The Department of Health has published statutory directions for release two of the Electronic Prescription Service, which it hopes will start to go live in early 2009.

The directions mean GP practices in the 17 early adopter PCTs can use the business processes introduced in release two including issuing prescriptions with electronic signatures, electronic cancellation of prescriptions and electronic repeat dispensing.

Guidance issued with the directions states that implementation of release one of EPS is almost complete, introducing the technical infrastructure to enable prescribers and dispensers to use the EPS.

A spokesperson for Connecting for Health told EHI Primary Care that only GPs in a PCT listed in the directions will be able to use EPS release two at the moment. There is no equivalent requirement for dispensers so a prescription issued in one of the initial implementer PCTs could be dispenser by a dispenser in any PCT.

However, CfH said initial implementation would be limited to “1-1 pairings of practices and pharmacies” to ensure systems are robust.

It added: “"Work is ongoing with initial implementer PCTs to finalise plans for initial implementation of EPS Release 2. Based on current system supplier plans it is anticipated that the first sites will go live early in 2009."

Release two includes the option for patients to choose or ‘nominate’ a dispenser to which their prescriptions can be sent electronically via the EPS.

The directions require initial implementer PCTs to monitor the identities of the nominated dispensers recorded on the Personal Demographics Service, and consider whether further investigation of action is appropriate “where they identify any unusual or unexpected distribution of nominations”.

Pharmacy representatives have expressed concern that the nomination functionality could lead to direction of prescriptions rather than patients having a genuine choice.

The guidance states that PCTs will be able to access nomination reports from within the Secondary Uses Services with summary and detailed information about nominations made.

It adds that all GP contractors have obligations not to persuade a patient to nominate a particular dispenser and if asked by a patients to recommend a pharmacist to nominate as their dispenser should provide the patient with the list of all the pharmacists in the area that provide an ETP service.

Further investigation or action could lead to PCTs taking action for breach of contract if trusts consider it appropriate, the guidance adds.

The initial implementer PCTs are, in wave one, Berkshire East, Leicestershire County & Rutland, Liverpool, Southwark and Sunderland. Wave two initial implementer PCTs are Berkshire West, Birmingham East & North, Blackburn with Darwin, City & Hackney, Haringey, Isle of Wight, Leeds, North East Lincolnshire, Nottingham City, Nottingham County, Suffolk and Trafford.