NHS e-prescription service goes TITSUP: Problems since Monday

The NHS electronic prescription service (EPS) has barely been working since Monday, and is still suffering a Total Inability To Support Usual Performance in many parts of England, thanks to problems with system supplier Cegedim.

The EPS allows General Practitioners to send patients' prescriptions electronically to a pharmacy, or other dispenser, of the patient's choice. It is intended to make the prescribing and dispensing process more efficient and convenient for patients and staff.

Unfortunately, and for reasons we've not been able to uncover, ESP hasn't quite been doing that since Monday.

The issue really lies with outsourcer Cegedim. Although the Health and Social Care Information Centre (HSCIC) told us that it is "beginning to resolve ... there are still prescriptions stuck in the system, as it were."

A HSCIC spokesperson added: “As a result of the issues with Cegidim earlier this week, a number of prescriptions are still held up. We are working with Cegedim to help resolve this. We hope the backlog will be cleared and the system running normally very swiftly.”

This is not the first time a Cegedim issue has caused EPS trouble. Pharmacies publication Chemist and Druggist reported (registration needed) on another EPS failure back in April of last year, which at that time Cegedim blamed on BT.

Failing gracefully

One retired GP told The Register: "It doesn't seem to have been designed or implemented by the various GP system suppliers (working to very close rules from I suppose HSCIC) to fail gracefully. Being a pessimist I'd have written it to announce ruefully 'I cannot send the prescriptions for today electronically, so I am printing them now' and do so."

They added: "Were I running the thing on a central or national basis, have announced there was a glitch centrally, so as to avoid a million patients making a million phone calls asking 'Where is my prescription?' to 40,000 General Practices about it. That's management and efficient use of resources in other organisations, nothing technical at all."

"Still," they told us, "the organisations responsible are as famous for managerial excellence and helpfulness as they are for technical expertise."

The Register has emailed Cegedim for comment. ®

Update

The head of Cegedim's Healthcare Software Division in the UK replied to The Register at 10pm on Sunday to explain:

On Monday evening (6 June) Cegedim Rx suffered a service interruption on its Message Broker in England which manages the transfer of electronic prescriptions prescribed by doctors through the NHS Spine to pharmacies using the Cegedim pharmacy patient medication record systems. The message brokering service used by Cegedim in the UK is provided by a number of external third party suppliers who were all actively engaged during this service interruption.

The fault was initially diagnosed and was thought to be rectified but subsequently re-occurred so the system had to be temporarily halted due to the backlog of traffic.

We restored the service in stages to monitor and control the traffic which took some time to get the service fully and safely back to normal online operation.

During the outage some electronic prescriptions were undelivered. When this occurs we work with HSCIC (the NHS responsible body) to ensure that these prescriptions are resent as soon as possible. This process is still underway but anticipated to be completed over the weekend.

Pharmacies in Scotland, Wales and Northern Ireland were not affected by this incident. We apologise for the inconvenience this has caused to patients and our customers.

Cegedim is currently completing a multi-million pound investment to transition the service to its new message broker which will be managed with full resilience and totally controlled by Cegedim staff thus removing the dependency on third parties. This operation should see the majority of our customers transferred by the last quarter of 2016.

On Monday morning, a spokesperson for the HSCIC added: "There have not been any problems with the EPS system as a whole, although there have been some issues relating to one of the system suppliers, Cegedim, which sends and receives EPS messages through the Spine infrastructure. No other system supplier has been affected and this entirely an issue related to the Cegedim system."

"Pharmacies arrange their own contracts with the system suppliers for EPS," the spokesperson added, "of which Cegedim is one. Cegedim is conducting a thorough investigation and providing HSCIC with regular updates."