1. Electronic Repeat Dispensing (eRD)
Will Gallear
Implementation Support Manager
NHS Digital
Rachel Habergham
EPS Programme Head

2. What is eRD?
Allows a patient to obtain repeat supplies of their medication or appliances without the prescriber having to sign repeat prescriptions each time.
Prescriber can authorise and issue a batch of repeat prescriptions until the patient needs to be reviewed.
Repeat dispensing can be issued for up to 12 months.
Can also be issued for shorter periods.
Repeat items that have not yet been dispensed by the pharmacy can be cancelled by the GP Practice.

3. EPS R2 Repeat Dispensing

4. How does ERD work at the practice?
An electronic repeat dispensing prescription can contain up to four items; the same number as on a normal electronic or paper prescription.
The legal date of the prescription is the original date it was signed. Interval dates are for guidance only.
If an item is not dispensed, it does not come off the prescribing budget.
Patients are required to give consent to the introduction of sharing of their information between the dispensing and prescribing site.

5. How does ERD work at the pharmacy?
A pharmacist can manually request future issues based on clinical judgement as long as all items of the previous issue have been marked as ‘dispensed’ or ‘not dispensed’.
A non-nominated dispenser will need the prescription barcode number/token to be able to access the prescriptions.
Patients can change their nominated pharmacy before the end of the repeat dispensing period. all outstanding issues which have not been downloaded will be available to download at the new nominated pharmacy.

6. Do you need to issue a Token?
No, it is no longer mandatory to issue an RA token at the start of a repeat dispensing prescription. System suppliers are in the process of updating their systems to stop this printing.
A token can be issued if specifically requested by the patient.  

7. Patient Selection
Most patients suitable for a repeat prescription should be suitable for electronic repeat dispensing.
Most items regularly prescribed by practices via a repeat prescribing system could be considered for supply.
Long term condition.
Medication expected to remain stable for the term of the prescription.

8. Exclusion criteria
Patients with unstable medical condition with frequent admissions to hospital.
Patients requiring frequent review of their condition.
Patients taking drugs that require additional monitoring such as anti-coagulant or Disease Modifying Anti-Rheumatic Drugs (DMARDs).
Patients who do not wish to participate in the service.

9. What’s in it for the GP Practice?
Process prescriptions more efficiently:
Reduction in workload associated with issuing and re-authorising repeat prescriptions.
Reduction in the amount of requests/queries coming into the practice each month (telephone calls, s, faxes, online requests), saving time.
Less time spent signing prescriptions:
Batches of prescriptions can be signed electronically, saving time.
Greater control of the prescription:
Prescriptions can be cancelled at any point during the regime
Electronic prescriptions can be tracked and traced – paper ones cannot. EPS tracker will give you the latest status of the prescription and how many batches have been dispensed.
Prompts medication review of patient.

10. What are the patient benefits?
Patients will not have to request their repeat prescription from the GP practice each time for the duration of the repeat regime.
Pharmacy nomination can be changed in the middle of a repeat dispensing regime meaning patients can receive their prescription items from a different pharmacy which may be more convenient.
Patients may not have to wait as long at the pharmacy as prescriptions can be received and made up before the patient arrives.
Patient can request multiple supplies of medication in a single patient visit, e.g. 2 month supply if going on holiday without going to GP practice.

11. Pharmacy benefits
Improved stock control as pharmacists will be able to order stock and prepare prescriptions in advance. Leading to few owings.
Dispensing work can be done in quieter times in the pharmacy, increasing efficiency and effective time management.
No need to order prescriptions each month on behalf of patients, saving time and workload.
No need to physically collect paper prescriptions from GP practices, saving time and money.

12. Benefits Estimator
New tool to give Prescribing and Dispensing sites a quick visual reference to the benefits realised through using EPS and eRD
Input your average number of items, percentage of scripts sent via EPS and percentage of scripts sent via eRD.

13. Prescription Tracker

14. Repeat Dispensing and the tracker
All issues have the same barcode
You can manually pull down next issue once previous has been dispensed
Tracker shows each prescription individually
Issues should only be marked as dispensed or not dispensed when patient has collected

15. Next issue of Repeat Dispensing is not downloading automatically
Check to ensure previous issue has been marked as dispensed
Next issue may not be due
Manually pull down
Scan previous token
Manually enter barcode and download
(can be obtained from prescription tracker)

16. https://digital.nhs.uk/media/651/eRD-toolkit/pdf/eRD-toolkit
Contacts
Will Gallear
(EPS Implementation Support Manager)
Resources:
NHS England Guidance
eRD Toolkit
e-learning Module