EPS Phase 4
EPS Phase 4
Phase 4 of the Electronic Prescription Service (EPS) is the point at which electronic rather than paper prescriptions become the default.
As part of the 2018/19 interim funding arrangements, PSNC agreed with the Department of Health and Social Care (DHSC) and NHS England to the piloting and then rollout of Phase 4.
What is Phase 4?
To date, it has only been possible to issue an EPS prescription where the patient has nominated a pharmacy or other dispenser. EPS has therefore been most advantageous for patients who receive regular medication and who tend to get their prescriptions dispensed at the same pharmacy most of the time.
Under Phase 4 of EPS, prescriptions would be sent via EPS by default, whether a patient has an EPS nomination in place or not. However, where certain criteria are met, a paper prescription would still be used, for example:
- when a patient explicitly asks their GP for a paper prescription; or
- when the medicine being prescribed is not listed in the NHS list of medicines (dm+d).
For Phase 4 EPS to be possible, the current regulatory requirement that EPS prescriptions may only be sent where a nomination has been set for the patient will be removed.
However, many of the benefits associated with EPS are associated with nomination, therefore when EPS progresses to Phase 4, it is important that appropriate patients continue to be given the opportunity to benefit from using nomination. All existing nominations will remain valid and further nominations for appropriate patients should continue to be set.
A change to the regulations that govern the work of general practices will also be required before the move to Phase 4, removing the current requirement that prescribers should get patient consent to use of EPS on each occasion it is used. This change has been agreed by the GP Committee of the British Medical Association as part of the 2018/19 agreement on the General Medical Services contract.
What happens if a patient has not set a nomination?
A patient who has not set a nomination or does not wish to do so would be issued with a token so that they may visit the pharmacy of their choice. Pharmacy teams would scan the bar code on the token to access the EPS script.
The token will be provided in a paper format, but in time tokens may be available in an electronic format (e.g. in an email from the GP practice, via a website or via an app). This approach would generally mean the prescription cannot be prepared before the patient presents in the pharmacy.
Preparations for Phase 4
NHS Digital identified several matters that needed addressing prior to the move to Phase 4 of EPS and they have undertaken the following preparatory work:
- the EPS service model was reviewed and the highest priority recommendations were implemented;
- pharmacy training events (PMR system-specific) were held across the country; and
- preparations for an upcoming pilot allowing Controlled Drugs (CDs) (Schedule 2 and 3) to be prescribed and dispensed using EPS, followed by further deployment if the pilot is a success.
PSNC continues to work with NHS England and NHS Digital to address issues with EPS which are detailed in PSNC’s EPS log.
Piloting Phase 4
A limited pilot of Phase 4 has been agreed but the start date is not yet confirmed, but it is likely to be in the autumn of 2018.
As patients are free to choose any pharmacy to get their medicines dispensed from, all pharmacy teams will need to be ready and know what to do should a patient present a Phase 4 token in their pharmacy. An NHS patient awareness campaign is expected to ensure patients are aware of the changes.
It will be important to learn the lessons from the initial pilot to ensure that issues identified are resolved and to enable community pharmacy teams to be properly supported where they have implementation challenges. A national rollout of Phase 4 to other GP practices will follow if the pilot is successfully completed.
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