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EPS Nomination and Direction of electronic Prescriptions
In April 2005, the National Health Service (Primary Medical Services) (Miscellaneous Amendments) Regulations 2005 came into force which stipulate that when operating the Electronic Prescription Service, a prescriber must not seek to persuade a patient to nominate a dispensing site recommended by the prescriber. The regulations also state that, if asked to recommend a chemist, the prescriber is to provide a list of all chemists in the area that operate EPS, as provided by the Primary Care Trust.
The Primary Medical Services (Electronic Prescription Service Authorisation) Directions 2008 (reproduced in Part XVIIID of the Drug Tariff) place an obligation on PCTs to proactively monitor the service and where they identify any unusual or unexpected distribution of nominations, consider whether further investigation or action is appropriate. This may include action for breach of contract.
To support them in their monitoring role, PCTs will have access to nomination reports which will provide both summary and detailed information about nominations made and can consider any concerns raised by patients, dispensers or prescribers.
Detailed guidance on the nomination functionality that will become available in EPS Release 2 is available here.
Direction of Paper prescriptions:
Although there are legal safeguards in place to prevent the EPS nomination functionality being used to facilitate the direction of prescriptions, there are no similar safeguards to protect patient choice for paper prescriptions. PSNC believes that as paper prescriptions will continue to be issued for some time; there should be a change to the regulations to prohibit the direction of prescriptions.
Although there is currently no legal prohibition, the GMC have guidelines linked to the direction of prescriptions which make it clear that patients should be free to choose from which pharmacy to have their prescribed medicines dispensed and doctors must not allow their own or their employers' financial or commercial interests in a pharmacy to influence the way they advise their patients. A doctor's failure to adhere to these standards could form the basis of a complaint of professional misconduct.