Community Pharmacy England is taking steps to tackle inappropriate EPS pharmacy nomination practices and service direction, which contravene the principles of patient choice.

Since concerns around certain IT functionality allowing automatic re-nomination (without patient consent) and the direction of services were first raised last year, our Regulatory and IT experts have been working to address these issues with NHS England, the British Medical Association (BMA), and pharmacy IT system suppliers.

This has been a significant workstream and progress so far includes:

Issuing guidance about respecting patient choice for pharmacy EPS nominations.
NHS England agreeing with our concerns and writing to pharmacy IT system suppliers to reaffirm nomination guidelines and set expectations on system behaviour (see progress update).
Working with NHS England to revise its nomination guidance for pharmacy teams and IT system suppliers (more on this below).
Supporting NHS England to work with system suppliers to ensure any non‑compliant features are removed and that future functionality aligns with the revised protocols.
Inviting NHS England’s EPS team to attend the March meeting of the Community Pharmacy IT Group (CP ITG) and provide an update on EPS patient nomination protocols and discuss the documentation changes.
Developing a patient-facing website which can be used by other healthcare providers such as GP practices to provide information on NHS pharmacy services and encourage use of the NHS website’s pharmacy and service finder tools (see our news story).
Collaborating with the BMA to revise the existing joint guidance on prescription direction to include guidance on service direction.
Working to update our existing nomination and patient choice materials (for pharmacy teams and patients) to provide greater clarity on the rules and requirements.
Considering changes to pharmacy owners’ terms of service to strengthen the provisions on nominations.
Reviewing terms of service provisions on ‘inducements’ which apply to all NHS pharmacy services.

This week, we were also pleased to see a pledge to protect patient choice of pharmacy in the 2026/27 GP Contract in relation to nominations and pharmacy services:

We will amend the core practice contract to expand the provisions on nominated dispensers, requiring practices to reconfirm the nominated pharmacy whenever a new prescription (not a repeat prescription) is issued, and to ensure that referrals and triage tools used for community pharmacy clinical services offer patients a full choice of providers. We expect in practice that most practices do this already and this should not add additional burden to appointments.

Community Pharmacy England will continue to monitor EPS pharmacy nomination and referrals and triage tools used for pharmacy services. We will also keep working to protect the principles of patient choice on behalf of the community pharmacy sector.

Changes to NHS England nomination guidance

NHS England is revising the Patient Nomination Protocols, with input from Community Pharmacy England. The updated guidance clarifies how pharmacy teams, system suppliers and others must manage nominations and use nomination‑related information from the NHS Personal Demographics Service (PDS).

The guidance emphasises that patient choice must remain central, with patients able to select or change their nominated pharmacy freely, without pressure, unintended direction, or the use of technical means that could influence or pre‑empt their choice. It also clarifies the appropriate use of PDS nomination data.

The documentation has been circulated to the CP ITG (which includes IT suppliers) in advance of publication so that it can be discussed at the meeting on 4th March. Subject to any final revisions, the updated guidance will be published shortly and will come into effect immediately.

As other guidance is updated and any changes are made to rules and regulations, Community Pharmacy England will bring these to your attention.

Gordon Hockey, Director, Legal at Community Pharmacy England, said:

“Community Pharmacy England has been clear for some time that inappropriate EPS nominations and service direction are unacceptable and risk undermining patient confidence in the pharmacy sector. We are working to bring about decisive action to stamp out these practices. The vast majority of pharmacy owners and their teams work incredibly hard to provide safe, patient‑centred care, and they should not be disadvantaged by the small number of operators who attempt to manipulate the system.

We welcome the strengthened measures being taken nationally and will continue working with NHS England, the BMA, and IT system suppliers to ensure the rules are enforced consistently and fairly. Protecting patient choice and maintaining trust in community pharmacy remain paramount, and we will keep pushing for robust safeguards.”