Eluned Morgan MS, Minister for Health and Social Services
Earlier this year, Welsh Government undertook an independent review into ePrescribing in Wales. The review, which involved stakeholders from across all parts of NHS Wales, concluded in April. Since then, officials have worked with NHS colleagues to develop a plan to introduce ePrescribing throughout the lifecycle of a prescription. This written statement outlines how we will deliver a comprehensive ePrescribing programme for Wales.
We want to make sure services deliver the best outcomes for citizens, and are designed around how citizens and service providers want to use and manage those services. Through ePrescribing, we can improve and digitise the way patients, clinicians and pharmacists access and manage the provision of medicines across the health system. This will include: patients’ access to medicines, prescribing of medication by clinicians, the assurance and dispensing of prescriptions by pharmacists, and the auditing and pricing of medicines by monitoring authorities.
The review determined the key recommendation to be progressing delivery across four “domains” of ePrescribing in parallel. This is expected to be delivered within three to five years. The four domains identified in the review are: primary care, secondary care, patient access, and a medicines data repository. This programme will transform prescribing in Wales, supported by a digital platform.
The programme will deliver a digital service regarding the issue and receipt of prescriptions. Currently, GPs and other clinicians in primary care produce prescriptions using electronic solutions but must print and sign hard copies which are transported to a pharmacy for fulfilment. The hard copy prescriptions are archived for reporting by the NHS Wales Shared Services Partnership. The programme will complete the digitisation of this process so that paper prescriptions and ‘wet’ signatures are replaced by electronic prescriptions and electronic signatures. Prescriptions will be sent electronically from the authorising prescriber directly to the pharmacy for fulfilment.
The programme will implement an electronic platform for prescriptions within hospitals, as well as providing electronic drug charts to simplify administration of medicines. Swansea Bay University Health Board recently implemented an ePrescribing solution pilot across two hospitals. We will apply the lessons they have learned around the organisational change to influence and shape our national ePrescribing Programme. Applying these lessons to other Health Boards and Trusts will allow us to accelerate the pace at which we can deploy the solution across Wales.
Providing patients with access to improved information about their medicines is an important consideration. The programme, in partnership with the Digital Services for Public and Patients programme, will develop features within the planned NHS Wales app to allow patients to order repeat prescriptions electronically, to record when they have taken their medication, and potentially to access instructional information on administering their medication. We know that not everyone can, or wants to, access online services; therefore, ensuring that the solution is digitally inclusive is a key priority of the programme. The app will not replace any existing methods to access information or services, it will only complement them. We will design our services around the needs of the patient to ensure this.
The programme, in partnership with the National Data Resource programme, will implement a central medicines data repository. This will store the electronic prescription records issued, whether in primary or secondary care and regardless of where in Wales the prescription is issued. The repository will mean data is available to clinicians across Wales whenever it is needed. For example, if a patient is admitted to a different hospital from the one they would normally attend, the staff would have immediate access to the patient’s medication records to understand what the patient has been prescribed. This will ensure they do not prescribe a medication that is incompatible with one they are already taking, or that could cause an adverse reaction. Access to this data would be restricted to those who need it, under very strict controls. The repository will allow other parts of NHS Wales to use anonymised data to review where medication is prescribed and in what quantities to allow proactive stock management and financial assurance.
The programme will be led by Digital Health and Care Wales, supported by the NHS Collaborative and teams within each health board and trust. The Centre for Digital Public Services will provide advice to help the programme to go forward in line with our digital service standards using appropriate user-centred design approaches.
I would like to take the opportunity to thank those stakeholders from across the Welsh health sector who have engaged with my officials and provided useful input to the independent review. Together with the Programme team, officials will continue to engage with these groups moving forwards as the Programme is established and begins implementation, to ensure users and practitioners are at the centre of our approach.
The first members of the team are due to be appointed in September to allow the programme to commence and I will update the Senedd periodically as the programme progresses.