EPS Phase 4

EPS Phase 4

NHS Digital proposed during 2016/17 the Electronic Prescription Service should start to move into Phase 4; this is the point at which electronic rather than paper prescriptions become the default.

Background

To date, it has only been possible to issue an Electronic Prescription Service Release 2 (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 collect their prescriptions from the same pharmacy most of the time.


The proposal

Under the proposed next phase of EPS, prescriptions would normally be sent via EPS by default. However where certain criteria are met, a paper prescription would still be used, for example:

  • when a patient 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 full EPS to be possible the current regulatory requirement that an EPS prescription can be issued for a patient only if a nomination is in place would need to be removed, so that some prescriptions can be sent via EPS even if a patient nomination is not set.

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 would remain valid and further nominations for appropriate patients should continue to be set.

Tokens may be issued where no nomination is set

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 be able to use this token to access the EPS script. The token would be provided in a paper format but in the further future electronic tokens (e.g. in an email from the GP practice, via a website or via an app) might become possible.

This approach would mean the pharmacy team generally cannot prepare the prescription prior to the patient visiting the pharmacy.

Full EPS diagram (Phase 4) revised-


EPS issues being addressed

PSNC works closely with NHS Digital and NHS England to try to ensure that issues are addressed as quickly as possible. PSNC compiles a log of priority EPS issues. It is informed by the EPS feedback PSNC receives from pharmacy teams, LPCs, and Committee members.

NHS Digital has identified a number of pre-requisites that need to be in place prior to the move to Phase 4 of EPS. Many of these pre-requisites, detailed below, were determined as a result of an NHS Digital service model review of the EPS.

  • The EPS service model was to be reviewed, and the review recommendations to be implemented;
  • Pharmacy System Supplier EPS agreements were to be put in place;
  • Pharmacy training – Further system-specific pharmacy training events were needed throughout the country (face-to-face events largely completed as of summer 2016);
  • Controlled Drugs – Schedule 2 and 3 Controlled Drugs to be able to be prescribed and dispensed using EPS; and
  • Costings: PSNC and NHS England were to agree with establishing a joint working group to review the costs of the EPS for community pharmacy.

PSNC has reviewed NHS Digital’s proposals for Phase 4 and in addition to the above prerequisites, we have identified a number of other issues that must be dealt with prior to the commencement of Phase 4 including improved system resilience and business continuity for contractors, improvement of Smartcard access via local Registration Authorities and further action to tackle direction of prescriptions.

NHS Digital provide progress updates (pdf) related to key items associated with the preparations for full EPS.

PSNC believes that the prerequisites need to be successfully addressed in order to reduce the risk of the introduction of Phase 4 adversely affecting the experiences of patients, pharmacy teams and other NHS stakeholders. We are working with NHS England and NHS Digital to ensure that these issues are addressed as quickly as possible.


Pilot of EPS Phase 4 approved

See here.

Related resources

For more information on the future of EPS use the buttons below:

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