E-prescriptions — will customers pick you?

Patient involvement with the electronic prescription service (EPS) is currently small, but more pharmacy customers will be coming across the service over coming months, and when they do they will be asked to nominate the pharmacy they want their prescriptions to go to.

So how do you make sure they choose you?

Promotion

Patient engagement so far has mainly been via NHS Connecting for Health’s EPS patient and public user group. Now, the focus is switching to the wider NHS patient body, with a patient communication programme that will include posters and leaflets explaining the nomination process.

Pharmacy suppliers say that the first EPS release two (EPS2) systems could be on the market as early as June 2008. On the day pharmacies go live with EPS2 they will be provided with a sign displaying the new EPS participation symbol (right), which can be used for window displays, counter tops and notice boards.

This will help patients recognise pharmacies that they can nominate.

Using financial inducements to persuade patients to nominate your pharmacy is a breach of the National Health Service (Pharmaceutical Services) Regulations 2005, and pharmacies caught offering free gifts or loyalty card points to encourage patient nomination could find themselves the subject of primary care trust disciplinary action.

However, the EPS is a service so, just like other NHS services, it can be promoted. A quick refresher of the Royal Pharmaceutical Society’s standards for advertising medicines and professional services will tell you just how far you can go.
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Prakesh Mahtani, pharmacist proprietor at Warwick Pharmacy, London, has been involved with EPS since early release one trials, yet he thinks that his patients are actually none the wiser about it. He says: “To them it’s just a prescription with a barcode. They really don’t understand the difference.”

Mr Mahtani, however, remains positive about the potential benefits of the EPS for both pharmacists and patients, and for this reason will be sitting down with patients to talk them through the service. He says: “I have seen it work, and I know that patients’ reactions will be positive. But we will need to be proactive. Patients need to know what it is and how they will benefit.”

Gareth Jones, NHS liaison manager at the National Pharmacy Association, also recommends explaining to patients the benefits of the new system. For example, most pharmacies only operate prescription collection services from local GP surgeries, but EPS will allow patients to nominate any pharmacy convenient for them, for example, a pharmacy near their place of work.

As well as active resisters (see panel below), pharmacists also have the much larger group of passivists to consider. Kathy Bairstow, senior advice and information officer at Epilepsy Action, is also a member of NHS CfH’s EPS patient user group.

Interestingly, she says that most EA members have no strong feelings about the EPS. Since most patients are already taking advantage of prescription collection and delivery services, they won’t see any advantage, except, perhaps, that they will no longer be restricted to pharmacies located close to their GP practice.

Looking to the future

Patients are free to change their nominated pharmacy at any time, and long-term, it is expected that they will not need to nominate at all. For these reasons, experts are urging pharmacists to think beyond “selling” the EPS. Instead, they should concentrate on promoting their pharmacy services, either in general, or those specifically relating to the EPS, says independent IT consultant Geoff Mackay of Stirling Consultants.

Prescription collection services, in particular, are only a short step away from EPS nomination. Not only are they easier for patients to accept, they are also a way to attract and keep patients coming to your pharmacy long after the EPS is established and nomination is a thing of the past.

When to start

There has been a recent increase in uptake of EPS by pharmacies that are enabled to use it.

The latest figures show that between 7 and 10 per cent of all messages transmitted each day using the EPS are now actually being dispensed (rather than the pharmacist ignoring the e-script and dispensing from the paper prescription in the usual way).

This is equivalent to about 2 per cent of all prescriptions.

Timing-wise, it is up to you when you start your EPS “sign-up”. EPS2 is being rolled out by PCT area in waves, but pharmacies are not limited by a PCT’s EPS2 implementation status and, regardless of your location, you can accept any nomination and e-script, as soon as you are in a position to operate an EPS2-enabled system.

There are, however, two caveats. First, if you sign patients up for nomination too soon before actual deployment, you risk having to do it all again, to check that patients’ circumstances have not changed. Secondly, EPS promotional materials will only be made available (from NHS Connecting for Health and, possibly, also PCTs and system vendors) as implementation progresses.

It is all very well for you and your customers to be ready and willing to use EPS, but the system relies on GP uptake (currently 80 per cent of GPs are EPS1 enabled, but only 20 per cent are using it). If your customers’ GPs are not engaging with the system, Mr Jones recommends discussing this with them and encouraging them to try it out, in order to iron out any problems early on.

“The new system will be integral to the working practice of GPs and pharmacies,” he says, “now is the ideal time to test the system — before it becomes business critical.”