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NHS to scrap paper prescriptions under plan to save £300m

helvella profile image
helvellaAdministratorThyroid UK
41 Replies

Thoughts:

Will we still be able to get paper prescriptions we can send abroad? (Whilst recognising that brexit will end much of their current use in relation to EU pharmacies.)

This is England-only - not Scotland, Wales and NI.

Has anyone used a barcode system? Sounds promising in that it should still allow traipsing round pharmacies to get specific products. Might even allow prescription-splitting - getting your 25 microgram tablet from one pharmacy and your 100 microgram from another. Or is that too, too optimistic?

And I don't like the headline justification being saving money. Though that might be a "good thing" overall.

NHS to scrap paper prescriptions under plan to save £300m

Electronic service will be rolled out in England next month in bid to achieve savings by 2021

Paper prescriptions will be scrapped next month under an NHS plan to save £300m over two years, with Jo Churchill, the primary care minister, announcing all prescriptions across England will be digitised.

The electronic prescription service (EPS) will be rolled out nationally after a trial run in 60 GP practices and hundreds of pharmacies.

At least 70% of all prescriptions are already being prescribed and dispensed through EPS and the Department of Health and Social Care (DHSC) has already received positive feedback from GPs and pharmacies.

Under the electronic system, patients can get their medications by either nominating a pharmacy that will receive the details directly from their GP or receive a paper prescription with the digital barcode.

The medical information is held on a secure NHS database called Spine and will allow a patient’s prescription to be accessed quickly by GPs and pharmacies.

Rest of article freely available here:

theguardian.com/society/201...

[ Added 30/01/2024 ]

See news about electronic prescriptions through the NHS England app:

healthunlocked.com/thyroidu...

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41 Replies
RedApple profile image
RedAppleAdministrator

I think there's something I'm not getting here.

First it say: NHS to scrap paper prescriptions

Then it says: or receive a paper prescription with the digital barcode.

So how is that scrapping the paper prescription?

helvella profile image
helvellaAdministratorThyroid UK in reply to RedApple

Was hoping someone would post that. :-)

And, what happens if the pharmacy's internet connecion fails?

With the increasing reliance on internet connectivity even for things which are life-critical, hyper-resilience is becoming important.

I can certainly imagine a pharmacy having a primary connection, with automatic fallover to, say a 3G/4G/5G connection. But even that is not actually sufficient, especially if there is any single point of failure (e.g. wired and phone signals both carried in such a way as to potentially be disupted by a significant event such as a fire or aircraft crash).

And their power supply needs to be just as reliable.

I believe that fibre connections at present only have limited resilience against power outages.

RedApple profile image
RedAppleAdministrator in reply to helvella

I'll be sticking with paper prescriptions!

Oh and...

after a trial run in 60 GP practices and hundreds of pharmacies.

the Department of Health and Social Care (DHSC) has already received positive feedback from GPs and pharmacies.

No mention of what the patients think about this. But of course, patients are irrelevant.

helvella profile image
helvellaAdministratorThyroid UK in reply to RedApple

Glad you realise.

It would be so awful if you thought your views actually mattered, and then found out the truth.

RedApple profile image
RedAppleAdministrator in reply to helvella

:D :D :D

SilverAvocado profile image
SilverAvocado in reply to RedApple

Yes, one reason I suspect pharmacies like it is that a patient can get locked into having all their prescriptions sent automatically there.

In fact that seems to be the thing you first pointed out! EITHER a specific pharmacy automatically picks up your digital prescription, OR you're issued a paper prescription and its not paperless at all.

I am already a bit locked in with my local pharmacy, who are pretty awful. One of the side benefits of self medicating is not having to worry about any of that... When I first got sick I didn't know any better and realise there were better pharmacies out there.

LAHs profile image
LAHs in reply to helvella

Yes, we should all have a back up plan if someone pulls the plug on our power supply in addition to internet connections. Some places in California had a chance to practice a couple of weeks ago when our electricity company (PG&E) shut down, i.e. turned the power off when the temperatures reached 100+. They went bankrupt last year when a spark started the Paradise fire which burned the whole little town down.

kissemiss profile image
kissemiss in reply to RedApple

"patients can get their medications by either nominating a pharmacy that will receive the details directly from their GP or receive a paper prescription with the digital barcode." I think it means if you receive a paper prescription with the digital barcode you will have the choice to shop around until you find a pharmacy who has your medication which of course is the best option .

helvella profile image
helvellaAdministratorThyroid UK in reply to kissemiss

The trouble is that they have not explained the barcode option.

Why do you need a new paper barcode for each prescription? If so, the advantage over real paper prescriptions seems questionable. Especially if you have to pick it up.

Could you not have the option to have the barcode sent as an email and displayed on your mobile phone, or print it yourself? (These would need to be optional.)

Could you not have a perpetual personal barcode (or "credit card") and just pass it over to be swiped in any pharmacy?

humanbean profile image
humanbean

I have refused to nominate a pharmacy to receive my prescriptions electronically, for the simple reason that I can't always get the prescribed drug I want. Over the years there have been occasions when I've traipsed over town looking for a prescription item that I need, or I've had to phone up loads of pharmacies in my area to find one that has the item I'm looking for. It is for this reason that I've refused to nominate a pharmacy.

Perhaps someone could explain to me how having a nominated pharmacy is a good idea if they can't always supply my prescription? I have never understood how that worked, and I haven't bothered to find out either. But if I'm going to be forced to nominate one perhaps its time I found out what they do when they can't supply.

bantam12 profile image
bantam12 in reply to humanbean

Our scripts have been sent electronically for a few years now, we don't have any issues getting our meds from the nominated pharmacy, they know if it's regular to have them in stock or can order if needed. My husband is on quite a few regular meds which the pharmacy are aware of and some need to be special order but they are usually in by next day.

I'm on something that they cannot source so my only option is to ask my GP for an alternative, problem with that is there isn't one ! not Boots fault.

RedApple profile image
RedAppleAdministrator in reply to bantam12

I suspect location plays a part in this. The Boots where I used to live were diabolical. The one where I live now are more than helpful. I still like to keep my options open with the paper script though.

bantam12 profile image
bantam12 in reply to RedApple

Each time you do your online script request there is the option to change your nominated Pharmacy so I guess if you had to chop and change to get what you needed it is possible. In our Boots which is only small as we are quite rural they can automatically do your meds requests for you so in theory all you have to do pick up the meds, we haven't tried that yet.

RedApple profile image
RedAppleAdministrator in reply to bantam12

The problem arises when you don't know until you actually pick up your meds that they've substituted your levo brand, even though it's on record that you must have brand X.

bantam12 profile image
bantam12 in reply to RedApple

It's still on the electronic script which brand you requested so that shouldn't happen.

kissemiss profile image
kissemiss in reply to bantam12

Yes but what Boots often does is to say.." we only got 2 jars left but when you arrive back to pick the rest of the prescription up they will say "we could only get this brand because the other one is out of stock". Either you have to accept the new brand or you will have to go back to your doctor for a new prescription and all these things take time. That is when you really need to be able to chose any other Pharmacy.

Hibs1 profile image
Hibs1 in reply to RedApple

But your check them in chemist and hand them back if incorrect surely? I do that with no problems

Jose651 profile image
Jose651 in reply to Hibs1

That's true Hibs1, but only if the patient is fit to go to the chemist.

The nominated Pharmacy delivers the Prescription to many patients here and since I nominated my usual chemist I have been receiving different brands every month.

Hibs1 profile image
Hibs1 in reply to Jose651

That's a shame the chemist does that. My neighbour gets hers delivered in a pack different chemist to me, and just phones up if wrong and gets replaced ok

Jose651 profile image
Jose651 in reply to Hibs1

I have phoned and explained that I would leave the 'wrong' tablets in the original bag in the porch table. Tablets were replaced the next day but they left the original tablets there.

When tablets leave the pharmacy they aren't supposed to take them back for obvious reasons.

Complicated or what? Not to mention a waste of well needed money.

RedApple profile image
RedAppleAdministrator in reply to Jose651

I have been wondering whether the recent requirement for blister packs to now be in sealed boxes might mean the pharmacy could take them back and issue to someone else. That would sort out the waste of money aspect. Probably just wishful thinking though.

RedApple profile image
RedAppleAdministrator in reply to Hibs1

Yes Hibs1 , of course check them before leaving the pharmacy and hand them back if incorrect. But if the pharmacy insist they can't get the brand you want, then you are left with no meds. And because the prescription is electronicly only with the 'nominated' pharmacy, you can't go to a different pharmacy.

If you have a paper prescription, you can check with the pharmacy that they can fulfil your requirements before you hand over the script. If they say no they don't have your brand or dose or whatever, you simply walk away with your script in hand to take to another pharmacy.

Hibs1 profile image
Hibs1 in reply to RedApple

See she you mean!🌞

humanbean profile image
humanbean in reply to bantam12

we don't have any issues getting our meds from the nominated pharmacy,

Now, my experience has been very different. I have been told categorically on many occasions that nobody can get item A or item B or whatever and I must go back to my GP for an alternative.

There was only one item on one occasion where I had to admit defeat and that was for an antibiotic in a particular dose. Eventually I had to write to my GP saying that I couldn't get it but that it was available in half the dose, so could I have a prescription for two capsules per dose instead of one. But for all other items I've been told are unobtainable I have eventually managed to find a pharmacy that could supply it.

bantam12 profile image
bantam12 in reply to humanbean

As I said one med I am on is unavailable, not just my pharmacy but everywhere, I have 2 weeks left so I may have to ask my GP for a paper script to try other places but we are in rural somerset so not many places to go and none of the online pharmacies have it either.

Independent pharmacies have more choice where to source meds whereas places like Boots apparently have less choice.

Obviously it's never going to work perfectly for everyone all the time and things do go wrong but that's technology!

Howard39 profile image
Howard39 in reply to humanbean

Hi

Am finding Mercury pharma a headache to obtain. A staff member at my surgery suggested I was lucky to get anything with the shortages!

kissemiss profile image
kissemiss in reply to Howard39

Yes I had the same problem. In the end I called the company who manufacture Mercury pharma in London to ask where I could get hold of my tablets. They were most helpful. Good Luck!

Howard39 profile image
Howard39 in reply to kissemiss

Good idea I’ll try and track down the number.

helvella profile image
helvellaAdministratorThyroid UK in reply to Howard39

Address

Capital House, 1st Floor, 85 King William Street, London, EC4N 7BL, UK

Telephone

+44 (0)208 588 9131

Medical Information Direct Line

08700 70 30 33

Customer Care direct line

+44 (0)208 588 9273

WWW

advanzpharma.com

Fax

+44 (0)208 588 9200

Medical Information e-mail

medicalinformation@advanzpharma.com

Medical Information Fax

+44 (0)20 8588 9200

medicines.org.uk/emc/compan...

Howard39 profile image
Howard39 in reply to helvella

Oh that’s so helpful.

Best wishes

Helena

helvella profile image
helvellaAdministratorThyroid UK in reply to humanbean

That is precisely why I am dead set against nominating a pharmacy.

Adding that there are numerous reasons to switch such as opening hours, where you are actually going to be that day, etc.

Interesting how this system will interact with NI, Wales and Scotland. After all, we are technically allowed to get our prescriptions dispensed in any pharmacy regardless of constituent country. (Though charges issues do arise.)

RedApple profile image
RedAppleAdministrator in reply to humanbean

Totally agree, I've never nominated a pharmacy either. Ability and freedom to take prescription to various pharmacies is essential. It's one of the major issues with those of us who cannot tolerate certain brands of levo.

LAHs profile image
LAHs in reply to humanbean

I think if your nominated pharmacy cannot get your brand or prescription then they phone around until they locate it. This is basically what my pharmacy does. I call to renew my prescription, they rarely have it so I am told to wait a couple of days before I can pick it up. They call me when it is in. They always locate it because they usually get a batch from the manufacturer.

Howard39 profile image
Howard39 in reply to LAHs

They tend to be independent pharmacies.

Larger companies say Boots or Lloyd’s only have set brands.

Boots only do 25 mcg in Mercury Pharma. Teva is popular in my area and activas gives me sinus issues. What a pickle!

helvella profile image
helvellaAdministratorThyroid UK

Good point - I don't know.

humanbean profile image
humanbean

I take a controlled drug. I hadn't thought of how that might be affected. :(

SlowDragon profile image
SlowDragonAdministrator

Sounds terrible......

I have to take my paper prescription to nearest independent pharmacy 10 miles away.

Boots is the only pharmacy in our town and they won't dispense the brand I need, even though it clearly says only Mercury Pharma brand on prescription

I was told it's impossible to get my electronic prescription dispensed anywhere other than local chemist....i.e. Boots

lilliput profile image
lilliput

My repeat prescriptions are done electronically via System Online (spelling). Very convenient but slow. Could be my named pharmacy. Could have them delivered but not at that stage yet. Generally think ordering meds to be delivered via a computer is fantastic. Many people who don't drive/ have limited mobility benefit.

Can take up to two weeks to get repeat meds (not a problem , used to it) after ordering them however; and pharmacy was packed when the computer system changed with a wait of about an hour; turned out OK for me as got chatting to other customers but unacceptable for those who eg needed antibiotics, I would have really struggled if I had a fever or mobility/ breathing problems. I still get paper prescriptions for one off complaints, fortunately rarely happens. The paper prescriptions were stuck waiting in the queue with everyone else.

Seriously thought that triage could have been a good idea.

So for repeat prescriptions great. especially with delivery. For one offs eg antibiotics, bad. Takes too long.

Think some all ages people could become seriously ill and if lucky make it to A and E.

No home visits either. Your average 80 year old , with a bit of a cough (pneumonia) How would they be? What really worries me is how difficult it is to get a doctors appointment and how isolating the internet can be. There needs to be real life contact. At least a phone number.

LAHs profile image
LAHs

I think in general it's a very good idea so long as a few exceptions are recognized. This is because a large portion of the thyroid community (us!) need to shop around to get what we need. It is basically how it works here in an HMO in the US. You see your doc, he prescribes something, he enters it into the computer and you just go over to the in-house pharmacy and pick up the 'script just by telling them your name and hospital number. If I ever wanted a paper script I could ask for one but I have never needed to do this.

(btw HMO stands for well... I forget! ... but in the US we sign onto a large hospital conglomerate where we can see a doctor, get a prescription, see a specialist, get surgery all under one roof. I am very happy with it but you do have to live within 30 miles of one of their hospitals.)

Howard39 profile image
Howard39

Hi they can be electronic you just have to sign for them upon collection.

E_lizab8 profile image
E_lizab8

The spanish national health has had electronic system for a while (around 2-3years ), you go to doc he registers your medicine via pc then you go to any farmacy hand over your nat health id card (the latest ones have foto), the chemist puts your card into machine and this shows a list of your medicines you are entitled to, at this moment if there is anything you dont want to have then you can tell them, they then hand over medicines and they are removed from list,( free for OAP small charge for others). If the doc has tagged medicine as pemanent/long term then the medicine will automatically be available for when you finish the ones you have. Seems to function ok though if the internet or electric is down then of course nothing works. They also have a scheme by which every farmacy should have a big bin where you can leave unwanted medicines, they used to send to third world countries but not sure what they do with them now.

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