The chief executive of Titan PMR, Tariq Muhammad, has welcomed the NHS England's move to update its EPS nomination standards, but said more needs to be done around enforcement to curb its misuse.
Muhammad told Pharmacy Business, "Whilst the initiatives being undertaken by stakeholders are welcome, unfortunately, they are meaningless unless there is serious enforcement and consequences for breaches.
"As a system supplier to almost 1,500 pharmacies around the country, at TITAN we hear many reports where our customers are being impacted due to unscrupulous businesses trying to take market share through ‘stealing’ patient nominations.
"Despite their best efforts of reporting issues to their local ICBs and CPE, as suggested by the guidelines, little or no action is taken. I have had reports from customers who suggest their ICB simply does not care, or is simply unable to do anything.
"The petition I launched earlier this year now has nearly 5,000 signatures. Although not enough to get a government response, it has raised awareness of this issue and helped drive the initiatives we are seeing. However, more needs to be done around enforcement than simply education or treating this like a tick-box exercise."
NHS England recently updated its national standards on how pharmacy teams and IT system suppliers process nominations.
This follows renewed scrutiny of nomination practices.
Regarding nomination standards, the NHS has spelled out four key points:
- Patients must choose their own nomination.
- Patients must not be persuaded, and inducements cannot be offered.
- Prescribers and dispensers will need to confirm, set, change, cancel and reconfirm a patient’s nomination on time.
- Prescribers and dispensers must use clear processes for nomination.
In its guidance, NHS England has clarified that “NHS Patient Demographic Services holds the patient nomination and, in accordance with the Data Protection Act, access to the nomination-related data held within PDS must only be where a legal basis exists.
"For dispensers, that would be because a patient has presented and wishes to change their nomination, requires a consultation or where dispensing activity is required. There would be no legal basis to access PDS nomination data outside of this, and a previous nomination is no guarantee of future intent.”
NHS England has written to system suppliers to remove any functionality that does not comply.
It said that its updated standard intends to protect patient choice and privacy; prevent unintended or inappropriate nomination changes; ensure consistent behaviour across all pharmacy IT systems; reduce queries to NHS England, GPhC and ICBs; and support public confidence in EPS and the NHS App, which enables change to nomination.
This position also reduces the risk of “patient ping‑pong”, where nominations switch back and forth between pharmacies without the patient’s knowledge.
Pharmacies can continue to set, change, or remove a nomination under the following circumstances:
- When the patient (or their representative) requests it
- After providing clear information about EPS and nomination
- With an auditable record of who made the change (as captured in Smartcard logs)
Teams must not:
- Routinely look up or monitor patient nomination status
- Use tools that perform periodic, automated, or bulk PDS checks
- Assume a patient wishes to stay with the pharmacy
- Change nominations without explicit consent
