Respecting Patient Choice for Pharmacy EPS Nominations

In recent months, Community Pharmacy England has received a number of concerns about EPS pharmacy nominations and re-nominations without patient consent, and wishes to remind pharmacy owners of the relevant Terms of Service requirements and the importance of patient choice of nominated pharmacy.

Terms of Service

The Terms of Service provide that a pharmacy owner must, if requested by a patient, nominate that patient in the NHS Patient Demographics Service (PDS) (paragraph 11 of Schedule 4 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. This is a familiar process for most pharmacies, and patient choice of nominated pharmacy underpins this requirement. In this context, that means, for example:

• Patients must be able to change their nomination without recourse to, or permission from, the currently nominated pharmacy, and
• Pharmacy owners or others must not automatically nominate patients or reverse patient nominations (automatically re-nominate patients), i.e. do so without patient consent.

Community Pharmacy England’s briefing, EPS nomination – core principles, provides additional information on patient nomination.

Patient choice of nominated pharmacy is also supported across the NHS, as follows:

• NHS guidance for patients choosing a pharmacy states that ‘when you request a prescription online, you can have your prescription sent electronically to a pharmacy of your choice. This is called choosing a pharmacy (it’s also known as nominating a pharmacy)‘. Patients can also change their nomination within the NHS App.
• The General Pharmaceutical Council (GPhC) guidance on patient consent and the EPS states that deliberately changing a patient’s EPS nomination without their consent could be a serious matter. It can cause unnecessary delays to patients receiving medication, as well as undermining trust in the profession. It may also amount to a misuse of sensitive patient information in breach of data protection legislation … patients must give informed, explicit consent if they want to change their nominated pharmacy.

The purpose and intent of the various rules and guidance is that, as appropriate, patients should be able to nominate a pharmacy, to stay with their nominated pharmacy, or nominate another pharmacy.

Community Pharmacy England is also concerned that certain IT functionality available to some pharmacy owners appears to facilitate automatic patient re-nomination (without patient consent) and is discussing this issue with NHS England.