There are few reasons why GPs should adopt the EPS - or why patients should press for it - researchers have concluded from the early adopter EPS sites. They suggest that GPs may require a "carefully presented message" and some incentives, for example, through QOF, before the service can gather critical mass on a national scale.
In an interim evaluation of the EPS, based on feedback from early adopters, the EPS research team finds that EPS R2 has challenged the test-bed GP sites' current work practices around repeat prescribing and has demanded the adoption of "new, time-consuming activities" associated with the early stages of adoption, such as nominating patients, and adjusting repeat dates, and quantities to allow repeat dispensing.
The evaluation also found that in some practices it took longer to sign electronic prescriptions. In GP practices with problems with lost prescriptions, the EPS was felt to reduce the time spent searching.
Patients were also asked for their feedback on using the EPS. From this, researchers conclude that patient benefits "seem relatively weak, and counterbalanced by some patients who have experienced problems". While some patients liked the service and reported that it was "quicker than existing arrangements" for requesting repeat prescriptions, that it reduced the number of urgent requests or the need to register for "cumbersome" on-line ordering from GP practice websites, others - particularly those who used repeat prescription collection services - noticed little difference.
Some patients said they were annoyed when prescriptions were not ready when they arrived at the pharmacy. Nomination also caused division, with patients reporting that it both constrained and facilitated choice. PCTs are, currently, drawing up nomination policies for local dispensing practices to follow (link to other story).
As for the benefits to pharmacies, the reporters conclude that "those which can fully embrace this technology, integrate it into their work practices and align it to their business goals may see stronger benefits". Early adopter pharmacies have reported frustration with system down-time and smartcards, although several said that the EPS had helped smooth daily workload. The findings lead researchers to predict that increased use of repeat dispensing prescriptions by GP practices could potentially facilitate a greater role by community pharmacies in the management of chronic conditions and in alleviating stock-shortages. Due to the low volumes of EPS R2 prescriptions, it was not possible to evaluate the administrative benefits of electronically claiming reimbursement.
Concluding the evaluation of the electronic prescription service in primary care, the researchers say: "The main beneficiaries of EPS R2 are likely to be NHS and Department of Health as a whole, rather than local practitioners, or patients. Given the challenge of implementing EPS R2 in primary care at present, there may be a need for central intervention to sustain the momentum of this roll-out."
The evaluation is due to finish at the end of 2012, with a final report expected in January 2013.