Nominating a dispenser

Patients can choose a pharmacy for their electronic prescriptions to be sent to. This is called a nomination.

Primary care patients who receive regular prescriptions and use the same pharmacy most of the time will see the most benefit, but nomination is suitable for almost all patients.

When prescribing, there will be the option to choose a community pharmacy that is listed in the Directory of Services (DoS). Pharmacies can be searched by location and opening times to find one suitable for the patient.

Some patients use a dispensing appliance contractor (DAC) for some of their items, so can also set a DAC nomination.

Patients registered with a dispensing practice who are eligible to use the practice dispensary may also be able to nominate the dispensary (this is only possible if the practice uses EPS in their dispensary).

Once a patient has nominated a dispenser, this preference will be stored (on the NHS Spine) until the patient chooses to change or remove their nomination.

Electronic prescribing in secondary care is an exception – this utilises a ‘one-off nomination’ to enable an electronic prescription to be sent. The same pharmacy can be used within secondary care EPS but must be searched for and applied for each prescription issue.

GP practices, secondary care providers, pharmacies or dispensers can talk to a patient about nomination and record their choice.  

All staff involved in prescribing or dispensing processes (including delivery drivers) should know about EPS and should be able to explain nomination to patients.  

Patients must be informed and give their consent before a nomination is recorded. The consent doesn't have to be in writing, but you do need to have an auditable process.

The patient's nomination should be recorded promptly in the pharmacy's patient medication record (PMR) system or prescribing system, and it is then updated on the NHS Spine. 

Some patients may be able to set their own pharmacy nomination via the NHS App or other patient facing services. 

Once updated, the nomination will be visible to both the patient's GP practice and their pharmacy. The patient’s prescriptions will then be sent via EPS to their nominated pharmacy, unless they request otherwise.

The nomination applied to EPS prescriptions in secondary care will not change or modify the patient’s primary care nomination, nor does it permanently record a patient’s nomination. It could, however, be added to the patient record in the electronic prescribing and medicines administration (ePMA) system. We advise that this is confirmed with the patient or their representative for each prescribing issue. 

Any procedures to capture and store patient nominations locally must be governed and assured by the organisation. 

Nominations should only be changed or removed at the request of the patient.  A patient can choose to change their nomination at any time.

Prescribing and dispensing staff should be aware that changes of nomination will affect future prescriptions, as well as any nominated EPS prescriptions on the spine that haven’t yet been downloaded by a pharmacy, or have previously been returned to spine by a pharmacy (that is - with status ‘To be dispensed’ on the EPS Prescription Tracker). This applies to acute, repeat, and repeat dispensing prescriptions. 

Post-dated prescriptions: A change to the patient’s regular nomination made after a post-dated prescription was issued (but before its effective date is reached) may not be applied to that prescription – the prescription will carry the nomination which was in place when it was signed.

Non-nominated prescriptions are not affected by nomination changes. 

The EPS Prescription Tracker can be used by GP practices and pharmacies to check the status and location of any EPS prescription by searching for a particular prescription ID, or using the patient's NHS number.

There are some occasions when a patient may not want a prescription to be sent to their usual nominated pharmacy. For example, a weekend or evening consultation when the patient’s nominated pharmacy will be closed and they cannot wait for the pharmacy to open in order to receive their medication, or a telephone consultation when the patient is away from home.

During a face to face consultation it may be preferable to issue the prescription as a non-nominated or paper FP10 prescription that the patient can take to the pharmacy of their choice.

If the patient is not present, they may ask for a prescription to be sent to a different pharmacy; options for this are set out below.  

If one-off nomination functionality is available within the prescribing system, use this to override the patient’s regular nominated pharmacy for a single prescription.

At the point of prescribing, there will be the option to choose a one-off nomination for a community pharmacy listed in the Directory of Services (DOS), with their opening times displayed.

EPS users in secondary can only create a ‘one-off nomination’ to enable a prescription to be sent electronically. This requires the patient nomination to be applied for each individual prescription. Patient agreement to the nomination applied should be sought on each occasion.

Each electronic prescriptions issued by secondary care will have an individual nominated pharmacy associated with it. This cannot be edited or changed post signing.

If a patient refuses to nominate a pharmacy, then they must understand that the EPS cannot be used and a paper FP10 must be issued.

If a patient does not have the capacity to nominate, their appropriate representative would be able to nominate on their behalf.

A patient can only nominate a single pharmacy. This can be changed, if required, for each individual prescription issue. 

The one-off nomination will not affect future primary care prescriptions; they will continue to be sent to the patient’s regular nominated pharmacy, but the one-off prescription would be affected if the regular nomination is changed before it has been downloaded by the one-off pharmacy. For this reason, it is not recommended to use one-off nomination for electronic repeat dispensing (eRD) prescriptions.

If one-off nomination functionality is not available within the prescribing system, and the patient wishes to make a ‘temporary’ change of nomination, it is important to advise the patient that: 

1. The change of nomination will apply to future prescriptions and may also affect any that they have not yet collected from their pharmacy.
2. Once they have received their medication from the ‘temporary’ pharmacy, they should ask the pharmacy to change their nomination back to their usual pharmacy. Alternatively, they can contact the practice or their usual pharmacy when they wish to re-set their nomination.

If the prescriber or practice change the nomination back, or remove it, too soon, i.e. before the intended pharmacy has downloaded the prescription - then that pharmacy will not receive the prescription in their routine download. It is much better to use a one-off nomination where possible, rather than making 'temporary' nomination switches.