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‘Tiny’ percentage of GPs using paperless scripts

Practice Less than 4 per cent of GP practices are using EPS2, compared with 61 per cent of pharmacists, leaving many pharmacies that had upgraded unable to put the service into practice.

Less than 4 per cent of GP practices are using the latest version of the electronic prescription service (EPS) despite the NHS investing nearly £100 million in the project to date, C+D has learned.

Responding to a freedom of information request from C+D, the Department of Health (DH) revealed it had spent £97m on EPS since its inception nine years ago. But a Connecting for Health update on October 12 showed that while 61 per cent of pharmacies had upgraded to EPS2 – a paperless system – only 321 of the 8,228 GP practices in England had also made the move.

Only 321 of the 8,228 GP practices in England have made the switch to EPS2

More on electronic prescriptions

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NHS – not patients – will be main EPS beneficiary

EPS could become ‘low priority' amid NHS upheaval

Experts voiced concerns over the "tiny" percentage of GPs using the system, leaving many pharmacies that had upgraded unable to put the service into practice. Currently, GPs are authorised to use EPS2 in 83 PCTs, and this will be extended to a further 33 PCTs in December.

Charles Alessi, GP and chairman of the National Association of Primary Care, said he was disappointed by the uptake rate. "I'm quite upset that [EPS release 2] hasn't been taken up as much as it could have. You can anticipate that it will make some significant savings," Dr Alessi told C+D.

But he predicted EPS2 would start gathering pace among GPs as they recognised how the system could help them communicate with pharmacists.

"Once healthy living pharmacies start to come upstream and pharmacies evolve to take on much more than dispensing, then I think communication [between GPs and pharmacists] will grow and practices will start to take up [the system]," Dr Alessi added.

And Numark urged pharmacists to keep pushing ahead with EPS2, despite the "tiny proportion of GPs" using the service.

"Repeat dispensing for appropriate patients will allow GPs and pharmacies alike to drive efficiencies into their current processes," said Andy Charlesworth, Numark's IT services manager. "It is however possible that these benefits have not been clearly acknowledged or understood by most practices."

"It's essential that contractors don't read these figures and use it as a reason to disengage with EPS2," Mr Charlesworth warned.

But Ryszard Cygan, owner of West Elloe Pharmacy, Spalding, said he was reluctant to upgrade until his local surgery made the move. "With EPS2 we wouldn't have to wait for the paper [prescriptions] – it would be brilliant and we would love to do it," he explained. "[But] there's no point now because the doctors don't write prescriptions for EPS2."

PSNC said it was "too early" to assess whether the £97m spend on EPS had paid off. And it stressed that rollout of the service should not be "rushed".

"EPS deployment, even though it is accelerating now major GP system suppliers have been given national rollout authority, needs to continue at a properly managed pace and not [be] rushed," said Lindsay McClure, PSNC NHS IT lead.

"A particular concern is the diminishing PCT resources as the NHS goes through its transition – PCTs have a key role in supporting EPS rollout, with responsibility for issuing smartcards and authorising GP practices to use the service," Ms McClure added. "Effective local infrastructures need to be in place to support day-to-day use of the service."

EPS rollout in figures

£97m spend on EPS to date

64% of pharmacies (7,117/10,951) EPS2 enabled

4% of GP practices (321/8,228) EPS2 enabled

741,655 patient nominations set

4.26m items dispensed through EPS2 prescriptions to date

Source: NHS Connecting for Health

Has your local GP practice signed up to EPS2?

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Gerry Diamond, Primary care pharmacist

Unless someone physically goes and does it all for the GP practice then it won't happen as they are probably too busy just getting on with consulting, hence, it needs to be driven by the lead partner and delegated to the practice manager to liaise with NHSIT.

Freelance Pharmacist, Academic pharmacist

Complete waste of time, what was wrong with the old system. As we all know we don't do technology well in this country, especially at government levels where the most incompetent people work.

max falconer, Superintendent Pharmacist

GPs don't get much credit in these columns but they deserve a big round of applause for their lack of enthusiasm for EPS.
This has the very real potential to be a total disaster for virtually all pharmacies except the national changes. I am aware of plans by at least 2 nationals to launch massive advertising campaigns to sign patients up probably via the comfort of their armchairs using the 'red' button. Worse EPS gives the government techical ability in due course to direct prescriptions to their choice of cheapest central dispensing factories. Of course they won't admit to this now but why do you think this is one of the few surviving aspects of the NHS IT project to survive?
Pharmacy is looking for somewhere to bring pressure to bear on the government, this could be the golden opportunity. No co-operation with EPS2- let's not be turkeys voting for christmas. The GP's don't want it, the patients either don't want it or don't understand it and it is potentially disastrous for us!

Clive Hodgson, Community pharmacist

Max is spot on. EPSr2 (if it works) could indeed be a "total disater" for virtually all phamacies except the multiples.

We have perhaps focussed too much on the cost, practical difficulties and increased workload of EPS r2 and missed elephant in the room.

Consider that could well mean, in the future, huge numbers of electronic scripts being directed to the multiple owned prescription factories that have tendered the lowest cost for dispensing and distributing. Independents or small groups would not stand a chance.

I think we need to think long and hard before co-operating with EPSr2.

Clive Hodgson, Community pharmacist

Those "thumbs down" for the comments above wouldn't have come from suppliers of EPSr2 systems would they?

Old Timer, Manager

It may be paperless for GP but the pharmacy using EPS2 are over run with paper generated by EPS2 ,this will be good only for central script factories who can dispense repeats over night and send out for delivery next day. economy of scale and patients will not to leave home to order and receive Rx.
Any one remember type setters in Fleet Street ,High Street Pharmacy could go the same way,sad but that is progress .

Clive Hodgson, Community pharmacist

Agree with Mr Freelance.

£97 million that could have been better spent elsewhere, this is as well as the £ millions spent by Pharmacy having been persuaded to pointlessly "upgrade" their systems to be EPS r2 compliant.

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