NHSE seeks ‘further evidence’ over ‘poor-quality’ medicines barcodes

CPE said it has received “more reports” of unusable or missing barcodes on medicines packs, as well as “inconsistent use” of GTINs.

Pharmacy teams have until June 18 to respond to the NHSE survey (Shutterstock)

Patient safety and pharmacy workload concerns have been raised following “more reports of missing, inaccurate or unscannable barcodes on medicines packs”, Community Pharmacy England (CPE) has revealed.

The negotiator said yesterday that pharmacies have seen more medicines enter the UK supply chain either “without a usable 2D DataMatrix barcode” or “with barcodes that do not scan reliably”.

It added that NHS England (NHSE) is “now seeking further evidence from pharmacy teams” and other parts of the health system “to better understand the impact and possible actions”, via a survey that runs until June 18.

Read more: RPS backs barcode regulation for patient safety as concerns grow

NHSE said the survey aims to “understand the patient safety impacts” across pharmacy services in England, and the findings will “inform NHSE recommendations” and “contribute to an MSc service evaluation”.

And NHSE principal terminology specialist Paul Wright noted that the issue of poor barcodes has “increased” since January 2025, “following changes to medicines packaging and labelling under the Windsor Framework”.

C+D previously reported that since the Windsor Framework was implemented, the inclusion of a 2D barcode on medicine packaging has been optional.

“Interrupts workflows”

CPE said the issues reported by pharmacists “matter” because barcode scanning “underpins safer, more efficient pharmacy services”.

Pharmacy teams told CPE that “poor-quality barcode data” can “interrupt dispensing and checking workflows” and “increase manual work, delays and frustration”.

Read more: Barcode accuracy must be treated as a patient safety issue

It can also “undermine digital safety checks that rely on scanning” which can reduce “the effectiveness of medicines verification”, it added.

CPE confirmed it has shared pharmacy teams’ concerns with NHSE, including the “limited availability” and “inconsistent use” of Global Trade Item Numbers (GTINs), and a “decline in 2D DataMatrix barcodes on UK-only medicine packs”.

RCPharm backs barcode regulation

It comes after the Royal College of Pharmacy (RCPharm) backed NHSE’s call for mandatory 2D barcodes on UK medicines packaging, and the inclusion of GTIN information in the licensing process for medicines.

And it follows a parliamentary petition being launched in October to make GTIN barcodes mandatory to “protect patient safety” - the same month a pharmacy using robotics sparked a medicine recall after reporting duplicate GTINs being used on some medicines.

Ben Lee

Read more by Ben Lee

Ben Lee joined C+D in June 2024 and writes news, features and interviews, as well as producing video and podcasts. He played an integral part in C+D winning the 2025 PPA Community Engagement Award.

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