A petition has been launched to “ban” technology that allows pharmacies to “auto renominate electronic prescription service (EPS) patients in bulk”.
Titan PMR’s chief executive Tariq Muhammad is petitioning parliament for NHS system suppliers to be prevented “by law” in providing technology that allows pharmacies to switch patient’s EPS nomination “without informed and current consent”.
The petition will run until June 19, 2026. It asks for it to be made illegal for pharmacies to “engage in this practice” as it “greatly impacts patient care” and puts the EPS infrastructure “at risk”.
Read more: ICB investigating pharmacy nominations ‘without consent’
It also suggests the process can lead to “confusion, inefficiency and delays to medication supplies”.
It comes after C+D reported that NHS Greater Manchester ICB is taking “action” against multiple pharmacies that have changed patients’ pharmacy nominations “without their consent”, amid reports from Community Pharmacy England (CPE) saying it has received “a number of concerns” about the same issue.
Two-tier system
In a letter on December 19, Muhammad told Titan customers that “we obviously cannot continue operating a two-tier system where unscrupulous pharmacies and PMR system providers are allowed to gain a competitive advantage at the expense of others”.
He said it encourages “unethical practice”, where nominations could “ping-pong between pharmacies”, which risks “harming patients” and causing delays in medication supply.
Muhammad also warned it could “collapse” the NHS EPS spine.
Read more: ‘No plans’ to allow DSP nomination on NHS App
He added that Titan had “raised this very serious issue with NHS EPS teams on numerous occasions. They are adamant this practice is not allowed and clear on its negative impact, but when asked why they are allowing other PMR systems to get away with this, it appears they lack the power to stop it and need clear policy from government.”
And he said “if nothing changes, we will look at alternative ways to level the playing field and find ways to ensure your business is not disadvantaged by this type of practice”.
Patient autonomy
Community Pharmacy South East London chief executive Raj Matharu told C+D nominations “must remain patient-led”, either via the NHS App or through “signed consent”.
“No healthcare professional should be involved in setting or changing a patient’s nomination without explicit, informed, and documented consent,” he said.
“This principle safeguards patient choice and trust in the system. Any deviation from these norms should require explanation and be subject to scrutiny by ICBs, the General Pharmaceutical Council (GPhC), and the Information Commissioner’s Office (ICO).”
Read more: NHS ‘working through constraints’ to enable online pharmacy nominations on app
Matharu also said he advises contractors and pharmacists to look at their data security and protection (DSP) toolkit obligations as “compliance is not optional”.
He said the challenges around nominations are “symptomatic of the wider underfunding of the Community Pharmacy Contractual Framework (CPCF)” and it shows “a decline in professional conduct in some areas, which is deeply concerning”.
One of the founding members of the Independent Pharmacy Contractors Network (IPCN), Tas Bhatti, also a senior partner at Avicenna Senatio LLP, said the issue is “one of collective responsibility rather than competitive advantage” and the petition will protect “fair competition” and “patient autonomy”.
Read more: COVID-19: Online pharmacies see rise in prescription nominations
He said he had heard of reports from its members of “mass renominations” taking place and it could risk “undermining public confidence in digital prescribing more broadly”.
He said it could “trigger restrictive changes to the EPS framework” that could include “tighter controls or removal of the ability for pharmacies to set or manage nominations at scale, impacting all contractors”.
“Short term gains achieved through aggressive or non-consensual nomination practices carry long tail risks that could ultimately reduce flexibility, increase regulation, and limit digital capability for the entire sector,” he said.
Read more: Contractors highlight fears over EPS nominations abuse
He also added that the petition is not about “opposing digital innovation” but about protecting the EPS to continue functioning “safely, fairly, and with public trust at its core”.
“Losing that autonomy because of sector wide misuse would be commercially damaging and operationally disruptive, even for pharmacies that have always followed best practice.”
In July, a health minister revealed that there are “no current plans” to allow patients to “directly nominate” a distance selling pharmacy (DSP) on the NHS App.
