Solve your EPS problems early

The second phase of the roll out of the electronic prescription service (EPS) in England is expected this summer. However, many users are still are still getting to grips with the first phase (release one).

Teething problems reported so far include prescriptions taking a long time to download, barcodes on prescriptions not scanning, and lack of GP engagement.

The National Pharmacy Association and Pharmaceutical Services Negotiating Committee are currently investigating the scale of these problems, and results are expected shortly. It is important that pharmacists who are experiencing problems sort them out at an early stage.

Download times

NHS Connecting for Health (CfH) reports that 30 per cent of the national daily volume of prescriptions are being processed in parallel with EPS, with up to 11 per cent of those being downloaded by pharmacists, and daily volumes prescribed and dispensed showing consistent growth.

However, many pharmacists have reported problems with prescriptions taking a long time to download, and this is putting some users off.

With each pharmacy dispensing an average of 200–250 items a day, waiting longer than 10 seconds for the data to appear on screen after scanning the prescription barcode really adds up.

Gareth Jones, NPA NHS liaison manager, believes download problems are one of the main issues affecting the slow take-up of release one. “Ten seconds is acceptable but many of our members say it is much longer — even up to several days. We encourage pharmacists to use release one but our feedback shows this delay is blocking progress,” he says.

At Dean & Smedley’s pharmacy in Swadlincote, Derbyshire, 15 per cent of all prescriptions processed are received via EPS. Pharmacist Ben Eaton says they have not experienced download problems. “Our PMR supplier set up a download time of 10 seconds and this is what it has been. In fact, because scripts are pre-populated [ie, patient information is already filled in on the screen] this saves time. However, if contractors are reporting delays at this stage, how will the spine cope when all of us are using it?”

It is worth bearing in mind that release one is only meant to be a pilot and pharmacists can still dispense traditionally if they are having problems. The solution is to raise the issue with your system supplier before release two. CfH points out that during release two, prescriptions will be able to be downloaded overnight, which could save time for obtaining repeat prescriptions, for example.

Tim Donohoe, group programme director at CfH emphasises the need for communication. “The key is to report all issues to your systems suppliers and GP practices immediately, so that we can work together to iron these out,” he says.

Problems scanning barcodes

Although the advent of barcodes on prescriptions should be a time-saving boon for pharmacists, some do not always scan, often due to low quality ink in the GPs’ printers or to the paper being creased. The answer is to speak directly to the GP practice, because it is possible that they have no idea this is happening.

Mr Eaton says: “It is also worth making sure that the surgeries are not using the “economy” ink setting on their printers.” Mr Jones adds: “If this doesn’t work, take it up with the primary care trust.”

GP is disinterested

Low GP engagement is another issue. Many GPs assume that pharmacies are not yet using EPS, despite an estimated 80 per cent of both parties now being enabled for release one. In turn, some pharmacists wonder if it is worth their while getting involved when GP use is so low. The simple solution is to tell your local surgeries that you are ready to use the system, and keep the channels of communication open.

Smart cards

Problems can also arise with the “smart cards” which give the pharmacist access to the CfH programme. The cards expire after two years and then a face-to-face meeting with the registration authority at your local PCT is required in order to get them reset.

Some cards are due to expire in 2008, and pharmacists need to be organised to ensure they are ready for this. Mr Eaton’s says that his PCT is “on the ball with this”, issuing pharmacists with reminders three months before their cards expire.

The NPA’s advice is to check with the registration authority in advance when your card is due to expire.

Shorthand

Prescribers often use Latin abbreviations to write prescriptions. With EPS this information is scanned straight onto the labels, which would leave the patient with directions they might not understand.

It is up to the pharmacist to translate the instructions before the labels are printed, which is more work for them. Work is under way on a standard dosage syntax to standardise this, but in the meantime, GPs may not realise this is causing problems so once again, it is worth alerting them to it.

Overall, it seems the key to solving issues with release one is to keep communicating with your system suppliers, GPs, PCT and CfH. Mr Eaton says: “Release two will undoubtedly have its own practical issues, but we will deal with these as they come up. We just need to keep the lines of communication open.”

Mr Donohoe says: “CfH works with all interested parties to communicate and solve the issues that have arisen from release one. With release two we will continue to publicise what we learn, every step of the way.”

And the advice from the NPA remains: get involved. As with any system, there were bound to be teething problems. The better you know how to use release one, the more technically equipped you will be for release two.