Using ePRaSE: Frequently Asked Questions

ePRaSE (ePrescribing Risk and Safety Evaluation) is a web-based assessment tool designed to help NHS organisations evaluate the safety and effectiveness of their electronic prescribing (EPMA) systems using fictional test patients and prescribing scenarios.

ePRaSE provides an objective review of how effectively an electronic prescribing system mitigates prescribing risks and highlights opportunities for optimisation and safety improvement.

Yes. New implementations can benefit from establishing a baseline safety position and identifying enhancement opportunities early in their digital prescribing journey.

No. The tool can be used by acute, specialist, district general and mental health organisations that use electronic prescribing systems.

Users must have:

• An NHS email address (nhs.net or nhs.uk)
• Access to the English NHS (HSCN) network or approved remote access connection
• Appropriate local permissions to undertake testing within their ePrescribing system.

Yes, provided you are connected through an approved NHS remote access solution.

Check:

• Your internet connection
• Browser compatibility
• NHS network access

If the issue persists, contact your local IT team to check whether firewall restrictions are preventing access.

Supported browsers include:

• Chrome
• Edge
• Firefox
• Safari
• Opera

Users are required to register or re-register annually in line with the current assessment cycle and password reset requirements. Always follow the instructions presented during registration.

Contact the ePRaSE team for support. New organisations, merged trusts, specialist services and community providers may need to be added.

The NHS-sponsored ePRaSE tool is hosted on the Health and Social Care Network (HSCN), a secure infrastructure specifically designed to safeguard sensitive patient information and mitigate cyber threats. Considering the increased risk of cyberattacks targeting healthcare and other critical national services, it has been determined that it is safer for organisations for the tool to continue to be hosted on HSCN. Home nations outside England can use the tool if they are able to make appropriate HSCN network access arrangements with their health boards.

If you require further information or support, please contact nuth.eprase@nhs.net.

Yes. Up to four registered users can contribute to the same assessment. However, only one user should actively edit the assessment at any one time.

Yes. The 2026 version supports multiple ePrescribing systems within the same organisation. Separate assessments should be completed for each system.

Yes. Organisations can undertake both Adult and Paediatric assessments for each ePrescribing system deployed within their Trust.

If your ePrescribing system is used in both adult and paediatric settings, both assessments should be completed.

For the best experience and most accurate results, complete each assessment in full before starting the next (for example, complete the adult assessment before beginning the paediatric assessment).

Yes. The assessment includes functionality to identify when testing is being completed on behalf of another Trust or organisation.

Yes. Progress is saved throughout the assessment, and you can log out and return later.

Go to the Assessment Selection screen and select your existing assessment. Many users mistakenly start a new assessment instead of continuing an existing one.

Yes. Before starting the live ePRaSE assessment, users can complete a Practice Session designed to familiarise themselves with the assessment process.

The Practice Session allows users to create a test patient, work through a sample prescribing scenario and practise recording outcomes using the same workflow as the live assessment. This provides an opportunity to gain confidence with the system before completing the scored assessment.

The Practice Session is not scored, does not contribute to organisational results and can be repeated as often as required.

However, the live ePRaSE assessment can only be completed once per Trust each year. It is therefore not possible to access the live assessment for a trial run or complete multiple submissions.

To prepare in advance, we recommend reviewing the explainer videos and user guide available at eprase.info and completing the Practice Session before beginning the live assessment.

The ePRaSE assessment is designed to be completed annually. Organisations can undertake both Adult and Paediatric assessments for each ePrescribing system deployed within their Trust.

If your ePrescribing system is used in both adult and paediatric settings, both assessments should be completed.

For the best experience and most accurate results, complete each assessment in full before starting the next.

The assessment can be completed by an individual or a team who have the access and capability required to use their electronic prescribing system to admit/edit patients and prescribe medicines.

For organisations completing both Adult and Paediatric assessments for the same system or assessments for multiple ePrescribing systems: Please estimate the proportion of staff time committed to each system and record the estimated WTE against each individual ePrescribing system.

For example: If you have six whole-time equivalents (WTEs) looking after your organisation's electronic prescribing system, and approximately two-thirds of their time is spent updating and maintaining the adult system, with one-third spent supporting the paediatric system, then you would record four WTEs under adults and two WTEs under paediatrics.

The Practice Session allows users to create a test patient, work through a sample prescribing scenario and practise recording outcomes using the same workflow as the live assessment. This provides an opportunity to gain confidence with the system before completing the scored assessment.

No. The Practice Session is not scored, does not contribute to organisational results and can be repeated as often as required.

Yes. It is strongly recommended for first-time users.

The assessment requires creation of 15 fictional patients generated by the tool.

Yes. Once the tool is opened patient build can be completed in advance of scenario testing. We recommend doing the patient build and test completion within 48 hours.

Yes. Users should follow normal local workflows, including PAS admission processes where appropriate. The fictional patient surnames incorporate the sequence 'zzz' to distinguish them from real patients.

Current medications presented in patient build should be entered so that they are available to prescribers during routine prescribing, as alerts may depend on them being active.

Record as much information as your system allows and continue with testing. System limitations themselves are important findings.

No. Printable patient build information is not available. Please use the information presented on the page within the online tool.

Some paediatric scenarios contain age-sensitive information, including gestational age and age-based dosing considerations.

If important information has been missed during patient build, you can return to review the patient build again. However, please contact nuth.eprase@nhs.net if you require further assistance.

Users complete 45 prescribing scenarios, comprising 3 tests for each fictional patient.

Use an account with full prescribing rights to avoid local prescribing restrictions influencing assessment results.

This prevents one test affecting another scenario and helps maintain assessment validity.

You placed the order for the new medicine using your normal processes, which may have included the selection of a provided order sentence and did not receive any advice or information from the electronic prescribing system.

You placed the order for the new medicine but had to ignore, modify, or override a provided order sentence to complete it.

You prescribed the medicine and received some system generated clinical decision support, alerts, warnings or other information that directed you to make a decision to modify the prescription.

The ePrescribing system blocks completion of the prescriptions entirely with no prescriber action possible. It is clear cut and the prescription cannot be executed.

Where the medicine presented in the test is not available in your system, the question will be passed over. This will be classed as an invalid test. It will not affect the overall mitigation results which are calculated on the valid tests taken.

Select "Unable to Perform Test". This will not negatively influence your mitigation score.

Clinical Decision Support (CDS) Categories form the basis of the ePRaSE mitigation analysis and help organisations understand how effectively their ePrescribing system supports safe prescribing practices across a broad range of clinical risk areas.

The following categories are used:

• Anti-Microbial Stewardship: Drug triggers recommendations on antimicrobial prescription support/guidelines and surveillance related to management of antimicrobial resistance.
• Drug Age: Drug contraindication (or dose adjustment) based on patient age.
• Drug Allergy: Allergy or intolerance to prescribed drug (or another drug in the same category) documented.
• Drug Brand: Drug that must be prescribed by BRAND rather than using generic name.
• Drug-Disease (Contraindication): Drug contraindication (or dose adjustment) based on patient diagnosis or co-morbidities.
• Drug Dose: Specified dose for prescribed drug is outside recommended dose range for any patient (includes doses that are too high or too low).
• Drug Duplication: Specified drug prescribed more than once for the same patient.
• Drug Frequency: Specified frequency is not appropriate for prescribed drug.
• Drug Laboratory: Drug contraindication (or dose adjustment) based on laboratory test result (includes therapeutic drug monitoring, direct notification/ display of abnormal labs; dosing suggestions; monitoring advisory or monitoring order request).
• Drug Omission: Critical medication NOT prescribed based upon patient diagnosis or other prescribed medication.
• Drug-Drug Interaction: Interaction between prescribed drug and one or more concomitant prescribed drug(s) may result in patient harm.
• Drug Route: Specified route is contraindicated for drug and/or dose prescribed.
• Pregnancy Prevention: Drug prescribed requires safety measures due to reproductive risks.
• Therapeutic Duplication: Two different medicines prescribed simultaneously with the same or similar therapeutic aims.

Up to two categories can be selected for each test triggering an intervention.

Select the category that most closely represents the main intervention observed. There are no right or wrong answers, and this does not impact your overall mitigation score.

No. Once saved, responses cannot normally be changed.

Assessment resets are generally restricted and considered only in exceptional circumstances. Contact the ePRaSE team if a significant error has occurred.

Contact the ePRaSE support team for advice before continuing further.

Reports include:

• Summary risk mitigation performance chart.
• Overview of results within prescribing risk category.
• Mandatory scenario outcomes and improvement advice
• Mitigations chart showing scores within clinical decision (CDS) support categories for user analysis

These are high-priority patient safety tests that all organisations are expected to assess.

The tool includes control scenarios designed to identify inappropriate alerts and false positives. This evaluates the quality of system decision support, not simply the quantity of alerts.

Yes. Reports can be exported as PDF documents for local review and retention.

Historical reports, where available, can be selected for your organisation from 'Assessment Selection' page.

In the latest version of ePRaSE, users are provided with enhanced test descriptions and direct feedback on mandatory scenarios. However, detailed feedback is not provided for all scenarios, as doing so would undermine the integrity of the assessment and could encourage optimisation targeted only at individual test cases. The aim of ePRaSE is to support a broader, system-wide approach to ePrescribing optimisation by promoting robust prescribing infrastructure, effective multidisciplinary use of the system, appropriate alert design and acuity, and clear, meaningful decision support. The focus is on strengthening overall medicines safety processes rather than addressing isolated scenario-specific events.

Yes. Organisations may choose to share their own results with peers or system suppliers to support learning and improvement through local or regional benchmarking meetings. Any data the ePRaSE team share outside your organisation is anonymised, and organisations are not identified in reports or dashboards. If you have questions about data use or governance, please contact nuth.eprase@nhs.net.

There are several reasons why your results may differ from what you anticipated. The patient build may not have been completed exactly as intended, some information may not have been available within your ePrescribing system, or local system configuration and clinical decision support settings may have influenced the outcome.

ePRaSE reflects how your electronic prescribing system functions in practice based on the way it has been configured, implemented, and maintained within your organisation. As a result, unexpected findings can help identify areas for review and optimisation.

The purpose of ePRaSE is not only to generate a score, but to help organisations understand what is working well within their ePrescribing system and where opportunities may exist to further improve medication safety.

If you have any queries about your report, please refer to the user guide, which provides an overview of the report structure. You can also access the 'Responding to ePRaSE' video in the 'Using ePRaSE' section of the eprase.info website, which explains the report and next steps to take from a user perspective.

If you require further help, please contact nuth.eprase@nhs.net.

This may indicate a session-management issue, browser problem, or expired session. Try logging in again and clearing the browser cache if required.

Possible causes include:

• Another active session is underway with another user
• The assessment has already been completed
• Session timeout
• Incorrect assessment selection

Please recheck the status of your organisation's assessment. If you continue to have issues, please contact nuth.eprase@nhs.net for support.

This can occur when sessions are left open by another user. Enhanced session management has been introduced to reduce this issue. If you continue to have issues, please contact nuth.eprase@nhs.net for support.

The name of the person who completed the assessment should be shown on the 'Assessment Selection' page.

No. Access to identifiable data is restricted to authorised members of the ePRaSE project team.

The tool platform is designed for use within controlled NHS network environments and uses NHS-authenticated access controls.

Yes. Thematic findings and lessons learned will be shared through masterclasses, publications, and national dissemination activities. Anonymised user result summaries are published on the eprase.info site at the end of each cycle as soon as the team have processed the data (typically March/April). National results have also enabled the team to build a Learning Lab toolkit to support users in optimising their systems.

No. Vendors do not have access to organisation-level assessment data and only receive anonymised, summary-level findings. Organisations may choose to share their own results locally or regionally, including with system suppliers, to support learning and system improvement.

Potential future developments the team are considering include:

• Pharmacogenomics scenarios
• Time-critical medicine scenarios
• Paused medication workflows
• Episodes of care testing
• Enhanced paediatric functionality
• Additional antimicrobial stewardship testing
• Improved trend analysis and year-on-year reporting

We do welcome any ideas that you may have for future assessment topics or questions.

For technical or assessment support:

Email us at nuth.eprase@nhs.net

Typical response times are between 48 and 72 hours during normal office hours.

Contact support if:

• You cannot access the tool
• You have registration issues
• You cannot access reports
• You experience unexpected system behaviour