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.
Roll-out from November 2019
NHS Digital will be rolling out EPS Phase 4 to additional GP practices using the TPP SystmOne GP system from Monday 18th November 2019, so all community pharmacy teams should be aware that they could start to receive EPS Phase 4 tokens from patients to process.
GP practices using the TPP SystmOne GP system will have Phase 4 rolled out in the coming weeks, with dates for EMIS, Microtest and Vision GP practices to be decided shortly. Specific dates will be made available on NHS Digital’s EPS Phase 4 deployment schedule webpage.
The start of the national rollout follows a successful pilot which tested the functionality in all four GP prescribing systems. The pilot began in November 2018 and involved 60 GP practices across England.
Under EPS Phase 4, patients can choose to take their token to any pharmacy in England. If you receive a Phase 4 token, simply scan the barcode and dispense it as you would any other electronic prescription.
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).
What is Phase 4?
Previously, it was only possible to issue an EPS prescription where the patient nominated a pharmacy or another dispenser. EPS had been most advantageous for patients who received regular medication and who tended 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 as EPS progresses with more GP practices being ‘Phase 4’ ready, 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 an EPS Phase 4 green prescription 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 made in association with Phase 4
NHS Digital identified several matters that needed addressing prior to the move to Phase 4 of EPS and preparatory work was undertaken:
- 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
- EPS Controlled Drugs (CDs) (Schedule 2 and 3)
The Phase 4 pilot
NHS Digital piloted EPS Phase 4 from late 2018 at around 60 GP practices. A successful outcome was reached.
Phase 4 top tips for pharmacy teams
- 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 earlier stages of the rollout, 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 there are some materials on the NHS Digital website:
- EPS Phase 4 webpage for GP practice staff (including the factsheet / checklist)
The Phase 4 deployment plan involves a plan so that GP practice staff within GP practices that are about to go live with Phase 4, should be made aware about EPS Phase 4.
How to report any Phase 4 technical issues which require reporting?
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