Moving from paper to

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Moving from paper to electronic prescriptions
An overview of Electronic Prescription Service
Release 2
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Contents

• Introduction
• Key benefits
• How it works
• Implementation
• Communication

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Introduction
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What is the Electronic Prescription Service (EPS)?

• The Electronic Prescription Service is part of
  the National Programme for IT
• It enables prescriptions to be generated,
  transmitted and received electronically without
  the need for paper in some cases
• It is being introduced in two stages, known as
  Release 1 and Release 2
• This presentation is about Release 2 which is
  being introduced now

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Locations

• Now
• GP practices (including dispensing practices)
• Community pharmacies
• Dispensing appliance contractors
• In the longer term
• Other primary care settings where prescribing and
  dispensing take place (for example dental
  practices, walk-in centres)
• Secondary care prescriptions for dispensing in
  the community

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Key Benefits
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For patients

• Greater convenience through a reduction of trips
  to the GP practice just to collect a piece of
  paper (particularly beneficial for those on
  regular repeat medication)
• Greater freedom of choice making it simpler for
  patients to use a dispensing contractor
  convenient to them (as opposed to one near the GP
  practice, as with existing prescription
  collection services)
• Potential to reduce pharmacy waiting times when
  electronic prescriptions are received and
  prepared in advance of the patient arriving

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For GP practice staff

• Potential reduction in workload as fewer patients
  will need to collect paper prescriptions
• Easier to make wider use of repeat dispensing
  (potentially reducing the number of requests for
  individual repeat prescriptions)
• Greater efficiency through the ability to sign
  prescriptions electronically
• Greater control from being able to cancel
  electronic prescriptions at any point before they
  are dispensed

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For dispensing staff

• Greater efficiency through
• removing the need for pharmacies offering
  prescription collection services to physically
  collect prescriptions for patients who have
  nominated them
• reducing the volume of paper that needs to be
  sorted and posted each month for reimbursement
  purposes
• providing scope to streamline workflow and manage
  stock control more effectively

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How does Release 2 work?
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Key points

• GPs and other prescribing staff can sign
  prescriptions electronically using their
  Smartcard and PIN
• Patients will be able to nominate a dispensing
  contractor to receive their electronic
  prescriptions automatically
• This will enable GPs to send electronic
  prescriptions to nominated dispensing contractors
  without the need for paper
• Patients who do not want to nominate a dispensing
  contractor will continue to receive a paper
  prescription

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How it works with nomination

• Patient decides which Release 2 enabled
  dispensing contractor to nominate by either
  looking for the EPS sign displayed in the
  dispensary or by searching online at www.nhs.uk
• Patient asks a member of staff at either a
  Release 2 enabled dispensing contractor or at
  their GP practice to record their nomination for
  them. Over time the patient will be able to
  record their own nomination on HealthSpace
• Next time the patient needs a prescription, they
  request it in the same way as today

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• The GP generates an electronic prescription and
  signs it electronically. The electronic
  prescription is then sent to the Electronic
  Prescription Service
• The nominated dispensing contractors system
  retrieves the electronic prescription
  automatically
• The dispenser can choose to prepare the
  prescription in advance of the patient arriving
• Patient goes directly to their nominated
  dispensing contractor without having to call at
  the GP practice first to collect a paper
  prescription

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• Upon arrival at the nominated dispensing
  contractor, the patient confirms their personal
  details and their prescription item(s) is handed
  to them
• If required (to capture payment/exemption
  declaration or at the patients request), the
  dispenser prints a dispensing token
• The dispenser sends a dispense notification to
  the Electronic Prescription Service which records
  what was dispensed
• The dispensing contractor sends all endorsements
  electronically to the reimbursement agency to
  claim payment

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How it works without nomination
In the initial stages of Release 2, prescriptions
that are not being sent to a nominated dispensary
will continue to be issued on hand signed paper
prescriptions printed with a barcode. In the
longer term, subject to a change in legislation,
non-nominated prescriptions will be able to be
sent electronically following this process

• Patient requests their prescription in the same
  way as today
• The GP generates an electronic prescription and
  signs it electronically. The electronic
  prescription is then sent to the EPS

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• The GP prints out a prescription token
• The patient calls at the GP practice to collect
  the prescription token
• Patient takes the prescription token to the
  Release 2 dispensing contractor of their choice
  (the vast majority will be Release 2 enabled by
  this time)
• Upon arrival the dispenser scans the barcode to
  retrieve the electronic prescription onto their
  system (like in Release 1)
• Prescription items are handed to the patient and
  the dispenser completes the processes the same
  asthey did for a nominated electronic
  prescription

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Additional points

• Authorised staff working in the GP practice where
  the electronic prescription was generated can
  cancel it at any point up until it is dispensed
• Prescription tokens can be issued for nominated
  electronic prescriptions if required
• Repeat dispensing can be administered
  electronically, alleviating the need for multiple
  paper batch issues to be printed (only a single
  prescription token is printed)

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Nomination

• Patients can choose to nominate up to three
  dispensing contractors, including
• one community pharmacy
• one dispensing appliance contractor
• one dispensing GP practice (subject to local
  system configuration)
• Only patients who are eligible to have their
  prescription dispensed by their GP practice will
  be able to have the practice dispensary as a
  third option
• In each case a specific site must be nominated

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Nomination (continued)

• Patients can change or cancel their nomination at
  any time (although it is not recommended to
  change it shortly before the next issue in an
  electronic repeat dispensing regime)
• Patients can nominate at any Release 2 enabled
  dispensary (not necessarily the one they wish to
  nominate). Alternatively, at their GP practice
  or overtime online at HealthSpace

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Nomination key messages for patients

• Once the nomination is recorded, all future
  prescriptions for that patient will be sent to
  their nominated dispensary
• If the patient wants to use a different
  dispensary it is up to them to state otherwise
  when requesting the prescription
• Patients can nominate a dispensing contractor as
  soon as it goes live with Release 2. However,
  they cannot start using nomination until their GP
  practice goes live
• GP practices may wish to inform patients when
  this will happen

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Controlling the use of nomination

• Dispensers must not offer any type of inducement
  to encourage patients to nominate them
• Any prescribing or dispenser setting a nomination
  must have explained what it means first
• The patients nomination must be recorded in a
  timely manner
• Patients registered for a prescription collection
  service cannot be automatically transferred onto
  nomination

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Implementing Release 2
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Controlled implementation

• In order for prescribers to be capable of signing
  prescriptions electronically, Direction must
  first be given from the Secretary of State for
  Health
• Release 2 compliant prescribing systems can be
  deployed with functionality disabled until the
  PCT and practice are ready to switch on
• Release 2 compliant dispensing systems can be
  rolled out freely not restricted to PCTs with
  Direction
• Initially, only prescriptions being sent to a
  nominated dispensary can be signed and sent
  electronically

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Why only nominated prescriptions?

• Removes the risk of a patient attempting to get
  an electronic prescription dispensed at a
  non-Release 2 enabled dispensing contractor
• It is important that the patient uses their
  nominated dispensing contractor when an
  electronic prescription is generated. If they go
  elsewhere there is a chance they wont be able to
  obtain their medication, even if they have a
  prescription token

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Communicating Release 2
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Materials to support Release 2

• A range of materials are available to help
  support the smooth implementation of Release 2.
  These include
• Introduction to Release 2 leaflet for healthcare
  professionals
• Information leaflet for patients
• Communications toolkit for NHS organisations,
  charities and commercial organisations
• Release 2 go-live signage (to help patients
  identify sites are live)
• Information posters and banner stands

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Detailed guidance

• More detailed guidance about specific business
  processes is available for end users in both
  printed and electronic format
• An e-learning module is also available
• All these materials are available to order or
  download from
• www.connectingforhealth.nhs.uk/eps

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cfh.eps_at_nhs.net www.connectingforhealth.nhs.uk/eps