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EPS in other care settings

EMIS and TPP have made EPS functionality available to care settings such as extended access hubs, community, out of hours and urgent care settings. 

 

How to enable EPS for your service

Services wishing to enable EPS should check their service falls within scope, and read the guidance on this page and ensure they understand the business process changes required before requesting enablement.

 

Sites using TPP SystmOne should contact TPP by emailing  Deployments@tpp-uk.com with the organisation ID of the SystmOne unit to request enablement. 
 

Sites using EMIS Web can read the information about activating EPS for clinical services set out on EMIS Now. 

 

Preparing for EPS

Before your EPS enablement, you should complete the site readiness checklist. You also need to make sure your team has read and understood the guidance on this page.

Your system supplier will provide information specific to your prescribing system

EPS and nominations

We have provided some business process considerations for an organisation starting to use the Electronic Prescription Service (EPS) for nominated and non-nominated (Phase 4) prescriptions.

Patients can choose to nominate a pharmacy for their electronic prescriptions to be sent to.  Nominations can be set or changed for a patient by the prescribing organisation or a dispensing organisation within the patient record, which will update the nomination on the spine.

Some Apps and Patient Facing Online services also provide the functionality for patients to change their own nomination.

Patients who use a Dispensing Appliance Contractor (DAC) for some of their items can also have a DAC nomination.

Nominated EPS prescriptions

If the patient has a nomination in place the prescribing system will default to send their EPS prescriptions to the nominated dispensing organisation (pharmacy or DAC). The prescription will be signed using the smartcard PIN and sent to the spine, with no need for a token to be printed.

The prescription will be released from the spine when the pharmacy requests a download for their nominated prescriptions. The prescription will then be processed electronically by the pharmacy

One-off nomination (only available in some prescribing systems)

If the prescribing system allows; there may be the option to select a ‘one-off’ nomination for an individual prescription. This is a useful option for an acute or repeat prescription if the patient can’t use their usual nominated dispenser.

At the point of prescribing, there will be the option to choose a pharmacy that is listed in the Directory of Services (DOS). The opening times will be displayed.

A one-off nomination does not affect the patient’s regular nomination, but the one-off prescription would be affected if the regular nomination is changed before it is collected.

Please do not use one-off nomination when issuing an eRD prescription.

Phase 4 (Non-Nominated) EPS Prescriptions

If the patient does not have a nomination in place the prescription will be signed using the smartcard PIN and the prescription will be sent to the spine. A token will print; this should be given to the patient who can then take it to a pharmacy of their choice. The barcode on the token will be scanned by the dispensing site and the legal prescription will be released from the spine for them to process electronically.

If the patient has a nomination but does not want to use their regular nominated dispenser and the functionality for ‘one-off’ nominations is not available, the prescription can be reverted to a Phase 4 prescription.  Check your system supplier guidance for how to revert a prescription to Phase 4.

This type of prescription will not be affected by any additions or changes to a nomination. 

In scenarios where patient is not present and cannot collect the token, they can still go to a pharmacy to ask them to download and dispense the prescription.  See the Using EPS in remote consultations section. 

Using EPS in remote consultations

Guidance for EPS prescribing organisations when using remote consultations, via the phone, video link or online.

Adding messages to an EPS prescription

The ability to add messages to the dispenser and/or clinical messages for the patient’s attention is available in prescribing systems.

Urgent prescriptions

Depending on the situation you are dealing with and the urgency of the prescription, you may consider it necessary to contact the dispenser to alert them to this prescription, for example if the patient is not attending the pharmacy in person, it requires delivery, or if you need to check they can supply the items (e.g. Controlled Drugs).

Do not assume that adding a message to the EPS prescription will be sufficient for urgent clinical need.

EPS troubleshooting

EPS will be enabled with Phase 4 which means the vast majority of prescriptions will be sent electronically.  If a prescription is not able to be sent via EPS, please check the following:

  • is the patient’s record synchronised to the PDS?
  • is an item marked ‘personally administered’ (PA)? To send the item via EPS, remove the tick from the PA box
  • does the patient have an exception code in their record which prevents EPS being used.  Check your system supplier’s guidance for how to manage these codes.
  • are the prescribed items matched to the dm+d? - The NHS Dictionary of Medicines and Devices (dm+d) provides a standardised reference for medicines and medical devices for use by different clinical systems.  Use the dm+d factsheet to assist with mapping common items
  • Is the user logged in with appropriate smartcard rights, and is your system configured correctly to enable users to generate and sign EPS prescriptions according to their roles.

Check your system supplier guidance for further help with EPS troubleshooting.

Exceptions

There are only a few scenarios where a prescription will not be sent electronically. These include:

  • private prescriptions
  • instalment dispensed CD (FP10MDA) prescriptions
  • if the patient wishes to have their prescription dispensed in Scotland, Wales or Northern Ireland
  • if, in the professional judgement of the prescriber, the welfare of the patient is likely to be in jeopardy unless a paper prescription is issued

Check your system supplier guidance for how to revert a prescription to FP10 if required.

Split prescriptions

Prescriptions that have a mixture of EPS and non-EPS compliant items will ‘split’

  • compliant items will be sent using EPS
  • non-compliant items will be printed on an FP10 paper prescription.  

The prescription messaging functionality can be used to alert a dispenser that there is an FP10 paper prescription in addition to the EPS prescription.  

A process needs to be in place for collection of the FP10.

Signing prescriptions

Prescriptions raised by prescribers will be digitally signed using their smartcard PIN and sent according to the patient’s nomination status.

Prescriptions raised by admin or a non-signing clinician will be sent to the EPS signing queue which will be accessed by the signing clinicians and signed digitally.  Check the system guidance for signing electronic prescriptions.   

Please consider-

  • Process to alert signing clinicians of urgent prescriptions in the EPS signing queue that need an immediate signature.
  • For non-nominated prescriptions, tokens will print after the prescription is signed. Consider when and where these tokens should print and refer to your system supplier guidance. 
  • How to advise the patient of their NHS number if the patient is unable to collect their EPS P4 token.  

Post-dating prescriptions

If post-dating an EPS prescription, please consider:

  • EPS prescriptions are not released to spine until post date is reached
  • prescriptions will not be visible on the EPS Tracker until it is released to the spine
  • an EPS Phase 4 token will print for non-nominated prescriptions with the intended dispense date showing in the ‘Date of issue’ box. This should be given to the patient if present or able to collect.

Electronic repeat dispensing

Electronic repeat dispensing (eRD) allows the prescriber to authorise and issue a batch of prescriptions with just one digital signature.  Learn more about more about eRD for prescribers

Pharmacy stock shortages

If a pharmacy does not have an item in stock, they can return the prescription to the spine and the patient can go to another pharmacy to get that item dispensed. This process should not need to involve the prescribing organisation unless the stock shortage affects multiple sites in the area and there is a need to prescribe an alternative medicine.

EPS prescription tracker

The Electronic Prescription Service (EPS) Prescription Tracker allows staff working at prescribing and dispensing sites to check the status of an EPS prescription.

Cancellation

The prescribing organisation can cancel the whole electronic prescription or individual item(s) on the prescription at any point until it's dispensed to the patient. A reason for cancellation is requested and then a cancellation message is sent to the Electronic Prescription Service. 

The success of cancellation and action to be taken to cancel depends on the status of the prescription.  Feedback will be received in the prescribing system to advise whether or not the cancellation was successful.

Ensure the correct people have access rights to cancel prescriptions assigned to their smartcards, and that cancellation responses are reviewed and actioned appropriately.  Check your system supplier guidance

EPS Trackers Prescription Status Cancellation Success Message from spine to Prescriber Action required 
To Be Dispensed (Prescription on Spine) Yes Prescription has been successfully cancelled

None.

Prescription is cancelled
With Dispenser (Prescription has been downloaded) No Cancellation Rejection – With Dispenser -Take manual means to cancel

Phone pharmacy to request they return prescription to the spine  

Prescription will then be cancelled
Dispensed (Patient has collected prescription) No Cancellation Rejection – Dispensed

If appropriate contact patient and/or pharmacy to advise of change

Prescription will not be cancelled

Claimed No Cancellation Rejection – Dispensed

If appropriate contact patient and/or pharmacy to advise of change

Prescription will not be cancelled

 

 

Resources for download

Poster to display
Digital display/TV screen artwork

If you have a digital screen in your waiting area, you may also wish to display a digital version of the poster.

Most prescriptions version 
 

Social media images

If you have a social media account for your service, you may wish to use the images below.

Version one 
Version two 

EPS in other care settings checklist

If you require further support or guidance, after reviewing these and your system supplier’s resources, please contact EPSsupport@nhs.net.

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Last edited: 7 September 2020 7:48 am