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?

Previously, it was only 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).

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.

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. Community Pharmacy IT Group (CP ITG) also feed into the log. 

Piloting Phase 4

NHS Digital continues to pilot EPS Phase 4. All pharmacy staff need to be aware that they could receive a paper EPS Phase 4 token from a patient to process.

The NHS Digital pilot of EPS Phase 4 is continuing and all pharmacy staff need to be aware that they could receive a paper EPS Phase 4 token from a patient to process.

Around 60 GP practices are now able to use EPS for patients without an EPS nomination: patients will be given a paper Phase 4 token with a scannable barcode instead of a signed paper prescription.

Although the GP pilot sites are in specific areas, patients can choose to take their token to any pharmacy in England.

As with all EPS prescriptions, dispense notifications and endorsements need to be added to the electronic prescription using your pharmacy system. Endorsements written or printed onto any type of EPS token will not be processed by the NHS Business Services Authority (NHSBSA).

If the pilot is determined a success, EPS Phase 4 will be deployed to further sites – potentially during Autumn 2019. Further announcements about wider roll-out will be made in due course.

If you have an EPS Phase 4 issue that requires reporting, you can use the usual escalation routes to do this. If you have any questions or comments on EPS Phase 4, please contact PSNC’s Community Pharmacy IT Lead, Daniel Ah-Thion.

Phase 4 top tips for pharmacy teams

Recommended tips:

  • If you receive a Phase 4 token, you should scan the barcode and dispense it as you would any other electronic prescription.
  • Pharmacy teams can use the green Phase 4 prescription tokens to capture any patient exemption-related or charge-related signatures.
  • Green Phase 4 tokens should be filed with all the other white EPS tokens and not within the main bundle of paper prescriptions before the submission is sent to the NHSBSA.
  • Consider your system and print settings. Many PMR systems have settings to customise which types of EPS prescriptions may automatically have a white EPS dispensing token printed.
  • Some pharmacy teams that process the Phase 4 token used a highlighter pen or a sticker to highlight the ‘Prescriber signature not required’ wording on the token, to highlight that it is a Phase 4 token rather than a barcoded paper prescription.
  • During the pilot, patients have sometimes filled in the back of the green Phase 4 token before they arrived at the pharmacy. If the pharmacy process involves shredding the green Phase 4 token and replacing it with a newly printed white dispensing token, the patient will have to complete the reverse of the dispensing token. To address this scenario, some pharmacy teams have changed their initial Phase 4 approach so that they use the green Phase 4 token for patient declarations, rather than printing out a new white EPS dispensing token for each Phase 4 script.

Phase 4 materials for GP practice staff

Should pharmacy teams receive a question from GP practice colleagues about what EPS Phase 4 is, then pharmacy teams may choose to highlight that some materials on the NHS Digital website:

The Phase 4 deployment plan involves a plan so that GP practice staff should be made aware about EPS Phase 4.

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