NHS e-prescription service goes TITSUP: Problems since Monday

When it got introduced at my local GPs practice last year, they were inundated with calls from patients where their prescription had been sent to the wrong pharmacy. Mine had been sent to Boots in Birmingham (used to use that store but stopped using it a few years back), someone else's got sent to Oswestry even though they had not lived there for over 15 years. It was a utter mess.

Recently I was told I couldn't have a repeat prescription as I hadn't had the doctor review my condition in the last 8 months. This restriction was only made known after several increasingly frantic discussions with the pharmacy as to why my recent online renewal had not yet reached them.

Apparently there has been a change in the handling of long term medication prescriptions. My doctor had agreed that my long term condition was so stable that we didn't need to waste NHS resources. So an annual check-up was all that was needed - unless my own monitoring raised any concern.

Eventually the surgery were able to give me a prescription by booking an appointment with my doctor at his earliest free date - some weeks hence. When I saw the doctor I was again down to my last day's pills. He decided the only efficient way round the 8 month review problem was to get him to do a "phone consultation" with me after 6 months. Basically - "Hi Doc - thanks for ringing - everything's ok - bye!"

So I managed to get my new set of pills. However when I came to request my next prescription the online system would only let me make the request 7 days before the pills were finished. The pharmacy said that the lead time on the request getting to them was now three days rather than two. So it only needs an intervening Bank Holiday weekend to cut things very fine.

Reminds me of the old adage - "Every solution breeds a new calamity". What was supposed to save the NHS money is in fact costing them more in my case.

Curate's egg.

I am a GP. We have used the system for 3+ years and it is much better for REGULAR prescriptions than paper. We get many less queries about missing ones than we used to.

If anything goes wrong it is a nightmare to sort out because the structure of the program is so rigid.

The Dept of Stealth and Total Obscurity believes that everyone collects their prescriptions every 28 days. No-one ever looses tablets or has them taken by the hospital or has any need to vary their timings because of holidays. They insist that we and pharmacies print paper copies of SOME prescriptions. Basically it is a partial and transitional system

Given all that I electronically signed 166 prescriptions this morning. I could not have handled them on paper.

Some chemists handle it badly. So do some GP practices. Overall it is hugely helpful. But it remains a pig to use!

Can I just for once here about gov IT project gone right ?

Perhaps the much bigger issue is that of Summary Care Records and pharmacies being allowed access to them.

A complete and utter farce which is currently rolling out, ripe for abuse (guidance is that each pharmacy COMPANY should have a a responsible person, and a person responsible for the responsible person, who would clearly be unable to check all of the SCR access requests so should just "pick a few and see if they seem ok") and so poorly implemented as to be of very limited clinical use.

But that would require actual investigative reporting...

To save licencing costs cegadim wrote their own service to integrate with the NHS SPINE and ditched the old suppier... that would be due to go live some time soon... wonder if that's it?!?

Annon for reasons.

checking you still need the meds is good.

I was put on Statins by some doctor when i went into hospital for a heart related issue.

The government has made it the law (effectively) that ANY heart related problem MUST be due to bad lifestyle and high cholesterol. Therefore statins (anti-cholesterol drugs) are prescribed almost routinely.

In my case, i had (and still have) unusually low cholesterol. I was in hospital for a few days but it took about 3 months to get a doctor, any doctor to take me off that medication ... because another doctor put me on it, so they should be the one to take me off, not my responsibility (liability) etc.. finally I told my GP to call the various hospital doctors and tell them whats what. She did fortunately.

I am now out of the UK and buy prescription drugs over the counter (there are no prescriptions here). However, if i come back to the UK i could not get a prescription anymore without going back into the full system and registering with a GP, don't know how long that would take, as GPs refer heart stuff to hospital consultants who's next appointment is 4 - 6 month from now.

My medicine is available in the UK from three manufacturers. Despite claims that they are "the same", everyone who has the experience knows they are all different. There are also frequent stock issues with one or other make not being available from some or all) pharmacies.

Whilst this is the case, I want paper prescriptions I can take round pharmacies and get the last packet from the back of the shelf, if necessary.

My GP practice is in a health centre with two other practices and an out patient minor surgery unit and a pharmacy. It great. Except I still have to queue to get my printed prescription from the receptionist then walk about 15' the pharmacist to hand it over then sit and wait 10-15 minutes while it's filled. It's the perfect situation to cut out the middle man and print off the prescriptions directly to pharmacists printer. But rules.

The fault is said to be that Pharmacies cannot download prescriptions

from the (Cegedim) servers.

Or as some people put it the trouble is at the Pharmacy end. (Clearly, it isn't).

The System does not either report back that the prescription has (not) been downloaded, to its originator, nor apparently is there a way for it to say "I can't send this on, here it is back flagged for automatically printing, signing (although logically that is redundant), and having conveyed to the Pharmacy.

Patient? What patient?

9/10ths of the problem with clinical systems in the NHS is that they have absolutely no clue about requirements gathering. They genuinely don't understand that the primary stakeholder is the patient. Everything from EPS to primary care systems to hospital systems, they're all designed around the clinician or pharmacist and their needs rather than the needs of the people that these people are hired to serve.

It's a common fault that happens in every industry but is not so blatantly obvious as in the health industry where the overwhelming ego of senior clinicians and pharmacists means it has to be all about them.