Digitising Pharmacy for Primary Care

Ruth Bradbury is a Senior NHS Navigator for the DigitalHealth.London Accelerator Programme. One of the companies she supported during the 2021/21 cohort was Phlo Digital Pharmacy – an online pharmacy that allows patients to easily order, manage and track their medication delivery straight to their door.

In September 2021, DigitalHealth.London and the Health Innovation Network hosted a roundtable event chaired by Ann Slee, Associate CCIO for Medicines at NHSX. The aim of the roundtable was to hear from GPs and Primary Care Pharmacists on two topics:

1. How innovation to digitise NHS pharmacy services is working
2. Whether the developments in online pharmacy services were making it more attractive to advocate for their use alongside traditional bricks and mortar services.

Ruth reflects on her key learnings from the roundtable event:

Prescribing pressure points

The Electronic Prescription Service (EPS) is an invaluable service for GPs and patients. Throughout the Covid-19 pandemic, EPS has supported digital prescribing of medication following primary care telephone or video consultations, reducing footfall into GP surgeries and reducing the need for the patients to visit multiple sites to get their medication.

However, there are some challenges for both GPs and patients. Repeat prescription management through the electronic repeat dispensing (eRD) service is a very useful function but one that doesn’t always meet the idiosyncrasies of multiple repeat medications with different timeframes for dispensing. This often means that GPs don’t use it as effectively as they could. Automation of these processes could be a potential solution to making repeat dispensing a more seamless process.

Patients and pharmacies also like that the patient can request or be prompted to request a repeat medication through their pharmacy who can then request the repeat prescription with the GP, however, some CCGs have taken to restricting this service due to the risks around over-prescribing and medication hoarding by patients. There are recognised time-savings by utilising this function of EPS and the eRD service which are unfortunately not always realised.

Additionally, the patient experience in the prescribing journey must be considered. Many patients want to be able to track their prescription on the ‘request-prescribe-dispense-collection’ pathway. GPs also want to be able to see if patients have collected their medication. Currently there are no NHS systems that provide the functionality to enable patients to know the right part of the system to approach should there be a prescribing bottleneck. Online Pharmacies, like Phlo Digital Pharmacy, do offer this solution to their patients but those who use bricks and mortar pharmacies have to rely on phone calls or face-to-face visits to surgeries and pharmacies to track the progress of the prescription. A solution to solve the tracking challenge could be through the NHS App. Whilst this solution is a desirable, patient-centric idea, there are currently challenges with surfacing the data into the NHS App because of the variety of different systems that would need to feed into it.

Opportunities for digital change

The current EPS offer could be improved to make the GP and patient experience better, for example, by using automation of processes to streamline repeat prescribing processes. 

Opportunities for pharmacies to play a more central role in monitoring patients’ medication adherence, which in turn would reduce the risk of stockpiling, could support confidence in pharmacy-led ordering. Digital systems and data tracking are central to creating this type of assured environment for commissioners.

Digitising dispensing processes also has the potential to help ensure patient safety, for example, Phlo’s technology can deploy checking algorithms and automation processes to achieve a 99% accuracy rate for medication dispensing which is significantly higher than settings where manual-only checking processes are employed. However, the focus needs to be on empowering the patient to track their prescription and engage with the right part of the pathway when there are issues or queries. Where national systems like the NHS App are not yet ready to provide such functionality, online pharmacy platforms and apps like those provided by Phlo are able to offer this solution to patients. 

Making digital accessible for patients

Pharmacy nomination is a patient choice. However, regardless of whether patients choose a bricks and mortar or an online pharmacy, it is critical that when making this choice they understand the benefits of digital systems on their medication management. 

There is growing awareness among Primary Care clinicians that online pharmacies can support convenient and covid-safe access to medication through delivery options that prevent the need to go to a physical pharmacy and that where routine dispensing can be managed by online pharmacies, bricks and mortar pharmacies can be freed up to deliver more front-line health care services in their communities.

If in the future we can focus on demonstrating the safety and excellent customer service that digitising pharmacy systems can deliver, then patients are more likely to be empowered to take more control in managing their medications.

If you would like to know more about Phlo Digital Pharmacy, visit their website.

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