The newly launched Digital Health and Care Wales (DHCW) joined us recently to deliver a webinar session on the Aneurin Bevan University Health Board (ABUHB) All-Wales Regional Implementation of WellSky Pharmacy and to share their experiences of being the first to go live with the system.
Chatting to us were:
- Lisa Forey, Pharmacy Manager / Principal Pharmacist Procurement, Logistics, Informatics and Clinical Pharmacy, Aneurin Bevan University Health Board
- Mark Collard, Principal Technician, Pharmacy Technical Services, Aneurin Bevan University Health Board
- Kate Headley, Project Manager, Digital Health and Care Wales.
Digital Health and Care Wales was created to provide better healthcare in Wales by utilising digital transformation to make services more accessible and sustainable.
Explaining more about the new organisation’s purpose, Kate said: “Building on recent digital investment, we have a leading role in delivering the national programmes needed for modern technology-enabled healthcare. These are large-scale developments that will make a significant difference to the people of Wales.
“Our key responsibilities will be: mobilising digital transformation and ensuring high-quality care, expanding access to the digital health and care, delivering high-quality digital services, and enabling big data analysis for better outcomes.”
Moving onto the Welsh Hospital Pharmacy Project, Kate provided more detail for the audience.
“The WHEPPMA programme [Welsh Hospital Electronic Prescribing Pharmacy Medicines Administration], as it’s known, is split into two distinct projects,” she said.
“Firstly, we have the project I’m here to talk about today – that’s the Welsh Hospital Pharmacy System. The project is to deliver an all-Wales pharmacy department stock control system for the managing and dispensing of medicine. This means that hospital pharmacies, so secondary care, will work from a national core system with a National Drug File managed by the hospital pharmacy central team at Digital Health and Care Wales…it also represents an important first step in the journey to implement national electronic prescribing in NHS Wales.”
“Our natural next step following the CMM implementation will be to deliver a national ePrescribing system for Wales,” she added, “this will enable the computerisation of the processes of prescribing, processing, stock control, and recording the administration of medicines in secondary care hospitals.
“It will also replace the current paper prescription record chart – normally completed for every inpatient, as well as discharge and outpatient prescription forms used by clinicians.”
Before delving into the CMM implementation, Kate went on to highlight why change was necessary. Illustrating through her slides the challenges of the current pharmacy stock control and medicines management system being used by NHS Wales – which was originally deployed in 1988 – she commented: “Pharmacy staff love it and over the years it’s served its purpose well. Though, as with many of the systems at DHCW, we want to build and support systems that can not only improve the service we provide for our patients, but also make services more accessible and sustainable in the long-run.
In addition to the plus points – such as economic benefits, enhanced efficiency, and improved compliance – Kate added that transformation “paves the way for the modernisation of prescribing in secondary care.”
Described as their “biggest hurdle”, the COVID-19 pandemic, Kate said, understandably “caused considerable delays” due to many changes – including shifting priorities for pharmacy staff.
As well as pandemic problems, the team were also faced with the news that a new multi-million-pound hospital – The Grange Hospital – was to open, unexpectedly, four months early to provide more “capacity and resilience” for the winter and future waves of the virus. This pushed forward the need for a new pharmacy system and a new timescale.
On the implementation itself, she added: “Implementation at each site brought up new challenges; some we had expected and some we hadn’t.”
Her five main lessons learned to pass on to others, included:
- Timing and delivery approach – more time than expected needed to address each site.
- Resources – the importance of support and acknowledgement that pharmacy staff also have day jobs.
- Data quality – the National Drug File was described as a “huge piece of work”, with more time ideally needed to fine tune it.
- Third parties – early and frequent communication is essential.
- Staying positive and optimistic – makes a difference due to the time and effort required.
“We learned so much from our first implementation,” she concluded, “it was invaluable to our team – and the honesty among ourselves, our health board and WellSky only helped us improve.”
Having now implemented the system for a second health board, priorities moving forward are set to include a full roll-out across Wales by October 2021 and more on-site support from August 2021.
The baton was then passed over to Lisa and Mark of ABUHB, to share their thoughts on the implementation. The health board has over 14,000 staff and covers four main hospital sites, which each have their own pharmacy department.
After running through more of the benefits of implementing CMM, Lisa turned to the task itself and admitted that their “roll-out was ambitious to say the least – we thought that we would be able to spend a day setting up at each site before moving on to the next.”
“I think it’s safe to say our post-COVID reality was somewhat different,” she explained, “in terms of the few months we all lost while dealing with the first wave.” This led to limited testing ability and less robust staff training, meaning the implementation took a few months longer than expected.
Lisa also gave extra insight into challenges relating to local implementations, before handing over to Mark, who added his early observations.
“The system is very intuitive to use,” he said, “so satisfaction, on the whole, has been high. The majority of staff have been keen to learn…as with any go-live we were not without issues. But due to our investment in the implementation and the engagement of staff in the overall project…morale remained high.”
He emphasised that, despite challenges and some sites being harder than others, this morale was crucial to overall success. While he also noted the importance of taking on board feedback and quickly learning and fine tuning as they progressed from site to site.
After covering complications associated with implementing a national-scale product and system – such as decisions on finance, homecare, aseptics, dispensing, and the drug file – he said these discussions had caused a “delay to some of the build”.
He concluded by focusing on the areas and times where national and local approaches need to work together for the benefit of the system, before sharing his overall reflections and tips, which included the need for teamwork, the need for a team that was neither too small nor too large, a positive mind-set, starting early, and matching data skills to the right individuals.
To sum up his impression of the implementation, Mark said, “if at all possible, use the project to ensure that all of your systems are at best and efficient. We used this installation as a driver for looking at our medicines stock holding across the health board…and many of the tasks that had been on the to-do list for quite some time.”
Read the original article and watch the video here: Video: Digital Health and Care Wales share their pharmacy system implementation experience – htn