Eluned Morgan, 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.
