EPS supplementary clinical information

EPS supplementary clinical information

Passing Clinical Messages onto Patients

Release 2 of the Electronic Prescription Service has considerably reduced the flow of paper between the prescriber and the patient so supplementary information must be passed on to patients via alternative routes. Pharmacy teams and local GPs should work together so that all parties agree how non-routine clinical (patient specific regarding medication) information will be communicated from the GP to the patient via the pharmacy team.

Historically, the right hand side of a paper prescription form was used by prescribers to communicate information such as; non-routine clinical information, review dates for patients, an order form for repeat medication and to promote the prescriber’s practice, for example, clinic opening and closing times as well as advertising particular services such as ‘flu clinics’.

However, there is growing concern that the right hand side of a prescription is not always the best option for prescribers to pass on non-routine clinical information to patients. This is because some pharmacists do not automatically see the right hand side of a prescription on their computer screens and can only do so by printing out a dispensing token, which is a practice that is currently being reduced in pharmacy as we move towards a paperless NHS. In addition, the dispensing systems do not always print out the information on the right hand sides of a prescription in an easy to read format, so key information can get lost or hidden.

The long term solution to this issue could be for prescribers to communicate directly with patients using systems such as Patient Facing Services. However, it is recognised that these changes will take time to implement and therefore a temporary solution is required.

Non-routine clinical information (which is specific to a patient and medication item) could be passed from prescribers to dispensers using the ‘message to dispenser’ field on the left hand side. The message content should be concise and appropriate. This should not be used for routine information, but must be specific to the patient.

Left Hand Side Message Prescriptio

This method would ensure that pharmacists have visibility of the message when reviewing the left hand side on their computer systems. This information could then be passed on verbally to the patient.
In addition to the above solution, NHS Digital will continue to highlight current inconsistencies with the right hand side of prescriptions within dispensing systems and try to get these issues fixed as soon as possible.

Non-routine clinical information includes:
•    Last repeat dispensing batch issue
•    Change in dosage of medicine
•    End of repeats process – for example,  ‘when repeats have run out please contact surgery for a review’
•    Details of review appointments, for example, instructions for the patient to arrange an appointment with the prescriber for a blood test where this is non-routine for that patient.
Pharmacy staff will not be required to pass on routine information linked to the services offered by another provider.

Routine information for which pharmacy is not required to pass on includes:

•    Patient information: Name, Address, DOB and NHS number
•    Doctor’s details
•    Repeats
□    Drug quantity, dose.
□    Last issued date.
□    Next issue date.
□    Review due date (when not within 4 weeks)
•    Flu jab
•    Check-up
□    well woman
□    well man
□    over 41s
□    over 75s
□    obesity
□    dementia
□    cancer screening
•    Advertisement for patient to take-up a non-essential service at the GP surgery
□    travel clinic,
□    physiotherapy,
□    chiropractor,
□    Chiropodist.
•    GP opening times

Although GP and pharmacy systems technically can allow this information to be communicated via the right hand side where this is locally agreed by the pharmacy team and the GP practice, there may be more appropriate alternatives. It is recommended that pharmacy teams co-work with their local GP practices to discuss the methods which will be used so that non-routine clinical information is to be passed to patients.

Non-routine information to pass on if the patient requests

Pharmacy staff will also be required to provide the following information to the patient, at the patient’s request:

  • A full list of the patient’s ‘repeat’ medication (as received in the electronic prescription message);
  • The patient’s review date (where greater than 4 weeks); and
  • Information on the number of times the medication can be reordered from the prescriber without a review.
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