The Pharmaceutical Journal
Vol 272 No 7304 p755
19 June 2004

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Hospital electronic prescribing brought forward

Electronic prescribing in hospitals in England looks set to start in 2006, two years earlier than planned, in a bid to reduce variation in drug usage across secondary care, which is partly caused by a lack of specialist pharmacists in hospitals.

The move was announced last week by health minister Lord Warner following publication of a report into the uptake of cancer drugs approved for use by the National Institute for Clinical Excellence.

The report, by Mike Richards, the Department of Health’s national cancer director, suggests that implementation of NICE guidance on cancer drugs is not uniform across cancer networks in England. “There are some networks that appear to be high users of most NICE-approved drugs and some others that are consistently at the lower end of usage for these drugs,” the report states. Cancer networks that appear to be slow on the uptake include Arden, Derby and Burton, North Trent and South Essex.

Professor Richards said that a shortage of specialist pharmacists was a factor in the variation seen in the use of cancer drugs across England. “Several networks expressed problems with capacity to deliver the drugs.” This included a lack of suitable space to prepare or administer toxic drugs and shortages of specialist pharmacists, nurses or doctors.

Tim Root, London specialist pharmacist, clinical governance and technical services, London Specialist Pharmacy Services, and a member of the report’s clinical reference group, echoed these concerns: “Capacity, especially workforce, issues are now probably the most significant constraint on our use of chemotherapy. The lack of experienced oncology pharmacists reflects the overall national shortage.” To address capacity issues Professor Richards recommends that NICE should examine non-drug costs in its guidance and provide an “implementation tool-kit”. Another recommendation is that there should be mechanisms in place to allow for prospective audit and feedback on usage of drugs. “To make this possible it is essential for electronic prescribing systems to be installed in every hospital providing a chemotherapy service.”

The Government has accepted Professor Richards’s recommendations and proposes to bring forward electronic prescribing in secondary care. “The intention is to deliver this part of the programme in 2006, rather than in 2008—10 as on current plans,” a statement issued by the DoH says.

Mr Root welcomed the proposal. “It is excellent news that electronic prescribing has moved up the priority list.” However, he warned that software development and implementation was a major challenge.