Pharmacy: improving digital messaging and the Future Enterprise Architecture

There are approximately 11,400 community pharmacies in England. Each day 1.6 million people visit a community pharmacy on their high streets, supermarkets, and often in the heart of the most deprived communities. Each year 606 million prescriptions are dispensed; that’s approximately 5.5 million paper prescriptions and 45 million electronic prescriptions each month.

The traditional role of the community pharmacist has evolved to include more patient-facing NHS clinical services to allow for improved patient access and better integration with the wider NHS and social care.

NHS Digital are working on improving information flow between pharmacies and GP. We have also developed the Future Enterprise Architecture for pharmacy IT suppliers, which addresses priority user needs identified in recent research.

NHS Digital's research has identified that many community pharmacies lack the ability to send secure electronic notifications to general practices following the provision of clinical services. This would help improve communication between health and care settings and ensure patient records are kept up to date.

Important information about medicines dispensed or vaccinations administered must be added to the patient’s medical record. Current methods for sending this information require human intervention by general practice staff.

Electronic notifications are used to securely share information about the urgent supply of medicines and pharmacy administered flu vaccinations with GP practices.

Electronic notifications are sent automatically from pharmacies to GP practices as a workflow task. Some GP systems can receive structured information, which means details can be added directly to a patient's GP record, without transcribing the information manually.

These electronic notifications are currently available for the urgent supply of medicines made as part of the Community Pharmacist Consultation Service (CPCS) and pharmacy administered flu vaccinations.

The content of the electronic notification is based on the pharmacy information flows data standard, developed in partnership with the Professional Record Standards Body (PRSB). The PRSB worked with clinicians from across primary care to develop and endorse the standard which covers vaccinations, urgent supply of medicines and other community pharmacy services.

This system of electronic notifications is currently in use in:

• TPP SystmOne
• EMIS Web
• Sonar Informatics
• Pinnacle PharmOutcomes
• Cegedim Pharmacy Systems
• Positive Solutions HxConsult

Notifications are sent as a structured Fast Healthcare Interoperability Resources (FHIR) message from a community pharmacy’s clinical system via Message Exchange for Social Care and Health (MESH) directly to a patient’s GP practice. This reduces manual processing and improves data quality.

Once added to the patient record, the practice can also update a patient’s Summary Care Record (SCR), making the information available to other care providers.

This is a more straightforward and efficient process for practice staff than the notifications previously sent via paper and NHSmail.

This functionality delivers urgent supply and flu vaccination notifications to the practice MESH mailbox and creates a workflow task to complete the process.

GP practices still receive the full details of the urgent supply or flu vaccination in a PDF document and can add any additional information to the patient record manually as appropriate.

If the electronic message cannot be sent, pharmacies may revert to previous processes, so practice teams should continue to check for notifications received via NHSmail or post.

TPP SystmOne

If you use TPP SystmOne, the structured information in the electronic message can be read by your system. For flu vaccinations, key information will be added directly to the patient record without manually transcribing or completing a workflow task. There are some exceptions where clinicians will need to accept the changes. Further information is available from TPP.

If the electronic message cannot be sent, pharmacies may revert to previous processes, so practice teams should continue to check for notifications received via NHSmail or post.

EMIS Web

The system can read the structured information in the electronic message. For flu vaccinations, key information is added directly to the patient record without manually transcribing or completing a workflow task. There are some exceptions where clinicians will need to accept the changes. Users must choose to opt in to receive flu vaccination notifications in this way, and instructions are available on EMIS Now.

Urgent supply of medicines notifications should be reviewed and accepted by a clinician. If you use a third-party product such as Docman for your patient document management, you will need to configure your Document Management task settings in Workflow Manager. Instructions are available on EMIS Now.

If the electronic message cannot be sent, pharmacies may revert to previous processes, so practice teams should continue to check for notifications received via NHSmail or post.

The way you record flu vaccinations and CPCS urgent supply consultations in your pharmacy services system have not changed. The system checks whether the patient’s GP practice can receive the new message type before securely sending it.

If an electronic notification cannot be sent, please follow the user guide for your pharmacy system on how this should be managed.

For more information, please contact your system supplier.

Community pharmacies using Sonar Informatics and Pinnacle PharmOutcomes can now send notifications for both NHS flu vaccinations and CPCS urgent supplies of medicines.

Community pharmacies using Cegedim Pharmacy Services and Positive Solutions HxConsult can send notifications for urgent supply of medicines.

GP practices using EMIS web and TPP SystmOne can receive notifications for both services.

The Future Enterprise Architecture for pharmacy is a conceptual service blueprint to inform the development plans for IT suppliers to best support the Community Pharmacy Contractual Framework (CPCF). It was developed through extensive strategic stakeholder, service user and supplier research during 2021 and 2022. It supports technology providers to define their product roadmaps to address user priorities. It also supports them to maximise the benefits from current and developing technologies and standards in the market.

If you have comments or questions to share, please get in touch via [email protected].