Advancing electronic prescribing

The Topol Review and innovative technologies in the NHS

The Electronic Prescription Service (EPS) sends electronic prescriptions from GP surgeries to pharmacies and currently accounts for around 64% of all prescriptions issued in England.
Eventually, EPS will remove the need for most paper prescriptions and this is becoming a reality as Phase 4, currently being piloted, is the point at which electronic rather than paper prescriptions become the norm. Phase 4 will be rolled out to all GP practices in England, making EPS the default method for prescribing, dispensing and reimbursement, increasing the proportion of prescriptions sent electronically to around 95%.

Phase 4 allows prescriptions for patients without an EPS nomination (where a patient has previously nominated a pharmacy to receive their electronic prescription) to be signed, sent and processed electronically. These patients will be given a token (which looks like a paper copy of their prescription) to present at a community pharmacy to obtain their medication. This token has a unique barcode which can be scanned at any pharmacy in England to download the prescription from the NHS Spine and retrieve the medication details. Although the current GP pilot sites are in specific areas, patients can choose to take their token to any pharmacy in England. Eventually, the token will also be digital making the whole system virtually paperless.

Added to this, the NHS Long Term Plan, published in January stated that: ‘All providers
will be expected to implement electronic prescribing systems to reduce errors by up to 30%’.

Benefits of EPS

Until Phase 4, EPS has been most advantageous for patients who receive regular medication and who tend to get their prescriptions dispensed at the same (nominated) pharmacy, most of the time. Existing nominations can continue and offer benefits of continuity of care for those on long term treatment.

For community pharmacy, there are advantages to extending EPS as currently we are managing two systems (paper and digital) and moving to a mainly digital process will provide operational efficiencies.

Opportunities and threats

However, like all change, it presents potential threats and opportunities as it reduces the importance of physical location of a pharmacy. Another sign that pharmacy must become less reliant on the traditional supply of medicines alone. The future of community pharmacy is in clinical services.

Wider benefits of EPS:

Wider benefits of EPS to the pharmacy, prescribers, NHS and patients will be fully realised once rollout is complete. These include:

  • Improved patient experience; prescriptions can be ordered online or through the new NHS App and the medicine picked up from the pharmacy, delivered to the patient’s home or place of work

• Patients spend less time waiting in GP practices and pharmacies

• Pharmacies prepare prescriptions in advance, ensuring stock is available

• Less time is spent on administration which means more time for patient care

• Decreased waste and increased savings

• Less paper to send to NHS Prescription Services

• Fewer reimbursement queries due to electronic prescription endorsement

• Notes added to electronic prescriptions allow messages from prescribers to be passed on to patients

• GPs spend less time dealing with prescription queries and signing prescriptions

• Improved prescription accuracy reduces the risk of patients receiving the wrong medication

• Eventually, fuller integration of digital systems across different areas of healthcare.

 

Deborah Evans FRPharmS FFRPS FRSPH is Managing Director of Pharmacy Complete, a training and consultancy company.