GP mythbuster 11: Electronic prescribing

Most prescriptions from GP practices are now signed, sent and processed electronically. This change gathered pace during the COVID-19 pandemic.

Practices must ensure electronic prescriptions are produced and signed, in line current regulations. The Human Medicines Regulations 2012 sets out the rules for electronic prescriptions in sections 217 and 219. The NHS Electronic Prescription Service (EPS) has these requirements built in. Other systems in use need to follow these regulations. For example, those producing private prescriptions.

Controlled drugs

Read GP mythbuster 28 for information about prescribing controlled drugs.

Medicines administered in the practice

Prescription-only medicines can be prescribed and authorised for administration in the practice. GP mythbuster 19 explains this.

Electronic repeat dispensing (eRD)

Electronic repeat dispensing (eRD) is an integral part of the Electronic Prescription Service. It allows prescribers to authorise and issue a batch of repeatable prescriptions. Prescribers can do this for up to 12 months with just one digital signature. The prescriptions are stored securely. They are downloaded to the patient’s choice of pharmacy, at the required intervals. The practice should check that the right pharmacy is allocated. This system has obvious advantages for the doctor and patient.

When making changes, there needs to be clear communication between the GP practice and the pharmacy. This is to make sure patients always receive the right medicines.

Dispensing doctors

Most dispensing doctors do not use the EPS for their dispensing patients. Prescriptions for these patients need to be prepared in line with:

• Schedule 6 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 and
• the associated paragraph 39(3) of Schedule 6 to the GMS Regulations.

These regulations specify that the doctor ‘must record any order for the provision of any drugs or appliances which are needed for the treatment of the patient, before the drugs or appliances are dispensed (unless it is personally administered)’.

All prescriptions should be signed before being dispensed. If practices do not sign prescriptions before dispensing, they should risk-assess this and have a process to minimise the risk. Examples of risk mitigation include:

• following robust practice protocol
• ensuring all prescriptions have been signed at the end of the day
• having clear exclusion criteria for certain situations. This includes controlled drugs.
• ensuring an audit trail of the process.

When we inspect

GP practices should make sure:

• medicines are prescribed and dispensed safely
• patients can access their medicines when needed.

This relates to our key lines of enquiry (KLOEs):

• S4.2 Are medicines appropriately prescribed, administered and/or supplied to people in line with the relevant legislation, current national guidance or best available evidence?
• S4.4 How does the service make sure that people receive their medicines as intended, and is this recorded appropriately?
• R3.1 Do people have timely access to initial assessment, test results, diagnosis or treatment?