The NHS Spine for Prescriptions

Do you know what this is? I certainly didn’t know about this service until just recently. My inquisitive mind needed some answers, but first a little background: by Gaynor Leech, Lymphoedema Patient Advocate and Founder of LWO Community


Female in uniform of doctor using digital technology laptop for Output Device and writing a patient report on the office desk.

Two months ago, I requested from my GP that she change my compression sleeve, and I was grateful that she was happy to do this for me. To be sure that I got the correct sleeve, I asked to be remeasured, which meant I was referred to our local Lymphoedema clinic.

Everything went perfectly, and the clinic informed me that Patient Choice will be used to order my first sleeve as well as any subsequent ones.

What could possibly go wrong?

The following month, I ordered my regular medication only to find that on delivery, there were items missing. I called the pharmacy, and they told me that these items had been sent to Patient Choice because they fell into the same category as my compression garment, which was quite simply untrue. The staff at Patient Choice were extremely helpful and informed me that the missing items were electronically returned to ‘The Spine’ the same day.

How does a prescription get on The Spine?

When a prescription is raised, it is sent electronically to the NHS Electronic Prescription Service (EPS), ‘The Spine’. Repeat prescriptions will also be sent this way from the prescribers to the dispensing pharmacy, saving you and the prescriber time and money.

This secure service stores your electronic prescription and is accessible at any pharmacy in England. You can request that a prescription be returned to the NHS Spine if your dispensing pharmacy is unable to fill it. This then enables you to take your prescription to another dispensing pharmacy. Personally, my family has experienced this on a few occasions during the past two years. It is worth mentioning that you have the right to take your prescription to a pharmacy of your choice.

A prescription may be automatically cancelled or marked as "not dispensed" when it is returned to the Spine. On the Spine, prescriptions can only be cancelled with your doctor's request. This is what your GP may do if there is a shortage of a certain medication and an alternative can be found.

The EPS Prescription Tracker status will show as ‘With dispenser’. Employees at prescribing and dispensing locations can monitor the status of a prescription using the Electronic Prescription Service (EPS) Prescription Tracker.

The NHS Spine supports health and social care in England and connects 44,000 healthcare IT systems in 26,000 organisations. In addition to the Electronic Prescription Service (EPS), it holds information about the Personal Demographics Service, the Summary Care Record, and the e-Referral Service.

My Missing Items

As my items had been sent back to the Spine by Patient Choice, you would think it would be a simple process to get my missing items dispensed. Unfortunately, there was a lot of back and forth between the surgery and pharmacy until the items were finally discovered on the Spine and dispensed after a few days. There was also an assurance that this wouldn’t happen again.

Guess what happened the following month?

As per usual, my monthly prescription was ordered and approved via my surgery app, but on delivery, the same items were missing again. However, this time I could go into the pharmacy and ask if the missing items are on the Spine. At the pharmacy, I was able to talk to someone who could fully explain how this may be avoided in the future. Fortunately, my surgery was next door, and I was able to explain to them how they could also make sure this did not happen again. Only time will tell.

Why is this Important?

Why is it important for those of us who live in the lymphoedema community to know about the Spine? On several occasions, I have read across lymphoedema social media that prescriptions for compression garments have not been dispensed or have disappeared, and often surgery or pharmacy may deny responsibility.

You can track when the surgery received and approved your order if you place an order through the NHS app or the app that your surgery uses. However, if part of your prescription, such as your compression garment, needs to be sent to an independent Dispensing Appliance Contractor and other unrelated items also get sent, then that is the responsibility of processing within the surgery. Perhaps someone who isn't entirely aware of the differences. The pharmacy can only dispense the prescription they have in front of them. The appliance company will send any unrelated items back to the Spine. To find out if your missing items are stored in this electronic system, kindly ask your pharmacy to check "The Spine" if something similar happens to you.



Gaynor Leech