Good communication between GP practices and your pharmacy is essential to ensure smooth transition to EPS Release 2.

Communication

• Identify named contacts at your local GP practices and establish an EPS lead within your pharmacy team who will deal with any queries and communication regarding EPS prescriptions.
• During the early stages consider setting up a weekly review meeting between the pharmacy and local practices; experience suggests that a 10 minute review session will suffice. Ideally this would be face to face; however a telephone call may also be considered. The main aim of your interaction is to discuss any potential problems and iron out issues regularly to ensure your transition runs as smoothly as possible. Of course, there will ultimately be more than one GP practice to engage with, therefore, time management of these review sessions is of high importance.
• We have developed an SOP which will help you with workflow relating specifically to EPS2. GPs will usually have their own processes to follow.  Some of our members have elected to share their SOPs and workflow process and have face to face sessions to work through each step.  This have proven to significantly help the implementation process.
• Consider enlisting the help of LPCs and LMCs to help facilitate dialogue, e.g. arranging an event for GP practices and pharmacies in the locality to meet jointly.

Preparing to launch

• Using EPS Release 1 helps smooth the implementation of EPS Release 2. Getting pharmacy staff used to scanning prescriptions and therefore populating the PMR record with NHS numbers, does make the process of registering EPS Release 2 nominations much easier. It also provides an opportunity to pick up any operational issues, such as codes that don’t scan for example.
• We strongly recommend that you get on with the nomination process as soon as possible as it does involve a significant amount of work, not only talking with patients, but registering the patients onto the NHS spine.
• You should also consider setting up refresher sessions with your pharmacy team along the way to remind them of the process and workflow regarding EPS. 
• The key thing for you is to ensure that you have captured your patients early on to ensure you beat the competition and importantly that you are able to manage should your local GP be given to the go ahead at short notice.

Split prescriptions

Controlled drugs in Schedule 1, 2 or 3 of the Misuse of Drug Regulations cannot be issued as electronic prescriptions. Experience from users suggests that GPs may need to work in conjunction with the pharmacy to identify patients in this group. Nomination may not be the best option for these patients.

Post-dated prescriptions

You should find out whether your local GP practices plan to post-date prescriptions. Post-dated prescriptions will be held on the GP systems and only sent to the NHS spine on that specified date, this has caused confusion with some sites.

An alternative to post-dated prescriptions is to use the repeat dispensing functionality which will allow the pharmacy to access the prescription in advance of the due date.

Prescription tokens

Does the GP practice plan to issue printed prescription tokens for acute prescriptions? In some cases acute prescriptions haven’t been downloaded at the pharmacy by the time the patient arrives there.

Depending on how local processes have been set up at the pharmacy and GP practice, providing a prescription token for acutes may speed up access to the prescription message.

Repeat prescription collection services

Will you plan on the continuation of a repeat prescription collection service following the introduction of EPS Release 2? In most cases, these services will continue as there will still be non-electronic prescriptions in the system for example for controlled drugs.

Repeat prescription order

Patients will still need to be presented with a repeat medication request form which is currently printed alongside the green FP10.

With EPS Release 2, the printing of these forms will move to the pharmacy, PMR systems set up to process EPS Release 2 prescriptions will be configured to print the prescription and associated medication request form.

Communicating supplementary clinical information to patients

Any clinical information normally printed on the right hand side of the green FP10 will also be provided in the electronic message to be printed locally at the pharmacy, as per the repeat medication request. 

As per the manual prescription process, these messages need to be delivered to the patients. Any messages the GP wishes to communicate with the pharmacy team will also be sent via this method also.  

Re-issue of prescriptions where amendments are required

If there is an error or omission on a paper NHS prescription, pharmacies will normally send back the paper prescriptions to the GP practice for manual amendment to be made by the prescriber. An NHS electronic prescription cannot be amended once it has been sent to the spine.

If amendment is required, the prescriber needs to cancel the prescription and regenerate it in an amended form.  You should talk to your practice to understand how requests for amendments should be sent and how they will action the request, you can then jointly establish a process.

Dosage instructions

There is currently no standard dosage syntax. Dosage information in the electronic prescription is stored using “free text” /text strings. A key benefit of EPS for pharmacies is that the dosage information in the electronic message can be used to pre-populate the medicine label, supporting a more efficient dispensing process.

In some cases there is not a direct transcription of the GP dosages through to the pharmacy PMR system, how this process works should be talked through with the GP as rekeying dosage information can be quite time consuming. Ideally dosage information should be in English and ideally in a form of words that can be passed directly on to the patient.

Making the most of EPS Release 2

Repeat dispensing has the potential to offer significant benefits to GPs, pharmacies and patients, improving accuracy, operational efficiencies and workflow processes.

Where repeat dispensing is not already used, there is potential to discuss how this can be rolled out in conjunction with the implementation of EPS Release 2.

Business continuity

• If there is a problem identified at the GP practice or pharmacy, you should ensure that you agree contact names on both sides.
• There have been some cases where a patient has visited a pharmacy that has been unable to locate their prescription.  In some cases this has been due to inadequate staff training; however there have been situations where the issue has been escalated back to the GP practice.  We have developed a process for this which you can find in the workflow SOP on NumarkNet.
• In cases where the electronic prescription cannot be sent or received, you should understand how this process is managed.  In some cases this has been handled by an emergency supply and reconciled later when the system is back online. The other option is to revert back to paper until the issue is resolved. Again, the process needs to be agreed between the GP practice and pharmacy.

Managing expectation with patients

There will be teething problems following the initial implementation of EPS Release 2. It is important to encourage good two way communication with patients about the changes.