Home Deployment of Release 2 (including Electronic Prescriptions)
With patient safety, access and choice of paramount importance, a range of controls have been put in place to manage the deployment of the Electronic Prescription Service.
Regulatory Controls
In preparation for the roll-out of Release 2 of the Electronic Prescription Service, changes were made to the relevant legislation, the Medicines for Human Use (Prescription Only) Order 1997 (the ‘POM Order’), the NHS (General Medical Service Contracts) Regulations 2004 and the NHS (Pharmaceutical Services) Regulations 2005, to enable the prescribing and dispensing of electronic prescriptions and to put in place controls to support the managed roll-out of the EPS service.
What is an electronic prescription?
EPS Release 1 enabled GP systems are able to send prescription details electronically to the spine. Each electronic message has a unique identifier code which is contained within the barcode printed on prescription forms by Release 1 systems. In Release 1, the paper FP10 is the legal prescription not the electronic message.
An electronic message becomes a legal electronic prescription where the prescription has been created in electronic form, is signed with an electronic signature and is then transferred to the dispensing site as an electronic communication. It is not yet possible to issue an electronic prescription for a drug specified in Schedule 1, 2 or 3 of the Misuse of Drugs Regulations 2005 and prescribers remain free to continue to issue paper prescriptions.
EPS Release 2 enabled systems will support prescribers in digitally signing prescription messages to convert them into legal electronic prescriptions.
When can NHS prescribers start issuing electronic prescriptions?
NHS prescribers are limited to when they can issue electronic prescriptions by the NHS (General Medical Service Contracts) Regulations 2004. Only PCTs that have been authorised through Secretary of State Directions can direct their GPs to start issuing electronic NHS prescriptions.
83 PCT's are currently listed in the Directions and are therefore able to authorise prescribers to use EPS Release 2:
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PCTs currently listed in Secretary of State Directions |
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Information on the process that Strategic Health Authorities need to follow to recommend that PCTs in their area are added to the Directions can be found on the Department of Health website. Guidance on actions PCTs and LPCs need to take to support deployment can be found in the 'Supporting Deployment of EPS Release 2' section of this site.
Access to Systems
In order to operate Release 2 safely, suppliers systems must pass through a compliance process. Once each system has successfully completed technical compliance it is permitted to begin further testing in a live environment, known as 'initial implementation'. This includes preparing documents to support the initial implementation such as a site readiness checklist. The system is then tested in this live environment and any issues are addressed. Once the system has successfully passed through all stages it is then approved for national rollout.
Click on the links below for more information on the development status of pharmacy and prescribing systems:
Initially only patients who nominate can have electronic prescripions
The NHS (General Medical Service Contracts) Regulations 2004 put in place controls around which patients can be issued with electronic prescriptions. Initially, it will only be possible to issue an electronic NHS prescription where the patient has nominated their dispensing site.
These restrictions were put in place to support the phased implementation of the Electronic Prescription Service.
Once the majority of dispensing sites are operating Release 2, and following further regulatory change, it is anticipated that it will also be possible for electronic prescriptions to be issued where the patient does not want to nominate a pharmacy.
Not all products can be prescribed via the service
Each electronic NHS prescription may contain up to 4 items. Prescribers are able to issue acute prescriptions, repeat prescriptions (repeat prescribing) and repeatable prescriptions (repeat dispensing) via the service but it will not be possible for a prescriber to use the service to request a bulk prescription (Drug Tariff Part VIII note 9) for a school or institution.
There are some prescription items that cannot be transmitted electronically, for example:
It is currently not permitted to issue an electronic prescription for a Controlled Drug specified in Schedule 1, 2 or 3 of the Misuse of Drugs Regulations, however this is currently under review and is expected to change in the future.
And there will be occasions where a product cannot be prescribed electronically for technical reasons. For example, this could occur if the product is not listed on the NHS Dictionary of Medicines & Devices or if the prescribing system is not able to issue a prescription for the item because the supplier hasn’t ‘mapped’ the appropriate codes. This is likely to affect less commonly prescribed items including products to be specially manufactured or extemporaneously dispensed products.
Tracking Deployment
NHS Connecting for Health has developed an online map marking the location of all GP surgeries and community pharmacies in England, showing if they are EPS Release 2 enabled, soon to be enabled or not enabled. The map provides information by SHA area, enabling users to zoom into street level. This map will help system suppliers develop their deployment plans and allow pharmacists to see if their neighbouring GPs and pharmacies are Release 2 enabled, or will be soon, so they can consider when is the right time for them to start using Release 2. The map is on the CFH Website.
Frequently Asked Questions
1. Could an electronic NHS prescription be received by a community pharmacy other than via the NHS Electronic Prescription Service?
No. The NHS (Pharmaceutical Services) Regulations 2005 are clear that for an electronic prescription to be dispensed as an NHS prescription, it must be sent via the NHS Electronic Prescription Service and no other messaging system.
2. Can a prescriber issue an FP10MDA Instalment Dispensing prescription electronically via the Electronic Prescription Service?
In England, only Schedule 2 Controlled Drugs plus Buprenorphine, Buprenorphine/Naloxone (Suboxone) and Diazepam can be prescribed in instalments on Form FP10MDA. Schedule 2 and 3 Controlled Drugs are currently outside of the scope of the Electronic Prescription Service however as a result of the Shipman Inquiry, consideration is currently being given to allowing the electronic transmission of prescriptions for Schedule 2 & 3 Controlled Drugs in the future.
Although there is no FP10MDA concept in the Electronic Prescription Service, prescribers could use the repeat dispensing arrangements to authorise multiple dispensing of diazepam to a patient. Schedule 2 and 3 Controlled Drugs cannot be prescribed within the NHS repeat dispensing arrangements.
3. Will I continue to receive paper prescriptions as well as electronic prescriptions?
Yes. The mix of paper versus electronic prescriptions will vary greatly depending on the location of a pharmacy and patient preferences. Initially only patients who have nominated a dispensing site will be able to receive their prescriptions electronically. There will also be occasions where the prescriber cannot issue an electronic prescription, for example if the prescription is issued during a home visit and the prescriber does not have access to the service or where a particular product cannot be prescribed electronically.
4. Could a private prescription be sent via the Electronic Prescription Service?
No, private prescriptions are currently out of scope of the Electronic Prescription Service. This may change in future.
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