Home Electronic Repeat Dispensing
Release 2 of the Electronic Prescription Service will provide electronic support to the repeat dispensing service. When issuing a repeatable prescription, the prescriber will authorise a prescription with a specified number of issues; each issue contains the same prescribed items. The Spine will then manage the release of each individual prescription issue. The first issue of the prescription will be available as soon as the prescription is received by the Spine, subsequent issues will be created on the Spine ready to be pulled down once a previous issue is deemed complete (that is either dispensed or marked as not dispensed).
Once all authorised issues of the prescription have been dispensed, or if the prescription has expired, the repeatable prescription is complete and the patient must contact his GP to arrange for another repeatable prescription to be issued. Pharmacists should advise patients of the need to contact their prescriber when dispensing the last issue of a repeatable prescription.
To allow pharmacists to prepare medicines for dispensing in advance of a patient visiting the pharmacy, the Spine will automatically send the nominated dispensing site a repeat dispensing prescription seven days before the expected end date of the previous issue of the prescription. The Spine will calculate the expected date of supply as 28 days after the date that the previous issue was marked as dispensed unless the prescriber has specified a number of days supply for each issue.
It is possible for a pharmacy to pull down issues in advance of them being sent automatically from the Spine, for example where the instalment dispensing interval is flexible and the pharmacist believes that an instalment should be dispensed at an earlier time because the patient is going on holiday. Pharmacy systems suppliers also have flexibility to implement more advanced scheduling functionality in their systems to support work flow in pharmacies.
As with all NHS electronic prescriptions, until there is further regulatory change, a repeatable prescription can only be issued electronically where it is being sent to a patient’s nominated pharmacy. Patients can choose to change their nominated pharmacy before the expiry of the repeatable prescription. In this case, all outstanding issues which have not been downloaded will be transferred to the new nominated pharmacy. This is a change from the current paper based arrangements where all issues must be obtained from the same pharmacy.
When issuing an electronic repeatable prescription, prescribers are required to always issue a ‘Repeatable Prescription Authorising Token’.
CPPE’s original programme which supports repeat dispensing (From pathfinder to practice) has been replaced by a focal point NHS repeat dispensing module. The focal point programme is designed to be used as part of a learning community or for self-study. It is available to order or download and has an associated e-assessment. Even if you have completed the previous programme you may find that the focal point format provides a useful resource of key information to refer to in everyday practice and is ideal to support repeat dispensing training for your team.
Although there has been low uptake of paperbased repeat dispensing, feedback received from GP groups suggests there is enthusiasm amongst GPs for adopting repeat dispensing under the Electronic Prescription Service. This has the potential to offer workload savings for GPs and GP practice staff and as Release 2 of the service also supports the cancellation of prescriptions, they can be reassured that if the patient’s circumstances do change, they have improved arrangements to cancel and reissue a repeat prescription for a patient.
Frequently Asked Questions
The prescriber has not identified a dispensing interval on the prescription and the patient has told me that they are going on holiday for 6 weeks. Can I dispense 2 issues at the same time for the patient?
Yes, where a prescriber has not indicated the interval, the pharmacist should use his professional judgement to dispense instalments at an appropriate interval. From a process perspective, the issues must be pulled down and dispensed in order, so the pharmacy would be required to pull down the first issue, update the Spine to indicate that the issue had been dispensed and then repeat the process with the second issue. When processing electronic repeatable prescriptions, the pharmacy system will record the Prescription ID to facilitate requesting subsequent issues of the prescription.
To further improve the efficiency of processing repeat dispensing prescriptions, PSNC would like to see a change to the model to allow multiple issues to be pulled down and prepared at the same time without the Spine having to be updated before the next issue can be retrieved.
Are patients required to consent to be issued with electronic repeatable prescriptions?
Patients must give informed consent to the sharing of information between the dispenser and prescriber before participating in the repeat dispensing service, both for the paper based and electronic repeat dispensing arrangements. Normally consent is obtained from patients by prescribers. A national leaflet (RD2) and consent form (RD1) have been produced by the Department of Health, PCTs are responsible for the distribution of these forms which can be obtained by PCTs through 3M Security Printing & Systems Limited (3MSPSL).
If a patient has already given his consent for the paper-based arrangements, there is no requirement to collect his consent again before issuing an electronic repeat dispensing prescription. If the patient has not already nominated a pharmacy, informed consent would be required before changing the patient’s nomination settings.
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