Clinical Indications and Electronic Prescriptions

How much prescribing is electronic?

Nearly all of it, counted by items dispensed. NHS Business Services Authority figures for England show 1.13 billion prescription items dispensed via EPS in 2024/25, 97% of the 1.16 billion items dispensed by community pharmacies. The figure counts items dispensed, not prescriptions issued.

What journey should an indication make?

From the prescriber to the patient, without being lost on the way. The site calls this “seamless delivery” (FAQ 15) and traces the chain:

1. The prescriber records the indication in the clinical record, for example in hospital, and makes sure the hospital pharmacy uses the same indications.
2. It flows out to primary care, where the GP practice computer captures it.
3. The local pharmacy computer captures it next.
4. It reaches the patient: on the medicine administration record (MAR) in a care home, or on the label of the medicine packet at home.

FAQ 15 says this “may be helped by the Electronic Prescription Service, which carried 97% of the prescription items dispensed in England in 2024/25”.

Does EPS carry the indication to the label?

As part of the directions. At present, clinicians add the indication as free text to the directions on the electronic prescription. In EMIS, the free text is stored and offered from a pick list on future issues of prescriptions, for all patients. There is no separate indication field. Pharmacists record the indication with the directions (FAQ 4), and Dr Masters’ 2013 BMJ letter likewise proposes adding the indication “to the prescription instructions at the time of issue”.

How can a practice check that it arrives?

With the site’s two audits, which FAQ 15 says can check this whole journey (departure and destination audits). A departure audit checks repeat prescriptions leaving the practice for an indication, against a standard of 80%. A destination audit checks the medicines where they end up: at one residential home, 47 of 52 prescribed items (90%) carried the indication.

Both audits on the site were carried out at Highfield Surgery before EPS was in wide use, so repeating them now would show that the indication reaches the label by the electronic route.

What should system suppliers know?

That the design of the field affects what gets recorded. In a New Zealand hospital, making the indication field compulsory raised the share of medicines with an indication from 29% to 76%, “with only a small increase in ‘rubbish text’” (Pairman et al., 2025). A UK study warns that mandatory fields “may be counterproductive” (Shemilt et al., 2019), and a 2026 systematic review calls for “agreed international standards to guide system vendors”.

In 2006 the site hoped indications would “become a standard feature of computerised prescribing packages” (FAQ 3), and said that working with the drug dictionary computer suppliers “will be vital” (FAQ 7). See for system suppliers and for pharmacists.