The future of the Electronic Prescription Service

Learn more about the future of the EPS, and what this will mean for prescribers and dispensers.

The Electronic Prescription Service (EPS) currently enables prescribers to send prescriptions electronically to a dispenser of the patient's choice - known as their 'nominated' dispenser. Electronic prescriptions currently account for around 40% of all prescriptions issued in England.

In the future, EPS Phase 4 will become the default option for the prescribing, dispensing and reimbursement of prescriptions in primary care in England. Paper prescriptions will continue to be available for special circumstances, but the vast majority of prescriptions will be processed electronically.

All patients will be offered a 'token' to present at a pharmacy to obtain their medication. This token will contain a unique barcode which can be scanned at any pharmacy to retrieve the medication details.

It's expected that Phase 4 will increase the proportion of prescriptions sent electronically to around 90%. Some prescriptions may remain unsuitable for transmission by EPS, such as when there are constraints regarding the prescribed drug. Further developments will look to address these restrictions and maximise EPS volumes. 

NHS Digital will initially pilot Phase 4 at a small number of GP practices across England. The main change will be that patients at these pilot sites who haven't got an EPS nomination will automatically receive electronic prescriptions and will be given a paper token. Pharmacy staff will be required to scan the barcode on the token in order to download the prescription from the NHS Spine.

Nothing will change for patients who already have a nomination and new nominations should continue to be set at GP practices and pharmacies.

What EPS Phase 4 means for GP practices

Initially, practices not taking part in the pilot will not be affected. GP practices involved in the pilot will receive support from the EPS team at NHS Digital. Details of the practices taking part will be published on this website.

What EPS Phase 4 means for dispensers

Patients at the GP practice pilot sites who haven't got a nomination will be given a paper token by their GP practice (patients may refer to these as paper copies of their prescription). They will be able to take these tokens to any pharmacy in England.

During the pilot stage, all pharmacies will need to be ready and know what to do if a patient presents a paper token from one of the pilot GP sites. NHS Digital will work closely with the pharmacies most affected by the Phase 4 pilot, ensuring lessons are learnt and taken on board in order to inform the national implementation plans. 

As with all EPS prescriptions, dispensers will need to endorse the electronic prescription through their pharmacy system. Endorsements written or printed onto any type of EPS token will not be processed by the NHS Business Services Authority (NHS BSA). 

National implementation of Phase 4

If the pilot is successful, we'll need to gain approval to start the rollout of EPS Phase 4 nationally. A move to Phase 4 will significantly increase the volume of electronic prescriptions and it's vital that all elements of the service are robust.

Controlled Drugs update

GP practices will soon be able to send Schedule 2 and 3 Controlled Drugs (CDs) electronically using the Electronic Prescription Service (EPS). This will include all Schedule 2 and 3 CDs, except for instalment FP10MDA prescriptions.

A few GP surgeries in the north-west and London using the Vision system will soon be able to use EPS to prescribe CDs in the same way as they can prescribe all other items. Other practices will follow.

As a patient can nominate any pharmacy in England, all dispensers must to be aware that they could receive an electronic prescription for a CD and that they can dispense it in the same way as any other EPS prescription.

A letter with more information has been sent to all pharmacies with the NHS BSA September mail out.

Standard Operating Procedures (SOPs) may need to be amended to reflect that Schedule 2 and 3 CDs could be prescribed by EPS as well as by FP10. There will be no changes to the process of Instalment Dispensing on paper FP10MDA forms.

The key changes to consider are:

  1. CDs and non-CDs could arrive on the same EPS script - any processes that rely on CDs being handled in isolation may need to be changed.
  2. The CD quantity in words and figures will appear in the "additional instructions" field of the prescription, written ahead of any other instructions from the prescriber. Extra care should be taken to check for the CD quantity and any additional messages during the dispensing process.
  3. A method of "marking" the prescription "at the time of supply" should be decided to ensure compliance with the Misuse of Drug Regulations. The dispense notification is suitable for this, but depending on local system configuration another patient medication record (PMR) process that records a date and leaves an electronic audit trail may be more suitable. Physically marking the EPS dispensing token (FP10DT) is not a suitable method as it is not the legal prescription.
  4. Best practice guidance to capture the details of the person collecting the CD prescription remains in place - an EPS dispensing token (FP10DT) should be used for this purpose. Guidance on the storage of signed FP10DT for CDs will be available shortly.