What is the best way of sending private prescriptions to patients?

Legally we know that we are required to

• Write or print legibly in indelible ink
• State a valid date
• The prescriber should sign in ink
• Ensure we have stated our address
• State the name and address of the patient
• Specify the age of the patient if under 12

All of this can be written on a piece of plain paper and should be accepted by most pharmacies.

In practice many of us now rely on computer-generated prescriptions and very helpfully most electronic health systems have wonderful drug data bases that do much of the work for us, ensuring the correct spelling and if you’re lucky, also suggesting the form of the medicine, route, strength, dose frequency and duration, and as an added bonus letting us know what pack sizes are available.  

Over the past few years those of us working in the NHS have almost completely stopped having to manage hard copies of prescriptions as the electronic prescribing service allows us to send prescriptions directly to the pharmacy nominated by the patient.  Within the EPS the electronic signature of the doctor is set up and all security requirements are met. But what are we able to offer our private patients who don’t attend the surgery?

In the past we used to call the pharmacy, ask to speak to the pharmacist and request that we phone through the prescription.  Getting hold of the both the pharmacy and the pharmacist is often the first and biggest challenge these days.  If you do find them, and they agree, the pharmacist will note down the details and you then you send the hard copy of your prescription in the post to the pharmacy.  A similar alternative used to be faxing the prescription, but these are now redundant.

Pharmacists will sometimes agree to accepting emailed prescriptions.  But as most email is not secure this should ideally be sent by NHS email to an NHS email address – which every pharmacy in the UK will have (though in our experience it often takes them some time to find out what it is and then another few minutes to relay that information to you as their addresses are long and complex).  Once received they will dispense the prescription and there is no need to send the hard copy.

There are also several companies offering a ‘private electronic prescribing service’.  And these are worth looking for at.  Our practice uses one that interfaces with EMIS Web - our electronic health record system. This private prescribing system (Signature Rx) enables clinicians to send medication issued in EMIS as a private electronic script to the patient via SMS.

The patient receives a barcode on their phone or email and takes this to a pharmacy who can then download the prescription and dispenses it.  This meets the security requirements by means of the IP address and prescriber uses a personalised PIN number.  We have now sent over 1000 prescriptions in this way and have found that it is fast effective and safe.  

With the exception of our CD prescribing we have almost done away with hard copies of prescriptions entirely and feel pleased about the environmental benefits too. There's the added benefit that we can track once a medication has been issued, through Signature Rx's prescribing portal.