NHS e-prescription problems persist after Cegedim fixes fault

The issues affecting the NHS electronic prescription service (EPS) which began on Monday 6 June have still not been fully resolved, despite supplier Cegedim anticipating they would be “completed over the weekend.”

While new prescriptions are being processed through Cegedim at the moment, those issued during the fault have got stuck, leaving patients potentially without medication.

On Sunday, Cegedim told us that a process to fix this was “still under way but anticipated to be completed over the weekend.” However, readers have been in touch and the Health and Social Care Information Centre (HSCIC) confirmed that this process has not yet been completed.

As we reported last week, the EPS went TITSUP after system supplier Cegedim's Message Broker, “which manages the transfer of electronic prescriptions prescribed by doctors through the NHS Spine to pharmacies using the Cegedim pharmacy patient medication record systems,” experienced “a service interruption.”

Internal NHS incident logs of the incident seen by The Register reveal that the issue was recorded as a Higher Severity Service Incident (HSSI) with a severity rating of 1. We were informed that, generally, when a service supplier becomes aware of a Severity 1 or 2 incident, it will will invoke the HSSI process.

As part of this process, the incident must be reported to the HSCIC Service Bridge who will help manage it through to resolution by ensuring enough resources are applied to it.

“Following the resolution of an HSSI, the supplier has a limited time to provide HSCIC with an HSSI Report including the scope, impact, resolution activities, root cause and preventative actions,” our source informed us.

The logs provide an interesting narrative sample of HSCIC's works to fix the issue. Cegedim support teams “applied a fix and brought the message brokers online” again back on June 7, however there was “still a backlog of messages in the queue which could cause delays when processing messages.”

This backlog was “expected to clear overnight,” but, it turns out, it didn't. This backlog was then expected it would be cleared by 16:00 on 8 June, but again did not. HSCIC intervened on 13 June to push this process along, but it has still not been completely resolved as of publication.

It is possible for General Practices and pharmacies to work around the backlogs in the system by ringing the GP and asking them to resend a new prescription while agreeing not to dispense the original one which has already been sent and then “return” it on the EPS when it does eventually come through, but this process is, in the words of our source, “a bit of a ballache.”

In a statement to The Register an HSCIC spokesperson reiterated their previous point that “the issues have been the result of problems with the system supplier, Cegedim, and not HSCIC so any detailed response should come from them.”

We are told that the HSCIC has been supporting Cegedim to resolve the issue, and the latest status update reads: “Cegedim have confirmed that all residual activities have been completed. To address the issue whereby prescriptions are in a state of 'with another dispenser', affected pharmacies have been provided with bar-codes to manually process prescriptions.”

Cegedim has not responded to The Register's enquiries by the time of publication. ®

Update

A spokesperson for Cegedim contacted The Register this morning (16th) claiming that problems remaining from the incident have now been resolved.

"We have sent files to each affected pharmacy along with specific instructions on how to request their 'prescription with another dispenser' (PWAD) scripts. The majority of pharmacies have now downloaded these scripts and we have been pro-actively contacting those pharmacies directly that have been most impacted," the spokesman said.