Non-nominated prescription information for GP practices

Benefits for prescribers include:

• almost all prescriptions will be processed and signed electronically - in most cases, over 98% of your prescriptions will be processed this way and only a small proportion will be hand-signed
• one main process for prescriptions will lead to a more efficient, faster and secure service
• if a patient without a nomination loses their token, it can be easily reprinted - there is no need to re-issue the electronic prescription
• it is also possible to track more prescriptions using the EPS Prescription Tracker

Millions of patients already have a nomination. Their nomination will remain valid and their prescriptions will still be sent electronically to their nominated dispenser.

If a patient does not have a nomination, their prescription can still be sent electronically. You may need to print a token which should be given to the patient, the patient’s representative or their prescription collection service.

The token contains a unique barcode and you should advise patients to take it to a pharmacy or Dispensing Appliance Contractor (DAC) of their choice in England. The electronic prescription will remain on the NHS Spine until dispensing staff scan the token to retrieve it and begin the dispensing process.

Alternatively, if the patient uses the NHS App, they may present the dispenser with the unique EPS barcode via the NHS App. This can be scanned in the same way as the barcode on a token. Note - this NHS App functionality is being introduced gradually. Not everyone will be able to access it straightaway.

For more information see 'Request or view prescriptions' on the NHS website.

Non-nominated prescriptions are not affected if a patient sets or changes an EPS nomination after they have been issued.

Patients without an EPS nomination will automatically have their prescriptions sent electronically.

Patients with a nomination may also choose to have a non-nominated prescription if they don’t wish to use their nomination for that prescription. 

A token (patients may refer to this as a ‘paper copy’) may be printed for all non-nominated prescriptions, unless the patient is able to view the prescription.

Tokens contain the same information as paper and EPS prescriptions such as the medications prescribed, quantity, dosage and instructions. However, as this is not the legal prescription, you do not sign this by hand.

The token is used by the dispenser, such as a community pharmacy or DAC, to scan the barcode to retrieve the prescription from the NHS Spine.

In exceptional circumstances, where it is not possible for the patient to collect a token – see guidance for using EPS in remote consultations. It will not be necessary to give patients tokens if they have the NHS App and are able to view their prescription unique barcode in it, as they can present this barcode to the dispenser of their choice.

Repeat dispensing (batch prescribing) 

With non-nominated eRD, prescriptions for patients are issued in the same way as eRD for those with a nomination. Specific guidance on how to cancel items on eRD prescriptions is available from your prescribing system supplier.

Patients without a nomination may be provided with a prescribing token that will cover the entire repeat dispensing batch. They can present this to a dispenser for each issue. Alternatively, patients may present the dispenser with the unique EPS barcode via the NHS App. This can be scanned in the same way as the barcode on a token.

Dispensers have access to the EPS Prescription Tracker and can use this to check the dispensing intervals of any previous issues and that these are appropriate for the prescribed dose and quantity. Patients can also speak to their local pharmacy or DAC about leaving their token with them if they would like them to dispense future issues in the batch.

If an eRD regime has been issued whilst a patient does not have a nomination, then all issues will remain non-nominated, even if a nomination is set during the regime. 

If a prescription is not able to be sent via EPS, please check:

1. Is the patient’s record synchronised to the PDS?
2. Is an item marked ‘personally administered’ (PA)? To send the item via EPS, remove the tick from the PA box.
3. 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. For more information about the dm+d and to access the dm+d browser to check how a product is represented see dm+d and prescribing systems information for prescribers.
4. Does the patient have an exception code in their record which is no longer relevant? An exception code may have been applied for a patient who is a dispensing patient and there is no EPS system available in the dispensary, or if the patient has their prescriptions dispensed in Scotland, Wales or Northern Ireland.
5. Is the user logged in with appropriate smartcard rights, and is the prescribing system configured correctly to enable users to generate and sign EPS prescriptions according to their roles?

There are only a few scenarios where a prescription won’t be sent electronically and a paper hand-signed prescription will need to be produced, such as:

• private prescriptions
• instalment dispensed CD (FP10MDA) prescriptions
• if the patient's details are not synchronised with the PDS, or if the patient is marked as sensitive within the PDS
• if the patient is a dispensing patient and there is no EPS system available in the dispensary
• if the patient has their prescriptions 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. 

Dispensing practices

If you are a dispensing practice and do not use EPS in your dispensary, you may need to check your system configuration to ensure your dispensing patients continue to receive FP10s that you are able to dispense. Guidance is available from your system supplier.

Exception codes and further guidance

The following exception codes will prevent EPS being used for a patient, meaning all prescriptions for that patient will need to be hand-signed. 

Cross-border – if a patient regularly uses a pharmacy outside of England, the following code can be added to ensure all their prescriptions will be issued as FP10.

Dispensing patient – if you are a dispensing practice and your dispensary does not yet use EPS, your GP system supplier will advise how prescriptions for dispensing patients are issued in non-nominated prescriptions. You may not need to use this code as your system may manage this differently.

 All practices should check for these codes when receiving GP2GP records for newly registered patients. If an exception is no longer applicable, add the retraction code to enable EPS. See your system supplier’s guidance for how to manage these codes.

The practice will need to consider processes for printing non-nominated prescription tokens, for example how your printers are routed and where the paper tokens are printed.

Printer guidance specific to your prescribing system is available from your system supplier.

When printing a non-nominated prescription token it must be of an appropriate quality to ensure pharmacies can scan the barcode to retrieve the prescription from the NHS Spine.

As data controllers, it is important that you signpost patients to where they can find further information about EPS if they wish to. We have provided posters and other resources to help you with this.