From 1 June 2022, almost every medical practice in England will no longer take prescription orders over the telephone. All future requests for prescriptions are to be made by one of the following ways:
- Online (via the Patient Access website or NHS app)
- Via Patient Triage (online, following an online consultation)
- In writing (using your re-order slip or full written details; including dose and quantity).
- At your local Pharmacy (depending on if the Pharmacy has access to the EPS service or not)
When discussing this decision, it is important to examine the ramifications, why it has been made, and the impact this will have on the most vulnerable members of our society.
So, what is EPS? The Electronic Prescription Service is an NHS service that was introduced in February 2014. The EPS was designed to give people the opportunity to change how their GP sends their prescription for either medication or medical appliances to their preferred location. On the 3 August 2020, the EPS "upgraded" which meant that almost all of our prescriptions will now be processed electronically. The claim made here was that "electronic prescriptions will help save the NHS money".
On the surface, the EPS seems like a forward thinking, easy, reliable, secure and confidential service. It emphasises how easy it is to order prescriptions; it is less time consuming in that it may reduce pharmacy waiting times, and allows for the prescriptions to be ready at the Pharmacy before you arrive to collect them. However, the EPS fails to highlight some key concerns that most of us have with this "new and improved" system.
Too good to be true?
It is easy to make the assumption that the introduction of the EPS will be preferable and accessible for most adults, and on the surface it seems like a positive move to reduce waiting times and save both time and money for the NHS. However, it is clear that little thought has been given to those adults who are unable to use this system. According to the Data and Analysis Census 2021; "almost all adults aged 16 – 44 years in the UK were internet users, compared with the 54% of adults 75 years or older". The first question we must ask, is; what about the 46% percent of adults over 75 who do not use the internet but do need regular access to prescriptions and medical services? Furthermore, in 2020 the Office for National Statistics reported that over 400,000 over 16s have no access to the internet. With the rising cost of living and an aging population, we can assume that in 2022 this figure will have increased further. Have those backing the universal roll out of the EPS taken into account how these people will access their prescriptions? Is the EPS's target audience only those adults who can easily access and use the internet, and if so, what about everyone else? It is painfully clear that the introduction of this service raises too many questions and very few answers.
The question of who will fall into the category of those unable to access the internet is something that the promoters of the EPS fail to answer. We can see that almost half of all adults over the age of 75 do not use the internet; they either do not have access to it, do not want access to it, or simply do not know how to use it. Whilst being in this age range doesn't necessarily mean that you cannot use the internet, it is clear that this group is one that will be greatly affected by these changes. That is not all; regardless of age, vulnerable adults who may lack the capacity to access the internet, and in turn access any applications or websites, will also be gravely affected. Those with physical or mental health needs may struggle to use this service, as would someone who lacks the financial means to have regular internet access.
We must keep asking the question; what happens to those who cannot use the EPS? From their interpretation, if anyone is to fall into the category of those who cannot access EPS, the following steps will need to be taken:
- If you are unable to access the internet, you should get a family member, carer, friend or neighbour to order your prescription for you using your details.
- If your local Pharmacy does not have access to the EPS, you will have to find another nominated pharmacy who does.
- If you are unable to collect your prescription due to the nominated pharmacy being a fair distance away from your usual Pharmacy, you should get a family member, carer, friend or neighbour to collect it for you.
Whilst at first glance these may seem like plausible answers, they do in fact raise more unanswered questions.
- How does a vulnerable or elderly person without internet access easily find another pharmacy, and why do all pharmacies not have access to EPS?
- What if you live alone and do not have any family, friends, carers or neighbours who can collect your prescription?
- How much do you trust others with your sensitive, personal information and prescription details, and do we even want people we trust to see what medications, aides or appliances are prescribed to us?
- Why should we have to rely on others to obtain our own prescriptions in the first place, when prior to the introduction of EPS this was something that many people could manage without assistance?
It is a blind assumption that everyone has someone they can trust and rely on to access and collect prescriptions for them. We already know that there are huge issues with social isolation amongst vulnerable adults those without family or close friends to follow the steps as laid out has every potential to cause distress and upset and expose the vulnerable to risk.
Perhaps even more worrying, is the question of whether or not we are at the point where autonomy is being removed from vulnerable members of society when it comes to their medical needs? Why does being elderly or disabled or vulnerable mean that your only choice to access medication or aides that you need to improve your quality of life is to share that personal, sensitive information with other people? Regardless of having a trusting relationship with someone who can take these steps for you, it is unreasonable to assume that the process will be without embarrassment or caution for some people. Do we really want to risk ending up in a situation where vulnerable people are risking their health and wellbeing because they feel unable, or are unable to, ask for help accessing something they have every right and need to access?
What does this mean for the future?
Since entering into the 21st Century, the technological boom has been nothing short of spectacular, and has changed how we live life in many positive ways. However, there are undeniable issues that we are still tackling when it comes to this societal progression. We cannot deny that by only allowing the ordering of prescriptions through an online application and not over the phone or even through face-to-face contact, a lot of people who need their prescriptions will not be able to access them. Are we willing to trust non-medical professionals with our prescriptions? Are we ready to operate on an internet only basis to gain everything that we need in life? And finally, considering all the flaws and questions raised, is this really a reliable, secure and confidential service after all?
Originally published 18 July 2022
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.