The Electronic Prescription Service (EPS) promises to make life easier for GPs, with prescriptions sent electronically to the pharmacy of the patient's choice, cutting down on paper and patients making journeys for repeat prescriptions.
In theory it sounds great. But not for dispensing GPs, who believe that their requirements were forgotten when the software was designed.
'I get the impression it is more a lack of knowledge really,' says Dr Jeremy Phipps, a GP in rural Lincolnshire. 'Because most civil servants tend to be based around London, they are used to what happens in cities and don't have any understanding of rural general practice and dispensing in particular.
'I think that makes it difficult for them to be able to comprehend the issues raised.'
The questions that arise are to do with dispensing practices already having their own software, with the GP prescribing a drug and a message immediately sent to the dispensary.
This is further complicated by the fact that having prescriptions dispensed at the practice is only the procedure for patients who live more than 1.6km from the nearest community pharmacy. All other patients go to their local pharmacist.
Link up systems
Linking the systems should in theory be relatively easy, says Dr David Baker, chief executive of the Dispensing Doctors' Association (DDA). 'What is missing to make it compatible with the EPS as envisaged currently is that electronic message going up the NHS IT spine and back again.'
Dr Baker says this should be 'incredibly easy' but a lot of the dispensing software suppliers in general practice do not necessarily use the same drug dictionary as the EPS one. 'The names (of drugs) have to be the same,' he says.
It is possible for a dispensing practice to be EPS-enabled, but it will have to run a double-entry system rather than the current integrated system.
Dr David Bailey, a GP in Caerphilly, Wales, has done this at his practice and is not impressed.
'We have it for a tiny number of patients purely because it was brought in as a marker for part of our prescription incentive scheme. Because of the problem of changing prescriptions, we only use it for a small number, who have, say, thyroxine.
'The problem is that every time you have to change anything on the prescription, you have to change the EPS. Until we can resolve that, it is not a time-saver for doctors,' he says.
But even for dispensing doctors prepared to do this, poor internet connections add to the problem. 'There are times when we struggle to get internet connection,' explains Dr Phipps.
The DDA suggests that instead of the prescription going up the spine and being pulled down for dispensing, it should be sent up the spine overnight when the internet is less busy. However, it has been told this is technically not possible.
Dr Phipps foresees a negative effect on rural GPs if patients move to an EPS practice where they can go to the pharmacist for their prescription instead of having to see the GP. 'That means we are unable to plough the money from that back into improving services,' he says.