Reporting Suspicious Patient Nomination Changes – Guidance for Derbyshire Pharmacy Contractors

Reporting Suspicious Patient Nomination Changes – Guidance for Derbyshire Pharmacy Contractors

The NHS Electronic Prescription Service (EPS) allows patients in England to choose a preferred pharmacy, to which their prescriptions can be sent to electronically, and from where they can then collect their medication. As pharmacy contractors, you play a vital role in protecting patients’ rights and maintaining the integrity of the NHS Electronic Prescription Service (EPS). Unauthorised changes to a patient’s nominated pharmacy can disrupt their care, send prescriptions to the wrong pharmacy, and breach patient consent requirements set out by the Terms of Service in the NHS Pharmaceutical Services Regulations.

Patients must be free to choose their nominated pharmacy. They must not be influenced, persuaded, or incentivised to nominate a specific pharmacy. Information received suggesting that these principles have been disregarded may be reported to the GPhC and treated as misconduct for the purposes of fitness to practise.

If you suspect that another pharmacy has changed a patient’s nomination without their consent, please follow the process below.

How to report a suspected unauthorised nomination change

1. Obtain the patient’s consent.
   You must have the patient’s consent before sharing their details. Confirm they understand and agree to the report being made.
2. Gather information.
   Record the patients NHS number, and a brief description of why you believe the nomination change was unauthorised.
3. Contact the Primary Care Team ensuring you use your NHS.Net email address (adding read receipt to ensure you have evidence of it being received. It is also advisable to save a copy of the email sent). 
   Email england.eastmidspharmacy@nhs.net, including:
   o  Patient’s NHS number only, not their name or address
   o  Summary of the issue and when it was noticed.
4. Primary Care Team action.
   The team can request a nomination report from NHS Digital showing who made the change, when and where it occurred, allowing them to investigate and confirm whether proper consent was obtained.
5. Escalation and next steps.
   If, following investigation, there is evidence that a pharmacy has changed nominations without consent, or has influenced, persuaded, or incentivised patients to nominate them, the ICB Primary Care Team may take contractual action and may also escalate the case to the GPhC as a potential fitness to practise concern.
6. Cooperate with follow-up
   You may be asked for further information to support the investigation. Keep a clear record of all communications.

Good practice reminders

• Make sure all staff know that changing a nomination must be done with the patient’s informed consent.
• Always record evidence of patient consent when changing nominations, for each and every change to a nomination.
• Patients must make their own choice of nominated pharmacy—without any pressure or incentives.
• Report any suspected unauthorised changes promptly to protect both patients and the EPS system.
• Information suggesting unethical nomination practices may be escalated to the GPhC as potential misconduct.