The Electronic Prescription Service (EPS) enables prescriptions to be sent electronically from a prescriber to the pharmacy and then on to the Pricing Authority for payment.
It has been deployed through two key releases. Release 1 (R1) in which the barcoded paper prescription form remains the legal prescription.
Release 2 which supports the transmission of electronic prescriptions; eRD (Electronic Repeat Dispensing); patient nomination of their selected pharmacy; GP cancellation of e-prescriptions; and the electronic submission of reimbursement claims to the Pricing Authority. Currently, prescriber’s can only issue an electronic NHS prescription where it is being sent electronically to a patient’s nominated pharmacy. EPS was originally rolled out to GP practices and community pharmacies. However, EPS continues to be expanded to urgent and other care settings.
NHS Digital manage the national infrastructure for a variety of NHS IT projects. From a community pharmacy perspective, the role of NHS Digital in managing the national infrastructure for the Electronic Prescription Service is the most high profile part of their service offerings.
Read more at: NHS and IT/EPS
EPS legal basis
An electronic message becomes a legal electronic NHS prescription where:
- the prescription has been created in electronic form;
- is signed with an electronic signature;
- must be sent via the NHS Electronic Prescription Service and no other messaging system*; and
- is then transferred to the dispensing site as an electronic communication.
REF: The NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013.
Note: NHS electronic prescriptions processed by NHS community pharmacy contractors must be sent and processed via EPS which uses an appropriate Advanced Electronic Signature (AES) system. The Human Medicines Act 2012 (page 124) explained that electronic prescriptions require appropriate AES.
Prescribers are able to issue via EPS:
- acute prescriptions,
- repeat prescriptions (repeat prescribing);
- and repeatable prescriptions (repeat dispensing)
Note: It will not be possible for a prescriber to use the service to request a bulk prescription (Drug Tariff Part VIII note 9) for a school or institution and private prescriptions are out of scope.
Each electronic NHS prescription may contain up to 4 items.
There will be occasions where a prescriber cannot issue the prescription they wish via EPS for technical reasons. For example, this could occur if the product is not listed on the NHS medicinal item list (Dictionary of Medicines & Devices, dm+d) or if the prescribing system is not able to issue a prescription for the item because the supplier has not ‘mapped’ the appropriate codes. This is likely to affect less commonly prescribed items including products to be specially manufactured or extemporaneously dispensed products.
EPS scope FAQs
Q. Can a nurse prescriber working in a GP practice, issue prescriptions via the EPS Service?
A. Yes, all types of nurse prescriber (community practitioner nurse prescriber, independent nurse prescriber and supplementary nurse prescriber) linked to GP Practices can issue prescriptions via the Electronic Prescription Service as long as they have the correct roles and GP Practice locations registered on their smartcard. When an electronic prescription is received, the prescriber type will be indicated on screen.
Q. The prescriber has signed the token; does this make it a legal NHS prescription?
A. No. If the prescriber has signed the prescription token, it cannot be treated as a legal NHS prescription as the form is not approved for this use by the NHS. A contractor would be reimbursed for dispensing against the electronic prescription, not the token. To minimise the risk of a prescriber signing the token, the signature box on the token will be over-written by the prescribing system to state that the token should not be used as a prescription.
Urgent & other care settings
EPS was originally rolled out to GP practices. However, EPS continues to be expanded to urgent and other care settings.
Following a successful pilot, NHS Digital rolled out the EPS to urgent care providers using the Advanced Adastra prescribing system from 2018. Integrated urgent care providers include: NHS 111, GP out of hours, Clinical Assessment Services (CAS), Walk-in Centres, Minor Injuries Units and Urgent Care Centres.
EPS is available within the following relevant prescribing systems:
- Advanced Adastra prescribing system
- EMIS Web
- TPP systems
Prescribers with EPS can use EPS to prescribe medicines in the same way that GP practices do.
How will this work?
Prescribers will identify a pharmacy that is open and accessible for the patient using similar processes to those used for paper FP10s.
EPS alone is unable to guarantee the pharmacy:
- will be made aware of the urgency of the prescription;
- has medication in stock; and
- has the ability to dispense the prescription.
Due to the nature of prescriptions issued in urgent care, prescribers have been advised to consider whether it is necessary to contact dispensers to notify them they are issuing an EPS prescription to advise it needs to be dispensed promptly.
The EPS system will use a type of ‘one-off nomination’ to send the prescription to the pharmacy that the patient has selected. This will not affect existing nominations for the patient’s ‘regular’ prescriptions.
The prescriptions will be downloaded by the contractor’s PMR system in the normal way. Pharmacies that are open out of hours and that regularly receive paper prescriptions written by prescribers from urgent care providers may want to consider reviewing how frequently they download prescriptions from the central NHS Spine, so that any prescriptions sent by urgent care services are downloaded promptly. The prescription message will contain the contact details of the prescribing site in case there are any queries for the prescriber. The existing EPS dispense/claim message sending processes are unaffected.
You can use the prescription ID number to locate and download prescriptions manually if you would like to delay a full download of all EPS prescriptions in order to help you to manage your EPS prescription workload.
It is possible that a patient may present at a pharmacy different to the one originally selected by them and the urgent care prescriber. In this case, the pharmacist at the pharmacy where the patient has presented, should obtain the patient’s NHS number through a Personal Demographic Service search and use this with the Prescription ID (which may be obtained from the patient or from EPS Tracker) to manually download the prescription from the Spine, or contact the pharmacy originally selected by the urgent care prescriber. Patients may be given their prescription ID either verbally or via text message.
What happens if there is a problem using EPS?
In the event of either a prescribing, dispensing or national system failure and the patient is not present to receive an FP10, the urgent care provider could send an FP10 prescription via NHSmail scanned attachment (ideally following up with a phone call) to the patient’s chosen pharmacy. This will initiate the emergency supply process, with the FP10 subsequently being posted to the pharmacy.
National COVID-19 Clinical Assessment Service electronic prescriptions
From 1st September 2020, the COVID-19 Clinical Assessment Service (CCAS), hosted by the South Central Ambulance Service, added the functionality for GPs within the service to prescribe, using EPS. This is intended to improve the patient journey and allow the CCAS GPs to complete an episode of care. The scope of prescribing will be for acute prescriptions only and may include controlled drug medicines where clinically appropriate.
EPS prescriptions coming from the CCAS are not restricted to patients in the South East Region as the service manages patient enquiries from across England. Pharmacy teams will be able to use the contact details on the EPS token to telephone the service to contact the prescriber in the event of a query.
EPS is not yet within Dentistry
EPS has not yet rolled out to dentistry: The overall volume of forms prescribed by dentists is low, and EPS has not yet been tested within dentistry. If dentistry EPS is to be rolled out in the future, there will be some challenges to overcome – regulatory and technical.
Ongoing and future rollout plans
As of April 2020, NHS Digital is working with EMIS and TPP so that EPS is an option for prescribers to use in extended access hubs, community, out of hours and urgent care settings.
Updates will be published by PSNC and NHS Digital.
Escalations about prescriptions from new care settings
If there is a technical issue with an EPS prescription from a pilot or other setting use EPS escalation route factsheet to escalate the issue appropriately and ensure a proper resolution.
- eRD utilisation at national, and regional level; and
- Phase 4 utilisation.
EPS nomination stats – As part of ongoing work, PSNC and NHS Digital begun publishing EPS nomination data for all pharmacies. NHS Digital publishes nomination changes each week. PSNC also publishes some extra nomination analysis.
Further eRD (Electronic Repeat Dispensing) regional stats (instructions: login as guest, then under ‘Report’ select ‘Prescribing Monitoring’, then ‘Repeat Dispensing (in EPS Items)’.
See more statistics at: EPS/IT statistics
Phase 4 (rollout plans and tips for usage)
Items relating to EPS future:
- Views on the next generation of EPS. This list has been developed and collated by CP ITG and incorporates pharmacy team feedback and future versions can continue to do so. If you require further information about the list or items on it, or you work within a community pharmacy and want to suggest changes, please contact email@example.com.
- System supplier enhancements – There is great flexibility for suppliers to be able to continue developing their systems to support their pharmacy clients.
- Contributing ideas regarding Smartcards / access control future – Pilots are in progress in whch tablets are being used for SCR access without the need for Smartcards
- Non-NHS RAs – Following a change to policy to permit non-NHS organisations to host Registration Authorities (RA) for the issue of smartcards, information and guidance is expected to be issued shortly by the NHS Digital to invite organisations to apply to become a pilot RA.
- Online repeat prescription ordering
- ‘Spine2’ developments – The Spine was brought under NHS Digital control back in 2014, and since then there has been increased flexibility for changes with EPS functionality. Since the transition to Spine 2, system suppliers have had the opportunity to introduce claim amend and positive acknowledgements.
See also Pharmacy IT future.
Return to the EPS sections relating to: Preparing&enhancing EPS / Nomination / Dispensing&Supply EPS / CDs / Tokens / EPS/IT contingency planning / Submission / Cancelling/changing EPS / RTEC / Future
EPS resources/factsheets also include: EPS essential checklists, EPS CDs FAQs, checking EPS totals, Nomination Principles, EPS/IT/ODS change, Phase 4, Reporting EPS issues, EPS studies including tips and lessons, Submitting EPS in time, Tokens, Tracker, Upgrading EPS from Release 1 to 2
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