielding in England, the Shielded Patient List (SPL) for England will be closed and changes to patient risk status have stopped being applied. This means:
  • any changes to local patient risk status are no longer captured in the national SPL, or shared with other health and care system partners; and
  • the high-risk flag is not an indicator to be relied upon to assess a patient’s current risk from COVID-19 by GPs or in practice management and reporting.
• NHS Digital plan to undertake a managed closure of the SPL during late 2021 and early 2022.

Shared Care Records (ShCR) update

LPCs and/or local contractors can continue to take steps to gain pharmacy access such as:

• identifying the ShCR project team from the List of records systems;
• learning about case studies such as Dorset Care Record ShCR pharmacy access case study and the East London Patient Record (eLPR) pharmacy case study;
• contacting the ShCR project team and other local partners to find out how to get involved;
• using the ‘Planning pharmacy access briefing’ and frequently updated ShCRs webpage; and
• reviewing the previous PSNC/RPS ShCRs/SCR letter to NHS orgs about records access.

Other updates:

• PSNC continues to work with NHSX and other relevant stakeholders on the actions set out within the Shared Care Record (ShCR/LHCR) NHSX and pharmacy outputs
• Ashley Hannah, NHSX Shared Care Records Programme Director reflected on the ShCR progress.

Local Pharmaceutical Committees (LPCs), ShCR project teams and other parties supporting ShCR pharmacy deployment are encouraged to contact it@psnc.org.uk with technical ShCR information so that supplier and IT support helpdesks can whitelist several ShCR domains at the same time.

NHSX are working with South Central West CSU to develop national Shared Care Records (ShCRs) guidance for the Pharmacy, Ambulance and Community sectors. ShCR usage in Community Pharmacy, Ambulance and Community sectors has been limited. This guidance will promote uptake by providing practical steps for how to join local ShCRs and how to onboard organisations onto ShCR programmes. The work is split into three work packages:

• Work package one: Case studies and best practice examples from ShCRs pilot sites and live sites. These case studies will highlight organisations’ experiences of using ShCRs and their feedback, including how they overcame any barriers and if any business change processes were implemented.
• Work package two: Guidance for PODAC organisations who want to make best use of ShCR solutions. This includes the practical steps required to join and access a ShCR solution.
• Work package three: Guidance for organisations who are responsible for the delivery of ShCRs to ensure they follow best practice architecture patterns and make use of existing and emerging national services and standards.

NHSX have commenced work package one and aim to start work packages two and three during November 2021.

Records

• NHSX CEO Matthew Gould called for NHS data-sharing system and the opt-out process to be simplified.
• NHS Digital updated IT supplier guidance about accessing SCR using the HL7 V3 API.
• NHS App will enable patients at EMIS/TPP GP practices to read all new entries in their health record by early 2022.
• North Cumbria Integrated Care NHS Foundation Trust has expanded the services that share data via the Great North Care Record to include children’s community services.
• GPs in the Dorset region are being given click through access to the Dorset Care Record (DCR) using robotic process automation (RPA) or artificial intelligence (AI).
• net reported NHSE&I are considering commissioning a national arrangement for the Epic electronic patient record within secondary care.
• A trust within North England has integrated its electronic prescribing medicines administration and its pharmacy stock control system.

Other updates about interoperability

• NHS Digital updated its guidance for developers on:
• Booking and Referral Standard;
• Fast Healthcare Interoperability Resources (the global industry standard for passing healthcare data between systems);
• GP Connect; and
• Interoperability Toolkit.
• A new Information Standard Notice (ISN) was published aiming to support improved medication and allergy/intolerance information sharing across healthcare services in England. PSNC has listed the item at org.uk/itrequirements and communicated to suppliers about the ISN and the related opportunity to engage with NHS Digital about the ISN and other interoperability projects.
• A Reinventing interoperability case study set out “why it is the time to put the brakes on business as usual”.
• At a previous meeting, the group agreed to support the capability for anonymised data to be accessible, so that pharmacy teams’ interventions can start to be auditable, and the value of community pharmacy can be better demonstrated. If PMR systems were to be adapted to allow such data sharing, it would require the development of a roadmap and a standard approach to data provision, which may benefit from use of SNOMED CT clinical terms. A PSNC-drafted dataset was prepared and a dataset for the Community Pharmacist Consultation Service (CPCS) could be added. If you would like to help with this work, please contact it@psnc.org.uk.

NHSmail

• NHS Digital has tasked an Accenture project team with exploring and boosting NHSmail and NHSmail Teams usage, including within the community pharmacy sector.
• Pharmacy use of NHSmail is higher than use within many other sectors, however, usage could be higher still.
• NHS Digital has now rolled out NHSmail MS Teams to 1.3 million users across the NHS since March, and in the space of six months it has been used for 14.5 million calls and has hosted more than 32 million virtual meetings.
• NHSmail support pages outline the benefit of the NHSmail Teams “Virtual Visits” patient consultation platform – namely, this platform enables appointment booking and video consultation. The NHSmail team previously provided a demo to PSNC and CP ITG representatives. Several contractors amongst the small alpha pilot group have begun to successfully use and pilot Virtual Visits. Pharmacy contractors that would like to pilot this are encouraged to contact it@psnc.org.uk with their name, ODS code and telephone number and include ‘Virtual Visits pilot’ within the email subject title. Prerequisites for piloting: a personal NHSmail account, NHSmail MS Teams, access to a webcam and a suitable computer or mobile device.

IG, identity and security

Data Security and Protection Toolkit (DSPTK)

• PSNC and NHS Digital are currently updating the Data Security and Protection Toolkit (DSPTK) and related tips. Additional user testing is also planned. If you would like to get involved with this user testing, please contact it@psnc.org.uk.
• NHS Digital may update contractors about the availability of the initial Toolkit version. However, we strongly recommend that contractors hold off accessing the Toolkit until the planned improvements have been finalised and PSNC releases its updated guidance. Contractors will still have adequate time to complete the Toolkit before the submission deadline on 30th June 2022. We will keep contractors informed of any developments.

Other data security updates

• BMJ reported on the General Practice Data for Planning and Research (GPDPR) programme, why it is currently on hold, and what the future plans may be for collecting patient data.
• The National Data Guardian has called for a “commitment to transparency” when developing innovative data tools to avoid concerns like those raised in regard to GPDPR.
• National Data Guardian sought clarity on Department of Health and Social Care’s draft data strategy.
• Keep I.T. Confidential aims to help NHS staff understand more about cyber security threats and about what to do to reduce the risk.
• Davey Winder, security expert explored whether healthcare data security may be doing its job.
• Sectra considered the cyber security landscape and how more cloud adoption can help the NHS.
• Google’s AI firm DeepMind was given the personal records of 1.6 million patients at the Royal Free London NHS Foundation Trust. DeepMind now faces legal action over NHS data use.

Connectivity, business continuity arrangements

• Microsoft announced Windows 11 plans. Many Windows 10 users are currently eligible for a free upgrade to Windows 11, provided that the computer meets the strict minimum system requirements (e.g. 64-bit processor and 4GB RAM). Pharmacy contractors are advised not to update their machines without the agreement of or supervision from their IT support. Read more: CP ITG: Windows briefing.
• Analysis: NHS App having an outage caused users challenges with accessing flights and venues

Reducing burden

• The group previously identified going paperless as a priority – within its Digital Priority List and Views on the next generation of EPS However, pharmacy teams continue to report considerable use of paper and printing for reasons such as enabling prescription information to move around the dispensary given limited space for PMR terminals. Following work with the group and the paperless sub-group the ‘Going paperless’ webpage is now available.
• The NHS Business Services Authority (NHSBSA) from October 2021 begun posting out a new version of the paper FP34C submission form. This FP34C version will continue to be issued until March 2022 (for prescriptions dispensed in February 2022), after which FP34C submissions through the Manage Your Service (MYS) portal will become compulsory. The revised FP34C form includes various improvements. Figures for Electronic Prescription Claims and FP10 Paper Claims now have separate entries on the form to ease the contractor reconciliation process and related EPS totals comparisons.
• PSNC published a factsheet that explains how pharmacy team members can check if they have an older NHS Smartcard needing replacement ahead of December 2021 deadlines.
• NHS Digital previously added the multi-site ‘FFFFF’ Smartcard code and SCR rights onto Smartcards with the pharmacist or pharmacy technician role, because of the COVID-19 pandemic. The initiative was supported by PSNC and NHS England and NHS Improvement. NHS Digital previously confirmed to PSNC that assignment codes will be further extended until 31st March 2022.
• NHSX, NHS Digital, PSNC and others are supporting an initiative to rationalise central lists of pharmacy data used within NHS systems and datasets. This will help align data, reduce pharmacy workload, and improve accuracy and data quality. The workstream is also helping to identify future NHS profile manager enhancements, some of which are being added to the roadmap.
• The Prescribing Policy and Charges team at DHSC are conducting discovery work to explore patient digital authentication. The group’s comments submitted at the previous meeting and via survey have been collated.

Development of pharmacy systems

• The group previously published its “Use and development of pharmacy systems – Suggested features list v1.0”. Additional feedback has led to this document being significantly updated version. Suppliers and the group are encouraged to share final comments, by emailing it@psnc.org.uk during November 2021. The updated list will be published shortly after the November 2021 meeting. A draft copy can be requested by contacting it@psnc.org.uk.
• DMS was introduced as an Essential service in early 2021. NHSE&I and PSNC were keen for suppliers to be given information on the service, IT implications and dataset requirements. Supplier briefings occurred previously. Contact persons on the project introduced themselves to the group: Charlotte Welsh (NHSE&I) and Rob Hills and Ben Tindale (both NHSBSA). There is an objective to progress the specification work further, and for a ‘go-live date’ ideally by late 2021. PSNC is continuing to push for this work to be completed at the earliest opportunity. Updates will be published at: org.uk/itrequirements and psnc.org.uk/dms.
• NHSE&I announced that a national procurement model would be in place to support community pharmacy contractors with the delivery of the Community Pharmacist Consultation Service (CPCS). This was scheduled to terminate on 1st October 2021, but was extended to the end of March 2022. Related preparations should be finished by contractors ideally November / December and no later than February 2021. Contractors are recommended to consider which CPCS IT supplier they want to choose in advance of the next change. From the autumn, contractors will be able to transition to their own contractual arrangements with one of the four assured IT providers: Cegedim; Positive Solutions; Sonar Informatics; or PharmOutcomes.
• NHSE&I has published a CPCS IT Provider ‘Switching’ guide.
• NHSX have published a new CPCS Buyer’s Guide with inputs from partner organisations including PSNC.

EPS and RTEC

Electronic Prescription Service (EPS)

• NHS Digital EPS and eRD utilisation rate statistics (for the August 2021 dispensing month) are set out on the right.
• NHS Digital ESP team are working on:
  • Enhancements to EPS dashboard to improve consistency of nomination data and include EPS activity from the non-GP settings.
  • Continuing assurance work for EPS prescribing and dispensing systems for current and Next Gen EPS.
• NHS Digital EPS (Next Generation work):
• The first system to use the new FHIR prescribing API for secondary care outpatients is aiming to start First-of-Type late Nov ember 2021.
• Another secondary care system supplier is developing against the prescribing API, and more suppliers are engaged – both prescribing and dispensing systems.
• Development of APIs for dispensing and prescribing system suppliers.
• Discovery work is ongoing around use of EPS for secondary care outpatients to homecare.
• Prioritisation of technical developments and potential EPS enhancements continues – considering the value/benefits and technical feasibility. Further cross-setting stakeholder engagement and user research will be taking place on this soon – including a future CP ITG slot.
• The group’s EPS future list is to have priority and feasibility rankings marked against its items. Please contact it@psnc.org.uk if you would like to support this work, such as via a workshop call or by emailing across views.
• EPS Serious Shortage Protocols (SSPs): The current ‘NCSO workaround’ is being phased out and it is recommended that all contractors and system suppliers ensure they are using the EPS SSP endorsement instead of NCSO as soon as possible. NHSBSA is issuing some guidance and support to system suppliers implementing the EPS SSP feature. Suppliers also have some flexibility as to the extent to which they will support pharmacy team members for example, by asking users to complete any missing or incomplete SSP endorsement information if the required endorsements are not present or not in the specified format. NHSBSA has received examples of invalid/incorrectly endorsed SSP claims submitted via EPS. PSNC tips explain how to avoid submitting invalid SSP claims.
• The Welsh Government pledged full electronic prescribing within five years.

Real Time Exemption Checking (RTEC)

• NHSBSA has led the RTEC project since January 2020. CP ITG and PSNC have been supportive of its continued roll-out. Read more on RTEC, its phases and continued piloting of Department for Work and Pensions (DWP) RTEC at five pharmacies using PSL at: RTEC. Feedback from RTEC users (PSL/EMIS/Cegedim/Titan/Lloyds/RxWeb systems) has continued to be very positive. Use of RTEC reduces the exchange of paper between pharmacy teams and patients, assisting infection control.
• NHSBSA, DWP and the RTEC steering group plan have allowed the expansion of the DWP RTEC functionality to additional pharmacy contractors since the last bulletin – from five to fifty sites.

Apps, wearables and technologies (incl videocon)

NHS App

• NHS App reached more than 16 million users by October 2021 with over 12 million new users since the COVID-19 vaccination status service was added on 17th May 2021. The NHS App is available on the Google Play store and the Apple App store. 28 million people have registered with NHS login – around half of the English population.
• The NHS App team are working on further features including: Personal Health Records (PHRs) integration with NHS App: The first supplier, Patients Know Best, was made available in the NHS App from April 2020 and more are expected to go live in late 2021.

Apps and tools

• NHS Wales selected Malinko to supply its e-scheduling software to all of Wales’ community healthcare professionals.
• Government policy advisers suggested tackling health inequalities partially by making digital tools for accessing health advice available to all.
• Patients being assessed remotely in general practice, rather than face-to-face, has been raised as a risk factor in reports on five deaths by a single coroner since the pandemic hit.
• Apps libraries focused on weight management and mental health support were extended across the South-West.
• Patients are expected to be able to rate GP practices in ‘real time’ via text message on how satisfied they are with their access to care.
• The government to pilot a new app linked to a wrist-worn device that issues personalised health recommendations and award points to motivate healthier habits.
• A project was initiated to explore patterns of use of online services in general practice across Surrey Heath CCG and barriers to their uptake.

Artificial intelligence (AI) and robotics

• NHSX are developing an AI strategy for health and care. PSNC and RPS are commenting onto a drafted version. If you’d like to feed into this work, please contact it@psnc.org.uk.
• The recently published National AI Strategy aims to boost the use of AI in the private and public sector, attract international investment and develop the next generation of tech talent.
• The new Patient Coalition for AI, Data and Digital Tech in Health formed from members from Royal Colleges, health charities and patient groups intend to ensure patient interests are considered within AI policy developments.
• NHSX’ NHS AI Lab and the Health Foundation awarded £1.4 million to four projects to address racial and ethnic health inequalities using artificial intelligence (AI).

See: CP ITG workstream update (current)‘ webpage.