Some of the most controlled drugs could be made available on the Electronic Prescribing Service under new plans put out for consultation by the Department of Health.
The current system does not allow more closely controlled drugs – those labelled as schedule 1-3 – to be made available through electoronic prescribing over fears that there is greater potential for them to be misused.
But the DH is asking for views on any potential problems that could arise from rewriting the Misuse of Drugs legislation, and is also looking at whether similar measures should be implemented for privately prescribed schedule 2 & 3 drugs electronically where the dispenser uses an NHS system.
This would mean drugs – such as tramadol, which has recently reclassified as schedule 3, and temazepam, which has had some prescribing exemptions lifted – would be able to be prescribed electronically.
The consultation says that this change could mitigate potential problems with patient safety under the current system, which sees some patients having a ’split prescription’, where one part is available via the EPS but another requires them to visit the practice.
It states: ‘As well as being inefficient and reducing the benefits of EPS, splitting prescriptions has also raised issues around patient safety. If the patient or dispenser has not realised that there is a “split prescription”, the patient may only get one part of that prescription and not the complete medicines prescribed. They may get the electronic and not the paper prescription or vice versa.’
It adds that the DH and other parties ‘understand this practical difficulty and therefore are consulting on extending the scope of electronic prescribing for Schedules 2 and 3 controlled drugs.’
Dr Bill Beeby, deputy chair of the GPC’s clinical and prescribing subcommittee, told Pulse that using EPS may reduce the opportunities for misusing prescriptions, which is inherent in conventional prescribing already.
Dr Beeby told Pulse: ‘There are still ways around getting the prescriptions. Perhaps actually getting prescriptions into EPS will prevent some of the days when these prescriptions got lost on the way to the pharmacy, or got washed in people’s clothes.’
Dr Beeby said care was needed with controlled drugs, because ‘by their very nature they’re drugs of misuse and dependence’.
He added: ‘We probably need to have robust systems for reviewing people on their medications, that’s almost a given, whatever system is used for getting the prescriptions to the patients and getting them dispensed.’
Dr Richard West, chair of the Dispensing Doctors Association, told Pulse: ‘It needs appropriate safeguards, like all controlled drugs do. But actually if you’re looking to prevent misuse of controlled drugs, then if you’ve got a database that you can search and manipulate the data within it, it must be easier to work out what’s going on than just having a whole pile of prescriptions.’