Electronic prescribing system cuts dispensing errors by almost half in one trust

Exclusive: As a result of implementing an electronic prescribing and medicines administration system, East London NHS Foundation Trust reduced dispensing errors by 45% and saved more than £900,000 per year.
woman using computer at hospital desk

Electronic prescribing systems have reduced the number of medicine dispensing errors by 45% in one London hospital trust, an audit report has revealed.

An audit of the electronic prescribing and medicines administration (ePMA) system at East London NHS Foundation Trust, obtained by the Pharmaceutical Journal through a freedom of information (FOI) request and dated September 2020, also found that it generated cost savings amounting to £916,058 per year.

This included a non-cash release saving of £10,368 by reducing dispensing errors, a saving of £52,125 by reducing medication administration errors and a saving of £547,156 by making medication rounds more efficient.

The trust was 1 of 13 early adopter hospitals in England to receive a share of £16m in November 2018 to implement ePMA systems — an IT system designed to replace handwritten prescriptions and paper medicines charts — by 2021.

However, responses to FOI requests submitted by The Pharmaceutical Journal from 11 of the 13 trusts reveal that less than half — 5 of the 11 responding trusts — have fully implemented an ePMA system, with trusts citing COVID-19 and software issues as causes for the delay.

Roger Fernandes, director of pharmacy at King’s College Hospital and interim chair of the Royal Pharmaceutical Society’s hospital advisory group, said the slow uptake was “astonishing” but added that trusts have had to manage three years’ worth of “competing priorities”.

“We had the vaccination programme to contend with, we had the monkeypox [virus], we had COVID patients in our beds that we had to contend with, so there were competing priorities in the NHS, which meant that ePMA was something less of a priority to focus on,” he said.

Of the five trusts that said they had fully implemented ePMA systems, three reported seeing benefits to patient care and staff workload.

In addition to a 45% reduction in dispensing errors, East London NHS Foundation Trust, which said it completed its ePMA implementation in 2018, also reported 47%, 43% and 70% reductions in the number of errors linked to administration, prescribing and transcribing post ePMA, respectively.

It added that “the total number of medication errors overall have reduced by 42%”.

An audit of the ePMA system at Northern Lincolnshire and Goole NHS Foundation Trust showed that the number of actual errors dropped from 0.46 per patient (139 errors relating to 299 patients) in October 2019 before the system was set up, to 0.37 per patient (71 errors relating to 189 patients) in March 2021, post-implementation.

Paulash Haider, assistant chief pharmacist at the trust, said: “We have seen a reduction in the number of medication errors since we implemented ePMA, and other benefits include the ability to cross-check for any drug interactions and to clearly see any allergies.

“Doctors tell us it makes their ward rounds much easier and, for nurses administering the drugs, they’re not having to contend with illegible handwriting on a paper chart.”

Mid Yorkshire Hospitals NHS Trust, which fully implemented its ePMA system in January 2020, said in a statement that the system has improved safety by using “pre-built protocols to aid decision-making”.

It added that, for pharmacy teams, the ePMA system means “drug charts are always accessible” and “it is easy for pharmacy to document medicine supplies”.

“For patients, it means fewer missed doses of critical medicines, improved timeliness of medicine supply requests, fewer prescribing incidents in patients with documented allergies, and standardised prescribing using quick lists and protocols which thus reduces the risk of prescribing errors,” the statement continued.

Last updated
The Pharmaceutical Journal, PJ, September 2022, Vol 309, No 7965;309(3965)::DOI:10.1211/PJ.2022.1.157602

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