Electronic prescribing has become an important patient-safety control across NHS hospitals, helping clinical teams manage medicines while reducing prescribing errors. New evidence highlights an opportunity to strengthen that protection through continuous testing and improvement. A national evaluation of 45 NHS trusts using 13 prescribing systems found considerable variation in how effectively digital safeguards performed in real-world environments, with an average “good mitigation” score of around 50%.

The ePRaSE research provides a structured way for organisations to test prescribing controls, identify configuration gaps and guide further optimisation. For Health & Safety teams, this supports a more proactive approach to clinical risk, helping identify potential weaknesses before they contribute to harm. The findings also show that local configuration, clinical decision-support rules, workflows and ongoing maintenance can influence how effectively safety controls operate.

This creates an important role for pharmacy, clinical governance and digital teams. Pharmacists already contribute to prescribing governance, clinical decision support and staff training, while Health & Safety professionals bring expertise in risk identification and continuous improvement. Bringing these disciplines together can help ensure digital safeguards remain aligned with frontline working practices and changing clinical environments.

The national direction is also becoming clearer. The Healthcare Safety Investigation Branch (HSSIB) has recommended a national framework for core electronic prescribing and medicines administration safety, alongside stronger assurance for NHS organisations. HSSIB also identifies ePRaSE as a tool for ongoing safety improvement and optimisation. This reinforces a wider Health & Safety principle: controls should be tested throughout their lifecycle rather than simply installed and assumed to remain effective.

Ultimately, electronic prescribing should be viewed as an evolving part of the patient-safety environment, not simply a technology implementation. By combining regular testing, strong governance and frontline expertise, NHS organisations can continue to strengthen digital medicines management. For the Health & Safety sector, the takeaway is clear: digital systems should be treated as safety controls that require ongoing assurance, optimisation and collaboration, creating an opportunity to make continuous improvement a core part of modern healthcare safety management.