Electronic prescriptions for prescribers

Prescriptions are processed more efficiently

• sign individual or multiple prescriptions electronically, there is no need to sign by hand
• during face-to-face, telephone or video consultations, prescriptions can be sent to the patient's nominated pharmacy, reducing footfall in the practice as patients collect their prescription from the pharmacy instead
• no need to post prescriptions, saving time and removing the risk of prescriptions getting lost in the post
• replacement prescriptions no longer need to be faxed

Spend less time dealing with prescriptions

• standardised prescription information reduces the number of queries from dispensers
• improved prescription accuracy reduces the chances of patients receiving the wrong medication
• electronic prescriptions can't be lost, reducing the risk of duplicate prescriptions being created
• no need to prepare and sort prescriptions ready for pharmacies to collect
• less chance of prescriptions going to the wrong dispenser 
• suitable patients can be moved on to electronic repeat dispensing, reducing time spent issuing and re-authorising prescriptions

Have greater control over prescriptions

• prescriptions can be cancelled at any time until they have been dispensed, and replacements can be sent electronically

Case studies

Case study - Dr John Hampson

Here are some resources to help you get the most out of using the Electronic Prescription Service.

NHS Dictionary of Medicines and Devices and prescribing systems

The NHS Dictionary of Medicines and Devices (dm+d) provides a standardised reference for medicines and medical devices for use by different clinical systems. 

Read more about dm+d and prescribing systems to find out about some of the common issues when using EPS.

Nominations

With electronic prescriptions, patients can choose where their prescriber will electronically send their prescriptions to. This is called nomination. 

• patients choose which pharmacy they wish to nominate, and this can be changed or removed at any time at the patient's request
• patients must be fully informed about EPS before their nomination can be set on the system 
• changes to a patient's nominated pharmacy can only be made at the patient's request
• nomination is suitable for most patients. Patients on regular repeats and who use the same pharmacy most of the time will see the most benefit

Read more about nomination

Using EPS for patients with both a pharmacy and appliance contractor nomination

Patients who use a Dispensing Appliance Contractor (DAC) for some of their items can set a DAC nomination, as well as their pharmacy nomination.

The contracts for pharmacies and DACs set out which prescription items they are permitted to dispense, nominated prescriptions should only be sent to them for appropriate items. These are as follows:

Community pharmacies and distance selling pharmacies (DSPs), are required to dispense any item, including appliances (if the pharmacy supplies the products in the normal course of their business).

Dispensing Appliance Contractors (DACs) are only permitted to dispense certain items, listed in relevant parts of the Drug Tariff:

• Appliances – as listed in Part IXA
• Incontinence appliances – as listed in Part IXB
• Stoma appliances – as listed in Part IXC

A DAC cannot dispense any medicines, ACBS foods and toilet preparations (as listed in Part XV), or chemical reagents (as listed in Part IXR).  These items should not be sent to a DAC nomination.

When sending a nominated EPS prescription, most items would normally be sent to the patient’s pharmacy nomination.   Prescribing users should check with the patient to ensure that items are sent to the correct nominated dispenser and make sure that only specific items, as set out above, are sent to a DAC nomination.

Generating and signing electronic prescriptions

Prescribers working in a GP practice can apply electronic signatures to prescriptions. These are unique to individual prescribers and applied using the user's smartcard and passcode.

Read more about generating and signing an electronic prescription.

Electronic repeat dispensing (eRD)

Find out about electronic repeat dispensing and how you could benefit from using it.

Read more about electronic repeat dispensing (eRD)

Cancelling electronic prescriptions

You 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.  

It's the responsibility of the person cancelling to ensure the patient is informed. Dispensers are notified of cancellations when they attempt to retrieve the electronic prescription. 

Read more about cancelling an electronic prescription as a prescriber.

Prescribing and dispensing tokens

Paper copies of electronic prescriptions will always need to be made available by the GP practice or the pharmacy, where necessary. Paper copies of electronic prescriptions are called 'tokens'. They act as a hard copy of the details contained within the electronic prescription. 

There are two types of token; prescription and dispensing. Read more about prescription and dispensing tokens.

Smartcards

Smartcards and access control are secure measures by which clinical and personal information is accessed by only those that have a valid reason to do so. You will need a smartcard to use electronic prescriptions.

Local Registration Authorities (RA) assign pre-approved pharmacy roles to smartcards and assign them to the relevant pharmacy, or multiple pharmacies, by applying the relevant Pharmacy Organisation code(s). 

Smartcards are uniquely attributed to individuals and shouldn't be shared with anyone, nor should the individual divulge their unique passcode to anyone.

General guidance for Smartcard users contains information on the following subjects: 

• smartcard Registration Authorities (RAs)
• smartcard roles in pharmacy
• Care Identity Service (CIS) - the online tool for smartcard management

Key Smartcard activities provides information on the following subjects:

• upgrading from EPS Release 1 to Release 2
• getting a smartcard
• updating passcode/contact details
• updating smartcard roles
• unlocking a smartcard
• renewing a smartcard certificate
• cancelling a smartcard or changing site

Download a leaflet for new smartcard users.

Find out more about Registration Authorities and Smartcards.

Temporary Access Cards

Temporary Access Cards (TACs) are temporary smartcards to be used if your personal smartcard is lost, stolen or damaged.

We're aware of the business continuity risks associated with lost or stolen smartcards, so we've issued guidance to local Registration Authorities (RA) on issuing locked Temporary Access Cards (TACs) to pharmacies that consider themselves at risk.

If you're a lone pharmacist working without support staff, you should consider requesting a TAC from your RA.

They can be activated by the sponsor or local smartcard administrator in conjunction with the pharmacist who needs the card activating.

Normal smartcard processes will apply: 

• lost and stolen cards should be reported to your local RA team as soon as possible
• TACs should be stored securely
• the TAC should be returned to a locked state when the pharmacist no longer needs it

Business continuity

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To log a suspected safety incident, please read our clinical safety health IT related incidents guidance.

Bulletins

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Information for GP Practices and other services live with EPS migrating to a new clinical system

It is important that you consider the actions that you will need to take prior to and after system migration with regards to your patients' prescriptions, particularly if you issue post-dated (also known as future dated) or Electronic Repeat Dispensing (also known as Batch Prescribing or eRD) prescriptions. There are two main reasons for this:

1. Post-dated prescriptions (including post-dated Electronic Repeat Dispensing) can either be sent to spine from the system in advance and post-dated to become available on their due date, or they can be held in the system and only sent to spine on the due date. If they are sent on the due date any post-dated prescriptions not due before the outgoing system is disabled will NOT be sent to the spine, as such they will not be available for the nominated Pharmacy to dispense to the patient. Please talk to your outgoing supplier prior to migration to understand what actions you may need to take.
2. No EPS prescriptions, including Electronic Repeat Dispensing or post-dated prescriptions, issued from the old system can be cancelled in the new system once the practice has migrated. Whilst your clinical prescriptions data will be migrated to your new system, it is not yet possible for your system supplier to migrate the prescription’s spine details to the new system. As such, the new system will not have the ability to cancel those prescriptions. Therefore, the practice may choose to cancel prescriptions prior to migration, for example any eRD batches extending way beyond the system migration.

As a minimum we recommend that GP practices take the following actions:

• contact your old and new system suppliers to discuss how they can support you to mitigate the above risks. (They can provide reports on post-dated prescriptions and electronic repeat dispensing prescriptions)
• discuss the above risks with your practice and local prescribing leads.
• in the run-up to your migration consider producing paper post-dated prescriptions instead of electronic ones, and not issuing eRD batches to extend beyond the migration day.
• seek appropriate advice from your medical defence union and discuss any mitigations they suggest putting in place to minimise clinical risk. 
• you should ensure you are aware how EPS works in your new system and if your practice will need to adapt their prescription management processes.

What happens if the practice takes no action prior to system migration?

• patients that usually receive post-dated prescriptions may need new prescriptions generating to receive their medication
• any prescriptions that have been prescribed from the outgoing system (which cannot be cancelled) will remain available on the spine until the prescription expiry date. If there is a need to cancel, you would need to contact the patient’s nominated dispenser directly to ensure the prescription is marked as “not dispensed” to prevent the patient receiving the medication
• it should be noted that the original prescriber continues to have responsibility for any outstanding prescriptions and any clinical safety incidents that arise as a result of absent, duplicate or excessive medications