Eluned Morgan MS, Minister for Health and Social Services
In September 2021, I announced the launch of the ePrescribing programme. Since then, my officials have worked with NHS colleagues and others to advance the work, and today I want to provide an update on progress to date, together with next steps.
The Digital Medicines Transformation Portfolio (DMTP, formerly referred to as ePrescribing) is made up of four key areas:
- Primary care, which includes the implementation of an Electronic Prescription Service in all settings, including dentistry and optometry.
- Secondary care, including the digitisation of hospital prescribing and medication administration activities, including the electronic transfer of prescription information on discharge to primary care settings and from outpatients to community pharmacies.
- Patient functionality – the ability, via the NHS Wales App, to see what medications are currently prescribed, to request further supplies, nominate a preferred pharmacy to collect them from and, where appropriate, record what over-the-counter medication you are taking.
- National Medicines Repository – this is a central location where all medicine information will be held to enable more seamless transfer of information between primary and secondary care settings, as well as between health boards, in real-time.
Work is underway on all four of these areas hosted by Digital Health and Care Wales (DHCW).
In primary care, officials and programme colleagues are in discussion with NHS Digital in England about the adoption of the Electronic Prescription Service currently used for the electronic transfer of prescriptions between GPs and pharmacies in England. We are also assessing how this will be made accessible to dentists and optometrists and other prescribers in primary care who do not currently use NHS Wales IT platforms.
A rollout to a small number of GPs and pharmacies will be started during summer 2023 and then it will be rolled out more widely. Discussions have started around how this can then be deployed at pace across all GPs and pharmacies, and the Programme team are working with system suppliers and primary care colleagues to make this possible. Work specifically to engage with and understand the requirements for non-medical primary care prescribers is being planned.
In secondary care, a procurement framework for electronic prescribing and medicines administration (ePMA) is being created. This is based on an all-Wales set of requirements, both clinical and technical, which will allow health boards and trusts to engage with suppliers on the framework to provide the best possible solution. All solutions must work with other national systems, ensuring data can be accessed across health board boundaries. Health Boards and Trusts are working at pace to establish pre-implementation teams to lead the work to capture their specific local requirements and begin planning for the adoption of an ePMA solution, with Cardiff and Vale University Health Board at the stage of recruiting into their pre-implementation team. Health Boards and Trusts are currently at differing levels of readiness to adopt ePMA – some have been planning adoption for some time already, whilst others have not had the capacity to do so until now. On this basis, Health Boards will not all start the adoption journey at the same time, nor at the same step of that journey, and so start dates for each Health Board may appear staggered. This allows learning to increase and be shared as the programme progresses across all our hospitals.
In terms of functionality for patients, the Digital Services for Patients and the Public Programme (also hosted by DHCW) has commissioned a piece of user research from the Centre for Digital Public Services about what primary care capabilities should be included in the NHS Wales App. DMTP will use this and its own work to determine how people want to use the NHS Wales App to manage their medicines. This will ensure the design of the NHS Wales App reflects the needs and views of patients.
The Medicines Repository work has started with the procurement (on a proof-of-concept basis) of a platform which could underpin it. A full assessment of potential technologies will take place this summer before the team progress with building the final version of the Medicines repository. The repository will be based on industry open standards for data, which means that any platform will be able to share data with it. The repository will also receive data from other prescribing platforms in use across NHS Wales, such as the Digital Intensive Care Unit system and the Cancer Information Systems Replacement, both of which have highly specialised prescribing functionality– but that data will be available to allow clinicians to make a fully informed medication decision when considering how to treat a patient.
The full, complex rollout of the Digital Medicines Transformation Portfolio is expected to take between three to five years. Some parts of the programme, such as primary care electronic prescriptions service and functionality in the NHS Wales App will be available sooner. Teams across the NHS are working hard to deliver this transformational change to improve the way that medications information is handled across Wales.
A communications team is being established to ensure that there is effective and consistent communication of progress from every part of the Portfolio and also regular two-way engagement with the many stakeholders across Wales who will benefit from our ambitious Digital Medicines Transformation Portfolio.
I will continue to update Members as work progresses.