Electronic Prescription Service for secondary care

The EPS allows prescribers to send prescriptions electronically to the community pharmacy of the patient's choice. This is facilitated by using Spine, the national messaging system in England which allows clinical messaging, such as EPS, to communicate between approved systems.

It should not be confused with the Electronic Prescribing and Medicines Administration (EPMA) system which is currently only used within the hospital setting.

The EPS is already widely used in primary care with over 95% of all prescriptions now being produced electronically.

The EPS has commenced roll-out to secondary care using the Prescription API.

1. Improved prescription issuing and management of workflows.
2. Removal of paper prescription pads leading to:
   • clinician time saved through reduced administrative burden
   • reduced prescription posting and courier costs
   • improved prescribing governance
   • enhanced prescription security and tracking as prescriptions can no longer be lost or stolen
   • reduction in prescribing errors caused by illegible prescriptions 
3. Supports remote consultations.
4. Improved patient experience via:
   • increased patient choice of dispenser
   • potential to reduce patient travel times
   • improved access to local medication
   • reduced waiting times in hospital
5. Improved reporting of prescribing data.
6. Ability to track all EPS prescriptions.

The EPS features available for secondary care include:

Within secondary care, EPS does not support: 

• the ability to flag prescriptions as urgent - see more about urgent prescriptions
• the prescribing of items not mapped to the dictionary of medicines and devices (dm+d)
• prescriptions to be sent to dispensers outside of England (cross-border dispensing)
• prescriptions to be sent to hospital pharmacies
• instalment prescribing/dispensing (FP10MDA prescriptions)
• the use of repeat prescribing templates
• repeat dispensing
• prescriptions to be sent to Dispensing Appliance Contractors and Distance Selling Pharmacies
• the addition of notes or other important information for the dispensing pharmacy
• the cancelation of individual items on a multi-item prescription
• homecare prescriptions, currently

Prescribing via EPS does not update the patient’s GP record. It remains the responsibility of the secondary care organisation to inform the GP of any medication prescribed via usual methods. 

Secondary care users can direct prescriptions to the patient’s regular nominated dispenser (primary nomination). However, they will not be able to change or add a primary nomination. If the prescription needs to be sent to an alternative dispenser, one-off nomination or non-nomination functionality should be used.

Before EPS is enabled in your trust, please make sure your team has read and understood the guidance and information about using EPS on this page, which can help with development of local business processes.

Your EPS system supplier will provide information specific to the system.

Things to consider

1. All users must have smartcards with roles and access rights required for EPS.
2. Service and user details must be correctly configured within EPS system.
3. You must have business processes in place for using EPS alongside other patient record systems and prescribing purposes.
4. You must be using dm+d and product-based prescribing.
5. Patient details must be matched to Personal Demographics Service (PDS).
6. You should be discussing dispenser choice with patients.

Cost centres for EPS

Before you start, all service level cost centres will need to be agreed and configured.

Cost centres used for electronic prescriptions sent to community pharmacy may be either:

• a 5-digit ‘trust site code’ ODS code, for example RAT01, used for FP10HP prescriptions 
• a 6-digit ‘prescribing cost centre’ ODS code, for example Y12345, used for FP10 prescriptions

Tips to establish your EPS cost centre codes

Ask yourself:

• what prescribing codes does your service currently use for paper FP10 or FP10HP prescriptions? (Do you print or use pads?)
• would you want to use the same for EPS, or take a different approach?  

Ask your trust prescribing lead for advice.

You can search for existing cost centre codes and any associated prescriber codes using the ODS portal.

Learn more about NHSBSA’s information about how to request a new cost centre, spurious medical prescriber codes, and non-medical prescriber (NMP) registration.

You will need to seek advice from your system supplier about how to configure your cost centres and prescribing users within the system. 

Prescribing using EPS

For hospital prescribers it is often routine practice, on handwritten prescriptions, to prescribe by dose, frequency, and duration. For example, Amoxicillin, 500mg three times daily for 7 days. This ‘open’ type of prescribing passes the product selection on to the dispenser. 

EPS requires prescribing by product (as listed in dm+d), dose and quantity (for example Amoxicillin 500mg capsules, 21, one to be taken three times daily).

Learn more about prescribing using dm+d.

Pharmacy stock

With EPS prescriptions the pharmacy can only dispense the item prescribed. It is important to consider this when selecting a branded or specific formulation.  It may be useful to contact the pharmacy to check availability, particularly for items which may not be routinely held in community pharmacies. 

If a pharmacy does not have an item in stock, and the patient does not wish to wait, the pharmacy can return the prescription to the spine and give the patient a printed token to take to another pharmacy. 

The prescriber should not need to be involved unless the pharmacy has already dispensed other items on the prescription, or if the stock shortage affects multiple sites in the area, in which case there may be a need to prescribe an alternative item.

EPS troubleshooting

Most prescriptions can be sent via EPS. However, there may be problems if 

• the patient cannot be found on the PDS if demographics in the local record do not match the details held on the Spine 
• the medication to be prescribed is not listed in the dictionary of medicines and devices (dm+d) 
• the prescriber has logged on without their smartcard, or the prescriber’s smartcard has insufficient roles 

For further help with trouble shooting check your system supplier guidance.

Exceptions

There are only a few scenarios where EPS should not currently be used. These include: 

• private prescriptions
• instalment dispensed CD (FP10MDA) prescriptions
• if the patient wishes to have their prescription dispensed by a pharmacy outside of England (in Scotland, Wales or Northern Ireland)

Check your system supplier guidance or agreed local process to revert a prescription to FP10 or use an alternative method, if required.  

For queries or further support about EPS contact your trust EPS lead.

Information for system suppliers is available about the FHIR API based EPS service.

Cancellation

The prescribing organisation can cancel the EPS prescription at any point until it is dispensed to the patient. You will need to include a reason for cancellation and then a cancellation message will be sent to the Electronic Prescription Service. 

The success of cancellation depends on the status of the prescription. You will receive feedback in the prescribing system to advise whether the cancellation was successful, and any further action to be taken.

Ensure users have access rights to cancel prescriptions assigned to their smartcards, and that cancellation responses are reviewed and dealt with appropriately.

Check your system supplier guidance. We have provided a summary of the action required in this table.

Users will need to have appropriate access assigned within the EPS system for each separate site/department you work for. Users will then select the appropriate site/department at log-in. It is important the correct site/department is selected as this will be directly aligned to your individual cost centre codes.

Each organisation will have a local registration authority team that manages issuing and updating smartcards. It is important that both clinical and administrator staff are assigned the correct access roles.

Users with an organisation-approved computer/laptop with appropriate smartcard and remote connectivity can access the EPS from anywhere with an internet connection. 

Locums are also able to access EPS, as long as they have: 

• an appropriate role and access on their NHS smartcard
• their professional code (GMC, NMS, GPhC, HCPC for example)
• they are configured with an appropriate prescribing cost code

Contact your Digital Partnering Regional Manager or email [email protected].