MPs told ETP plans may jeopardise patient choice

Pharmacist representatives have told MPs that plans to allow GPs and other prescribers to nominate a patient’s pharmacy for electronic transmission of prescriptions (ETP) will jeopardise patient choice.

The Pharmaceutical Services Negotiating Committee (PSNC) is lobbying the Department of Health and the National Programme for IT (NPfIT) to change the system so that choice of pharmacy lies solely with patients.

Lindsay McClure, head of information services for the PSNC, told an All Party Pharmacy Group meeting on NPfIT last week that patients should continue to have the choice of which pharmacy to have their prescriptions dispensed at and not have that decision made for them.

She told EHI Primary Care: “We do have concern that prescriber nomination of a patient’s pharmacy will lead to direction of prescriptions rather than patients having a genuine choice. We don’t believe any prescribers, including GPs, nurses or pharmacist prescribers, should be able to nominate a pharmacy and if that does go ahead there needs to be systems in place to prevent abuse.”

Current plans for ETP, which began implementation at one early adopter site this week, are that patients will eventually be able to nominate a pharmacy via the internet, in their GP surgery or at their pharmacy. Those who do not wish to nominate a preferred pharmacy will be given an ‘e-prescription token’ – currently a prescription with a barcode – that can be presented at any pharmacy for the prescription to be dispensed.

An NPfIT spokesperson told EHI Primary Care that prescribers will also be able to nominate pharmacies. He added: “The ETP model supports the nomination of pharmacies by prescribers. The process surrounding nomination has yet to be defined and is currently under discussion with both GP and pharmacy user groups.”

McClure told the All Party Pharmacy Group meeting that the PSNC was also concerned that during the roll-out of ETP a level playing field was maintained between ETP-enabled and non-ETP-enabled practices.

Later she told EHI Primary Care: “There is a risk there but we have been talking to the National Programme about this and we do feel slightly more positive about that.”

McClure also told MPs that NPfIT needed to improve clinical engagement with pharmacists and called for the programme to appoint a national clinical lead for pharmacy.

She added: “ETP itself is only the tip of the iceberg of what the National Programme can offer pharmacies. The NHS Care Records Service and access to patient information has the potential to realise many more benefits for the profession.”

She said the PSNC was expecting the Department of Health to consult shortly on community pharmacy access to patient records.

Harry Cayton, chair of the Care Record Development Board, also spoke at the All Party Pharmacy group meeting. He told MPs that the Care Record Guarantee is currently awaiting ministerial approval. This will lay down a framework for how records will be created and shared, how they will be used, how consent will be obtained and confidentiality achieved.

The All Party Pharmacy group is writing a report to ministers following the meeting which it expects to finalise by the end of the week. A spokesman for APPG said the report is likely to share concerns expressed at the meeting about the implications of prescribers being able to nominate pharmacies.

He added: “A system in which electronic scrips are sent to a central point for pharmacies then to pull down would maintain patient choice and avoid the potential problems associated with nomination.”

The report will also back calls for a national clinical lead for pharmacy. A spokesperson for NPfIT said the appointment of a clinical lead for pharmacists was currently being considered.