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Phase 4 information for GP practices

In EPS Phase 4, patients without a nomination will be given an EPS token (patients may refer to these as ‘paper copies’ of their prescription) at the GP practice. This will be given to the patient (or their representative) or collected as part of a prescription collection service. Patients can take these tokens to any pharmacy in England.

This information is for GP practices preparing for EPS Phase 4. 

Your CCG will contact you when they are ready to arrange your Phase 4 switch on date. For more information about the roll out please see the national roll out schedule page.

Ahead of Phase 4 being switched on, you should complete the site readiness checklist. You also need to make sure your team has read and understood the information on this page.

Your system supplier can provide information specific to your prescribing system.

Benefits for prescribers

Benefits for prescribers include:

  • almost all prescriptions will be processed and signed electronically - in most cases, over 95% 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

Patients who already have a nomination

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

Patients who do not have a nomination

If a patient does not have a nomination, their prescription will also be sent electronically in Phase 4. You will need to print a token and this must be given to the patient, the patient’s representative or their prescription collection service.Tokens do not need a signature because the prescription is signed electronically.

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.

EPS Phase 4 prescriptions are not affected if a patient sets or changes an EPS nomination after they have been issued. The token is still required for a dispenser to retrieve the prescription. 

Phase 4 prescriptions and tokens

Patients without an EPS nomination will automatically have their prescriptions sent electronically. Patients with a nomination may also choose to have a Phase 4 prescription if they don’t wish to use their nomination for that prescription. 

A token (patients may refer to this as a ‘paper copy’) must be printed for all Phase 4 prescriptions, even if you are prescribing remotely. 

Tokens contain the same information as an FP10 such as the medications prescribed, quantity, dosage and instructions. However, as this is not the legal prescription, you do not need to sign this by hand.

Without a Phase 4 token, patients won’t be able to get their medication as the barcode needs to be scanned by the dispenser, such as a community pharmacy or DAC, to retrieve the prescription from the NHS Spine. 

Acute and repeat prescriptions 

Acute prescriptions and repeats, where each is issued separately (not repeat dispensing) for patients without a nomination, require the patient be given a token each time a prescription is issued.


Repeat Dispensing (RD) or batch prescribing 

Electronic repeat dispensing (eRD) for patients with a nomination will not be affected by Phase 4.

If a patient is part way through a paper-based RD regime when Phase 4 is switched on, that batch will continue on paper until it is complete and the final issue dispensed. If a new batch is prescribed after this, it will be issued using eRD.

In Phase 4, eRD prescriptions for patients without a nomination are issued in the same way as eRD for those with a nomination. Guidance on how to cancel items on eRD prescriptions is available from your prescribing system supplier.

Unlike a paper-based RD batch, patients without a nomination will receive one token which will cover the entire regime. They will need to present this to a dispenser at each issue.
Dispensers have access to the EPS Prescription Tracker and can use this to check the dispensing intervals of any previous issue and that these are appropriate for the prescribed dose and quantity. Patients can also speak to their local pharmacy or DAC about leaving this 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. 

Exceptions

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:

  • if the prescription contains items that are not EPS compliant, such as non dm+d items and personally administered items
  • 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.

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.  

SNOMED CT  Description
1034851000000105   Electronic Prescription Service exception - cross-border patient 

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 Phase 4.  You may not need to use this code as your system may manage this differently.

SNOMED CT  Description
1034941000000103   Electronic Prescription Service exception - dispensing general practice not yet EPS compliant.

 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.

SNOMED CT Description
1060681000000104   Electronic Prescription Service exception retraction

   

Existing paper prescriptions

All existing paper prescriptions that have not been dispensed will still be valid until their normal expiry date. These prescriptions do not need to be reissued electronically.

Remote prescribing

If you are prescribing remotely and the patient does not currently have an EPS nomination, you may wish to suggest that nomination may be suitable for them. This will allow you to send the prescription directly to their nominated dispenser.

If nomination is not suitable for the patient and they are present (such as during a home visit), you should hand write an FP10 and give it to the patient.

If the patient is not present, you should process the prescription electronically and ask someone at the practice to print out the token ready for collection. 

Printer set up

Your practice will need to consider your processes for printing and how you will sort and file paper tokens. You may want to re-consider how your printers are routed and where paper tokens for patients without a nomination are printed.

For example, it may be better for some tokens to be printed in a consultation room and other tokens to be printed in the reception area.

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

Token printing quality

The quality of printing on a Phase 4 token must be of an appropriate quality to ensure pharmacies can scan the barcode to retrieve the prescription from the NHS Spine. To avoid delays in dispensing a patient’s prescription, pharmacies can use the 18-digit Prescription ID to download the prescription manually. However, this is a time-consuming process and should be avoided.

Problem resolution

If you encounter any issues with your prescribing system following Phase 4 switch-on, a query should be raised according to your existing process for other EPS-related issues with your supplier.

If you encounter any business process issues, you should first raise them with your CCG.

Communication resources

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.

Template information for your website

We are upgrading to the next phase of the Electronic Prescription Service (EPS) which will mean that almost all our prescriptions will be processed electronically from [go live date]

Electronic prescriptions help save the NHS money.

You will receive your prescriptions in the same way as you do now.

Read more about EPS on the NHS website.
 

Poster to display in your practice

You will receive a printed copy of the poster from your CCG ahead of national roll-out but may also wish to print additional copies.

‘Most prescriptions’ version

With crop marks (for professional printing) 
Without crop marks (for printing on an office printer) 

‘Many prescriptions’ version (for practices with many patients who choose to have their prescriptions dispensed in Scotland, Wales or Northern Ireland)

With crop marks (for professional printing) 
Without crop marks (for printing on an office printer)

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 
Many prescriptions version (for practices with many patients who choose to have their prescriptions dispensed in Scotland, Wales or Northern Ireland)

Social media images

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

Version one 
Version two 

Template letter/email to send to local pharmacies

Electronic Prescription Service (EPS) Phase 4 

From [go live date], [Practice name] will have EPS Phase 4 switched on. This means that patients without an EPS nomination will have their prescriptions signed and sent electronically. 

Patients will be given a Phase 4 token with a scannable barcode instead of a signed FP10. The legal prescription is always the electronic prescription. You should scan the token to retrieve the prescription from the NHS Spine and ensure it is still valid. You should not dispense from the token alone.

If you have difficulty scanning the token, please contact us.

For more information about Phase 4 of the Electronic Prescription Service (EPS), visit www.digital.nhs.uk/eps

We look forward to working with you on this new development. Thank you.
[Practice name]

Download a printable Word document version

Last edited: 27 February 2020 4:29 pm