The first trial of electronic prescriptions, which kicked off in Yorkshire earlier this month, is just the start of a process that will change the role of pharmacies.

At its simplest, the electronic transfer of prescriptions (eTP) system, part of the £6bn National Programme for NHS IT (NPfIT), will automate the current paper-based process.

More than 325 million paper prescriptions are issued each year. Each one is taken to a pharmacy, where the data is re-keyed into its own system. The paper script is sent on to the Prescription Pricing Authority (PPA), which deals with the remuneration of pharmacies for the cost of the drugs, where the data is re-entered again.

?The process is tremendously wasteful when you look at it from end to end,? Tom Donohoe, group programme director for NPfIT, told Computing.

?Essentially, the concept of electronic prescriptions is that the data carried around in script form is carried electronically between the GP, the pharmacy and the PPA.?

With eTP, patients will be able to nominate which pharmacy they want to collect drugs from, and their prescription will be transferred electronically there and to the PPA.

The Keighley site in West Yorkshire is the first of up to six trials that will go live over the next few months, with a target to have 50 per cent of pharmacies using the system by the end of this year, and 100 per cent by the end of 2007.

The Pharmaceutical Services Negotiating Committee (PSNC) represents the pharmacy sector in negotiations with the NHS. Lindsay McClure, head of information services for the PSNC, says the rollout of eTP is central to improving the overall efficiency of drug dispensing services and to the plans for a greater role for pharmacists in patient care.

?We certainly think eprescriptions will be fundamental in helping improve the efficiency of dispensing processes,? she said.

?That will free up pharmacists? time to help deliver new services, such as diagnostic testing and medicine use reviews.?

eTP is central to government plans to give pharmacists a wider role, helping to take the pressure off GPs, says McClure.

?Electronic prescriptions will help boost efficiency, but pharmacies perceive that as only the start of what NPfIT can offer,? she said.

?They are also keen to have access to the national electronic care records service once that becomes available, because access to that information could help improve the pharmacists? care of patients.?

One area that could be affected is ?supplementary prescribing?, where a pharmacist can authorise medicines for patients under a clinical management plan agreed with their doctor.

For example, patients on the anti-coagulant warfarin need to have their blood checked regularly and their medication level adjusted accordingly. With an agreed clinical plan and electronic access to a patient?s medical record, this diagnostic testing and dosage alteration could be done in the pharmacy, rather than needing an appointment with a doctor.

?Access to patient data would help pharmacists become even more effective members of the primary healthcare team,? said McClure.

But there is still considerable work to be done before eTP, let alone wider NPfIT systems, are in place.

The government is providing funding ? £58m in the first year ? to pay for any new front-end IT systems that pharmacies will need for eTP. But the details of how the money will be divided and the overall rollout strategy are not yet finalised.

While the core software is already largely finished, as part of the ?data spine? contract being developed by BT for the NPfIT as a whole, connecting all 9,700 pharmacies in England to the high-speed N3 NHS network will be a significant and time-consuming job.

Furthermore, the 11 front-end pharmacy software packages will each have to go through development and compliance testing to make them work with the BT back-end, before being fully rolled out.

The final major hurdle will be training. Instruction on using the newly-compliant front-end systems is best left to individual suppliers, but there is also considerable work to be done around the business process changes the new system will create.

User group to examine the impact of eTP

Stable central processing software for national electronic transfer of prescriptions (eTP) is now established, but there are still plenty of details about how the system will work on the ground that are not yet firmly agreed.

The National Programme for NHS IT (NPfIT) has set up an eTP user group bringing together GPs and pharmacies who use different systems in different types of organisations, to look in detail at the impact of eTP on business processes.

?We?re trying to get a cross-section of GPs and pharmacies from a range of backgrounds to help work through these issues,? said NPfIT group programme director Tim Donohoe.

?The aim is to ensure that the benefits of the electronic service are maximised, and that when we come to the wider rollout we have a clear set of lessons learned from a range of different contexts.

?The core software is all in place, but what we are talking about at the user end is the interaction with the system ? the human side rather than the rigid processes built into the central system.?