Which sites can a patient nominate?

Which sites can a patient nominate?

When a nominated electronic prescription is generated, it is then sent to the Electronic Prescription Service and can be retrieved by the nominated dispensing system – without the need to scan a barcode on the prescription token.

Patients or their carers can set their nominated dispensing site at any Release 2 enabled pharmacy or at the GP Surgery that they are registered with (if Release 2 enabled). The patient will be able to set up to three dispensing sites:

  • a community pharmacy; and/or
  • an appliance contractor; and/or
  • a dispensing doctor.

It will not be possible for a patient to select more than one dispensing site of the same type, for example more than one pharmacy, however consideration is being given to enabling this in the future. Also, it will not be possible for patients to nominate a chain of pharmacies, only a specific dispensing location.

Unlike with established prescription collection services, patients will be able to request that their prescription is sent to any pharmacy regardless of the geographical location or the working relationship between the pharmacy and the prescriber.

Dispensing doctor arrangements

Dispensing doctors will continue to only be able to dispense to patients where the criteria in the regulations is satisfied, including that the patient is resident in a controlled locality, at a distance of more than 1.6 kilometres from any pharmacy. It would be a breach of a dispensing doctor’s Terms of Service to use the Electronic Prescription Service to dispense for a patient for whom they are not entitled to provide pharmaceutical services. For this reason, patients will not be able to nominate a dispensing doctor through a provider other than the dispensing doctor that they are nominating.

Are your Pharmacy contact details up to date on the NHS Choices Website?
Information on which pharmacies are EPS Release 2 enabled will be provided by the NHS Choices Website (www.nhs.uk) which will be updated automatically as individual pharmacies become Release 2 enabled. It is essential that the information held on nhs.uk is up to date to support prescribers in locating and setting the nomination of a particular pharmacy on their prescribing system at the patient’s request. Pharmacy contractors can check now whether the information held online at the NHS Choices website is up to date. It is particularly important to check whether the pharmacy name displayed on the NHS Choices site is the pharmacy’s current trading name and that the postcode is accurate.Requests for changes to the pharmacy name and address should be put in writing to the local NHS England team. Pharmacies can register to independently edit other information on their NHS Choices profile.

 

What If?….Scenario

What If?  Scenario: A patient has a regular nominated pharmacy (Pharmacy A) but has requested that as a one-off, their prescription is sent to another pharmacy (Pharmacy B).
It is not possible for a patient to select more than one dispensing site of the same type, for example more than one pharmacy and where a patient changes their nominated pharmacy, all nominated prescriptions that have not yet been downloaded for dispensing from the original nominated pharmacy will be transferred across to the new nominated pharmacy. When this scenario arose in one of the first sites to implement EPS Release 2, staff in the GP Practice, changed the nomination to the new pharmacy (Pharmacy B) at the patient’s request and sent the prescription but before Pharmacy B had downloaded the prescription, the staff in the GP Practice changed the nomination straight back to the original pharmacy (Pharmacy A) so that future prescriptions would be sent to Pharmacy A as per the patient’s request. As the change to the nomination settings in this scenario was made before the new pharmacy (Pharmacy B) had downloaded the prescription message, the prescription that the patient wanted sent to Pharmacy B was instead transferred to Pharmacy A. To avoid this happening, the GP practice could instead have:
  • Issued a paper FP10, if the patient is present;
  • Advised the patient to ask Pharmacy B to change their nomination to Pharmacy A when they collect their prescription;
  • Sent a message to Pharmacy B in the electronic message alerting them that the patient has indicated they would like their nomination switched back to Pharmacy A after the prescription has been dispensed.

Frequently asked questions

Q. If a patient has nominated multiple dispensing sites, how will they know which dispensing site has been sent their prescription?”]
A.
The patient can set up to three dispensing sites: a community pharmacy and/or an appliance contractor and/or a dispensing doctor. It is not possible for a patient to select more than one dispensing site of the same type. If a patient has nominated more than one dispensing site, they will need to discuss with the prescriber which dispensing site they would like a particular prescription sent to, for example if they wish to have their medicines dispensed by their nominated pharmacy but appliances dispensed by their nominated appliance contractor.

Q. A patient has visited my pharmacy and asked that I set their nomination for both my pharmacy and an appliance contractor that provides the patient with their stoma products. Do I have to set the nomination for the appliance contractor?
A.
Yes. The Terms of Service require that where the EPS service is available, the pharmacist must update a patient’s nomination settings as requested by the patient, this would include adding a pharmacy or appliance contractor as the patient’s nominated dispensing sites. A nomination to a dispensing doctor is only possible at that dispensing doctor’s location.

Q. What if the patient forgets which pharmacy they have nominated, how can the patient find this out?
A.
Pharmacy systems will support querying a patient’s current nominated dispensing sites. Pharmacy staff with appropriate access rights will, with patient consent, be able to view the contractor type (i.e. pharmacy, appliance contractor or dispensing doctor) as well as the organisation name, address and postcode for the patient’s nominated dispensing site. Prescribers will also be able to view this information.

Q. Could staff in a GP Practice, for example a GP receptionist, change the nomination settings at a patient’s request?
A.
Yes, if the individual has a smartcard and has been granted the appropriate access rights, they could, with the consent of the patient or their representative, record a patient’s nomination on the Personal Demographics Service.

Q. If a patient has nominated a particular pharmacy, does a particular prescription have to be sent to that pharmacy electronically?
A.
No. Even though a patient may have set a nominated pharmacy, they are free to request that the prescriber issues a standard paper FP10 prescription or a barcoded FP10 prescription. This may be preferable if the patient is, for example, planning to go to a pharmacy in Scotland or Wales, where the EPS is not available.

In time, following further regulatory change, it is anticipated that it will be possible to also issue electronic prescriptions to patients who have not nominated a pharmacy. When this happens, the patient would be able to request that they receive an electronic prescription and a prescription token that can be taken to any Release 2 enabled pharmacy.

Q. Does a patient require separate electronic prescriptions for medicines and appliances?
A.
If the patient requires both medicines and appliances, the prescriber must decide, as now, whether to generate two separate prescriptions. This will depend on where the patient wishes to have their medicines and appliances dispensed, for example if they wish to receive all items from the pharmacy or whether they would like an appliance contractor to dispense their appliances.

Q. How should I confirm the identity of a patient who has nominated my pharmacy to receive their prescriptions and does not have a prescription token?
A.
As with repeat collection services, this would be for a pharmacy contractor to determine as part of local standard operating procedures, for example, if the patient is not known to pharmacy staff, the patient may be asked to confirm their address and date of birth or if there is doubt over the patient’s identify, the patient may be asked to show some form of ID.

Q. What is the timescale from a pharmacy deploying EPS Release 2 to NHS Choices being updated?
A.
When a R2 system is installed a commissioning prescription is scanned and a message sent to the Pricing Authority. This triggers payment of the EPS Release 2 allowance. Also the Pricing Authority send a message to NHS Choices, this happens on a weekly basis (Thursday). Between commissioning and the next Thursday night the pharmacy would be able to set nominations.

Q. Where a patient has requested a change to their nomination settings but I don’t have their NHS number, I have been undertaking simple traces on the Personal Demographics Service to locate this information. Occasionally, even where I have entered the correct demographic information in the search box, my system is not returning an NHS number. What should I do?
A. The demographic information contained in PDS is extracted from a range of local clinical systems. Problems can arise if this information is not transferred from local systems to PDS in the required form. Where there is confidence that the demographic information being used to perform a simple trace is accurate but it is not returning a result, it is important to contact your PMR supplier so that they can co-ordinate resolution of this issue through the HSCIC.

Related resources

 For more of an EPS overview use the buttons below:

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For more on nomination use the buttons below:

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