Digital prescriptions – good for patients, good for prescribers and good for dispensers

Full digital prescribing became available nationwide in the United Kingdom of Great Britain and Northern Ireland (UK) from January 2024. Like many health authorities in the WHO European Region, the National Health Service (NHS) in the UK has been developing and implementing new digital technologies over the last few years to improve public health and access to services, and to bring efficiencies to health service delivery at a time when health systems are facing ever-increasing pressures.

The NHS mobile application (App) has been one of these key technologies, reflecting the continuing growth in smartphone use in the country. Since its launch 6 years ago, new functionality has been gradually added to allow users to view their general practitioner (GP) health records, manage hospital appointments, and designate a preferred pharmacy at which to receive medicine prescriptions.

"The NHS App now has more than 33 million registered users, representing 75% of the adult population in England. This demonstrates the growing appetite for patients to manage their health care online, which in turn brings benefits for health providers and medicine dispensers," commented Natasha Lane, Senior Programme Manager for Digital Medicines at NHS England.

Taking digital prescriptions up a level

The App enables users to order repeat prescriptions online without having to visit a GP or health centre. Health providers receive the electronic request, confirm it with the dispenser, and the patient receives a notification when the medication is ready for collection at their designated pharmacy. In the last year alone, the number of these digital requests rose by more than 45%, amounting to 3.1 million repeat prescriptions a month.

Buoyed up by such a positive response, the team at NHS England looked at the feasibility of managing all prescriptions in this way, provided patients had had an initial consultation with their GP in person, through a telephone appointment or via a remote video consultation.

"We initially piloted digital prescriptions in one general practice in October 2023, before quickly scaling up to a network of GP practices, a region, and then across 5 integrated care boards until we had 1 million users," says Ms Lane. "This staged approach allowed us to identify and resolve technical issues and any points of confusion, as well as to manage any potential risks associated with increased volumes of users," she continues.

The trial also allowed NHS England to consult with users on the App content and layout, leading to changes that made it easier for patients to understand, navigate and use.

Easing the burden on health professionals

Commenting on its launch, UK Secretary of State for Health and Social Care Victoria Atkins, said: "This is a tool that will ease pressures on our hardworking pharmacists and GPs, freeing up valuable time for them to see more patients and helping to cut waiting lists."

It is estimated that digital prescriptions, as opposed to traditional paper ones requiring a prescriber's signature and printing, save GPs an average of 3 minutes per prescription, adding up to considerable time savings over a working day and week, as well as a cost savings for health centres. Pharmacists and other dispensers also benefit as patients can show scannable barcodes, making it much easier for dispensers to locate prescriptions and manage stock levels.

Since the start of the year, pharmacists have also been given the authority to offer treatment and prescription medicines for 7 common ailments, such as sore throat and earache, to reduce the patient burden on GPs. This "Pharmacy First" scheme is likely to lead to an increase in patients visiting pharmacies, so the App's efficiencies for prescribing will become ever more important.

The App's new feature also allows patients to view all their prescription information in one secure place, giving them the opportunity to query any issues early on and so avoid any unnecessary delays.

"Adding digital prescriptions to the App contributes to improving the transparency of health systems and allows patients to take more ownership of their health care," believes Ms Lane. "It also, of course, means patients no longer have the inconvenience of having to go to a prescriber to collect a paper prescription, which we estimate saves a person an average of 18 minutes per prescription."

Digital prescriptions in the WHO European Region

The UK is far from being the only country in the Region to introduce digital prescriptions. Indeed, WHO/Europe's latest regional digital health report, "Digital health in the WHO European Region: the ongoing journey to commitment and transformation", shows that 82% of Member States routinely make prescriptions electronically available to their populations.

In addition, in the European Union (EU), some Member States have even gone as far as establishing interoperable systems to allow citizens from one EU country to obtain their medication through a pharmacy located in another (referred to as cross-border e-prescriptions). This means, for example, that a digital prescription issued in Finland could be used in Croatia, Estonia and Portugal without the need for a paper copy.

WHO/Europe views digital prescriptions as an essential part of the digital transformation of health systems. By improving patient safety and quality of care, especially for vulnerable communities, the service boosts efficiency and advances progress towards universal health coverage.

The example set by the UK in its development of the NHS App reflects the priorities of WHO/Europe's Regional digital health action plan for the WHO European Region 2023-2030, which aims to identify patient-centred solutions that can be scaled up at country or regional level to help to shape public health and health systems in the digital era.

Their approach responds to and aligns well with WHO/Europe's report titled "Health and care workforce in Europe: time to act," which highlights how the expanded use of digital tools can support the health workforce.

The UK is also included in a new WHO/Europe report titled "Exploring the digital health landscape in the WHO European Region: digital health country profiles", which takes a closer look at the state of data and digital health in countries within the Region.

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