Enabling Digital Prescribing in Secure Environments: Exploring Electronic Transmission of Prescriptions (ETP) Model for Health & Justice
Friday, 26 September 2025
Background
Electronic prescribing and transmission models are widely adopted in NHS settings, but secure environments remain reliant on manual, paper-based workflows requiring wet signatures. This leads to operational inefficiencies, delays in patient access to medication, and increased risk of transcription errors. Schedule 2 & 3 Controlled Drugs cannot currently be prescribed electronically under UK legislation, requiring physical signed copies to be posted or delivered to pharmacies.
A discovery project was undertaken to assess the feasibility of implementing an Electronic Transmission of Prescriptions (ETP) solution for internal prescriptions in secure environments. Engagement was carried with stakeholders, clinical system provider, and third party ETP providers to understand technical capability, legislative constraints, and potential digital solutions.
Action
The project team reviewed current prescribing workflows across secure environments with on-site, hub-and-spoke, and community pharmacy models. Technical assessments were undertaken with the current clinical system provider to explore potential enablement of ETP to support compliant digital prescribing.
Parallel engagement with two external ETP providers explored standalone solutions offering Advanced Electronic Signature (AES) functionality and interoperability with the current clinical system. The project team also reviewed legal and governance requirements.
A set of recommendations were developed including piloting digital prescribing in selected sites, progressing technical feasibility with the current clinical system supplier, monitoring legislative changes for Controlled Drugs, and developing an implementation roadmap for future rollout.
Impact
The discovery work explored digital solutions to improve prescribing processes within secure environments:
Key outcomes included:
- engaged stakeholder groups across three secure environments, and three ETP providers to align future implementation options
- identified two potential digital models to enable secure electronic prescribing
- highlighted the potential for Advanced Electronic Signatures (AES) to enable compliant digital prescribing within secure environments
- mapped out opportunities to reduce operational inefficiencies and time spent on administrative tasks, freeing up clinical capacity for patient-facing care
- identified risks associated with Schedule 2 and 3 controlled drug prescribing legislation requiring wet signatures, highlighting areas needing legislative clarity for digital enablement
- developed initial recommendations and considerations for phased piloting of ETP solutions in secure environments
- aligned findings with wider NHS digital transformation and medicines optimisation strategies.
“The support from the NHS Midlands and Lancashire team has been invaluable throughout this project. Their expertise in digital transformation, stakeholder engagement, and prescribing workflows enabled us to explore innovative solutions for electronic transmission of prescriptions within secure environments. The team worked at pace and collaboratively with all partners involved, producing clear recommendations and practical insights that will help inform our next steps. Their professionalism, responsiveness, and knowledge of the Health and Justice system were greatly appreciated”
Denise Farmer,
National Pharmaceutical Adviser,
Health and Justice, NHS England