Online repeat prescription ordering has been a requirement of the GP contract since 2015. This is one of the most popular online services and has wide ranging benefits for patients and practices. It is one of a range of online patient services, including appointment booking and cancellation, access to patient records, and electronic consultations.
Online services complement other ways patients can book appointments, order prescriptions, and access their general practice medical record.
Online ordering is not expected to entirely replace paper-based requests or telephone ordering.
Uptake for practices can be high if the practice promotes the service effectively.
Online prescription ordering has a number of benefits to both patients and to practices.
Benefits to patients include:
- ease of use via a wide variety of apps or websites, such as the NHS App
- links via the practice website on smartphone, tablet, or computer and available 24/7
- ability to add a query or comment to a prescription request via the messaging option
- option for parents, carers, relatives, and care home staff to order using proxy access
- reduces the number of times a patient needs to contact their GP practice
- ability to see changes made to their repeat medication online
- ability to see a current list of repeat medication which can provide information for other services (e.g., hospital visits)
- ability to check when medication was last ordered or is due
Benefits to the practice include:
- improved clinical/patient safety, reducing the potential for prescribing errors
- fewer telephone calls and unplanned surgery visits
- saving staff time as direct patient contact is reduced
- message option saves telephone and appointment time and allows the practice to respond by text, email, telephone when they have capacity
- may help to reduce medicines wastage as the patient can see clearly what they are ordering and are less likely to order unwanted medication
- prescribers can make any immediate changes in medication that are necessary following a consultation or receipt of a clinic letter
- patients are aware of the medication that has been prescribed, reducing the number of patient queries
Practices need to be mindful of, and make alternative arrangements for, patients who cannot or prefer not to access online services.
Practices should also consider whether the patient is suitable for electronic repeat dispensing (e-RD) which can be beneficial to both practice and patients.
Proxy access to online repeat prescriptions
Access to online services by someone representing the patient, their ‘proxy’, can be helpful in supporting the care of patients with long-term conditions, or those identified as lacking competence to manage their health and care. Proxy access gives parents, relatives, carers, friends, or care home staff the option to order medication. Proxy access can be particularly useful for parents with children aged 11 or under who need regular medications.
The practice must be satisfied that there are no safeguarding concerns in relation to the patient. The patient or their representative must provide consent, in the case of children consent is assumed until the child is 11 years old.
A proxy does not have to be registered with the same practice as the patient to be given access to the patient’s record.
Proxy access by care home staff
Care home staff can become designated proxies for home residents and, therefore, order medication of their behalf.
A proxy access by care home staff toolkit has been developed by NHS England which includes all the relevant forms and information for residents, their families and care home staff. The toolkit includes several downloadable resources.
Governance and training
Practices should have a GP prescribing lead and an administrative lead, to identify and manage risks, monitor the system, and ensure all staff have the appropriate training.
New staff need to understand how the system works. They also need to understand the policies of the practice relating to online requests for repeat prescriptions.
Training should be provided in the following areas:
- how the online prescription and messaging system works
- the effect on medication reviews
- informing patients about using online services and helping them to register
- verifying identity of patients
- helping patients keep their NHS account secure
- support for patients with sensory, intellectual, or other needs (including limited IT )
- being alert to the risk of coercion
- how to manage proxy access
- addressing patient concerns
Barriers to take up
Barriers to take up tend to focus on the following:
- patients being unaware of the (practices should routinely and continuously promote the service)
- patients lack skills or confidence in using IT (patients can be directed to help and support services)
- patients’ problems with access or activation of an online account (staff should be ready and able to help with)
- mistrust that the system is not secure, and that information may be accessible to others
- patients lacking equipment and the infrastructure required for online access or not realising they don’t need a tablet or computer and that a smartphone can be used
These barriers are important to think about when promoting services.
Monitoring online repeat prescribing
Practices have contractual targets for patient take up of online services. The patient online management information report can be useful for practices to see the percentage of online or transactional services that are most used in their own and neighbouring practices.
- Ordering prescriptions online is one of a range of online services practices are required by contract to provide and to promote.
- Online services can be accessed via a smartphone, tablet, or computer.
- There are a range of benefits for practices and for patients when patients order prescriptions online.
- Practices need to be aware of the risks of digital exclusion and services tailored accordingly.
- Proxy access for online ordering of prescriptions is supported by clinical systems.
- Practices should appoint a GP prescribing lead and an administrative lead for online ordering of prescriptions.
Related GPG content
- Identity (ID) verification
- Health equalities and inclusion – to follow
- Digital skills for patients
- Proxy access
- Promoting online services
- Registering patients for online services
- Online appointment booking
- Safeguarding – to follow
- Electronic repeat dispensing (eRD)
Other helpful resources
- UK, Information for patients, How to order online – NHS guide
- UK, General information for patients about online services
- Healthy London Partnership, YouTube video on benefits of online prescription ordering (51 mins)
- NHS England, Safeguarding, related to online services, coercion, and proxy access