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GPs switch off update patient record function in new Pharmacy First IT twist

Pharmacies will have to send Pharmacy First consultation information by email after GP practices have opted out of update record functionality, CPE has warned.

Large numbers of GPs have switched off the “update record” function of GP Connect, which allows pharmacies to send routine consultation information to their patients’ GP practices, a spokesperson for the British Medical Association (BMA) told C+D yesterday (July 2).

In April, C+D exclusively revealed that pharmacists were finally able to update GP records with Pharmacy First consultation data after delays to the functionality since the common conditions service launched in January meant they had to use “cumbersome alternatives”.

Read more: BREAKING: Pharmacists able to update GP records from today

But now, where GP practices have “update record” turned off, pharmacy IT systems will “automatically revert to using the NHSmail system that has been used for many years to send post-event messages to general practices”, according to Community Pharmacy England (CPE) director of NHS services Alastair Buxton.

In a video posted on Saturday (June 29), BMA England general practitioners committee (GPC England) chair Dr Katie Bramall-Stainer urged BMA members to switch off the update record function in GP Connect “this weekend”.

A BMA spokesperson told C+D that thousands of GPs had engaged with it over the weekend and it believed a huge majority had taken part in the action.

Read more: Pharmacy First: IT updates could be delayed by ‘months’

Guidance published by the BMA on Saturday warned that the update record function “could potentially further enable workload and subtle responsibility transfer from an external provider directly to the GP in the future”. 

The update record function “allows any permitted third-party provider to not only view the GP clinical record but also add coded and free text data directly into it”, according to the guidance. 

Read more: Pharmacy First: Pharmacies stuck with ‘cumbersome’ IT systems for ‘weeks’

It warned GPs that “new issues are coming to light” about a “potential influx of data for which [GPs] must take legal responsibility”.

The guidance reminded GPs that their legal responsibility as data controller for “all patient data in the GP medical record” means that there is no way to “force a GP to relinquish data controllership” outside a change of law.


“Nightmare waiting list”


In the video, Bramall-Stainer explained that while pharmacist access to records don’t “necessarily reach the threshold for concern”, there are plausible scenarios in which NHS England (NHSE) would permit “any qualified provider access to the update record function”.

She said that this may lead to “a nightmare waiting list situation that's the responsibility of GPs”.

Bramall-Stainer claimed that NHSE has asked software providers “for that off switch to be removed” by the start of this week (July 1).

Read more: IT chaos left 3/4 of pharmacies unable to complete Pharmacy First consultations

But NHSE’s national director for primary care Dr Amanda Doyle said that the BMA’s claim that it had requested the “imminent” removal of the option to switch off the update record function is “completely inaccurate”.

Doyle said that NHSE does not “currently” plan to “extend this use beyond Pharmacy First”, adding that “any changes would always involve consultation with the GPC and Royal College of General Practitioners (RCGP)". 

She added that it was “odd” for GPs to turn off the update record function and revert to manually inputting data from emails as it was brought in “to make GPs working lives easier and improve patient outcomes”.

CPE’s Buxton also said that it appeared “counterintuitive to switch off functionality designed to reduce administrative workload at practices and improve patient safety”.


“Not yet”


BMA GPC deputy chair and digital lead Dr David Wrigley said that the union was recommending that GPs turn off the update record function until it could “better understand the implications of this software”.

Wrigley said the BMA was concerned about the “unintended consequences” of permitting other clinicians to “add diagnoses, observations and medications”. 

Read more: Pharmacy First IT: ‘Urgent action’ needed to prevent payments ‘chaos’, warns NPA

He added that GPs may face “further pressure” if they are required to provide “follow up and ongoing care” to patients because of “other clinicians’ decisions and actions”.

"As data controllers, GPs have a responsibility to have full oversight of the data of their patients - we're not saying 'no' to this development, just 'not yet',” he said.


“Cumbersome” systems


In April, C+D exclusively revealed that tech company Cegedim had become the first IT provider to allow pharmacists to update GP records with Pharmacy First consultation data.

Back in November, the negotiator had said that pharmacies would have access to and be able to update GP records via GP Connect for the new Pharmacy First service.

However, no GP Connect functionality was available to pharmacists when the service launched on January 31. 

Read more: Pharmacy First IT updates: Pharmacists to have greater GP records access

At the time, MPs criticised the delay, with shadow pharmacy minister Preet Kaur Gill saying that “the government has had 12 months to get that ready, but from what I am hearing…it is still not live”. 

Instead, pharmacies had to “download [their consultation notes] and email it across to the GP - that is cumbersome”, she added.

In February, the government admitted that pharmacies delivering the new Pharmacy First service could be stuck with “not ideal” alternative IT systems for “months” before having full access to GP software.

Read more: Contractors ‘still getting nowhere’ a week on from Pharmacy First IT crash

Meanwhile, CPE last month announced plans to audit the “huge amount of unpaid work” triggered by Pharmacy First, including the extra unpaid “informal advice” delivered by pharmacies since its launch.   

Also last month, C+D exclusively revealed that a “young girl” had to be treated in A&E after presenting with life threatening symptoms after taking weight loss drug Wegovy obtained through Boots Online Doctor.

Boots Online Doctor told C+D at the time that it “informs each patient’s GP of the prescription as an additional safety measure and may contact the patient’s GP if required”.

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