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Calls for clarity on legal implications of patient records access

NHS England must clarify whether access to records could affect pharmacists' liability in cases of patient harm, says Kent LPC chief Mike Keen

NHS England should spell out whether access to patient records could affect pharmacists' personal liability before the plans go ahead, say pharmacy leaders including Kent LPC chief Mike Keen


Pharmacy leaders have called for clarity about whether greater records access will increase pharmacists' liability for patient harm.

Kent LPC chief executive Mike Keen warned that the sector needed to "look closely" at the legal implications of viewing a patient's summary care record (SCR), in response to predictions that all pharmacists will be able to access the records within two years.

Pharmacists might miss information "buried" at the end of the SCR, and NHS England should clarify whether this could affect pharmacists' personal liability before the sector "jumps in with both feet".

The full records could be "several pages long" and pharmacists would have to search through a patient's "deepest, darkest history" to ensure they were not going to suffer an adverse drug reaction, he told C+D.

PSNC said any increase in responsibility should be "clearly set out" to ensure contractors were not exposed to "undue risks or difficulties". 

"We very much support moves to grant pharmacies further access to records but, as with any professional development, the benefits and risks need careful consideration," PSNC head of NHS services Alastair Buxton told C+D.

Essex LPC chief executive Ash Pandya and Swindon and Wiltshire LPC chief executive Fiona Castle both backed Mr Keen's calls for clarity, but told C+D that pharmacists were ready to "take on the responsibility" of records access.

Mr Pandya warned that access may increase the time it took to assess each patient and this should be taken into account when considering the value of pharmacy interventions.

Pharmacy Voice chief executive Rob Darracott said the sector should not be "too concerned" over the issue, pointing out that hospital pharmacists already managed to use SCRs "judiciously and appropriately".

"Access to patient records will add to the information that a [community] pharmacist will have to form professional judgements and make clinical decisions. That has to be good," he told C+D.

But hospital pharmacist Mary Evans said access to the SCR "certainly has a risk" and pharmacists would be expected to familiarise themselves with a patient's medical history.

"I am not disputing this is a good thing, just agreeing it will have a big impact which needs to be worked through," Ms Evans wrote on Twitter.

A pilot project by NHS England and the Health and Social Care Information Centre (HSCIC) will give between 80 and 100 pharmacies across five regions read-only access to the SCR in the autumn. If the pilot is successful, all pharmacies in England will be granted access within two years, with full read-write access within five years, the project's clinical lead told C+D last week.

Would you still want access to records if it meant increased liability in cases of patient harm? 

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Chris Locum, Locum pharmacist

Decisions made in haste may have implications regretted at leisure

Paul Bing, Community pharmacist

A load of ho-hah about Pharmacists targeting the sales of their talc and perfumed goods like we're common oiks. OUTRAGEOUS!

David Miller, Hospital pharmacist

Is it better and safety for the patient ?

David Miller, Hospital pharmacist

That should say safer - professionally that is my priority not my risk of potential litigation

[email protected], Community pharmacist

Better or safer for the patient?
A bit Hong Kong phooey really. Better, could be. Safer, could be.
I have been racking my brains but I can't see many cases where it will be better for the patient.
Will we be allowed to go off licence with recommendations as we have more info? Eg can we now sell Sudafed to a pt with well controlled hypertension? I don't think so.

Will it be easier to carry out weekend or out of hours emergency supplies. Yes, but it's not like it is all that difficult now.

We may be able to give better advice to patients about their condition, as we will be able to see what the diagnosis is. Unfortunately we do not get paid for 20 minutes counselling on patient conditions. I suppose we could always print out info from and send them on their merry way like GP's do.

Will it mean that customers will have to wait an additional 10 minutes or so. Most likely.
Not an issue for hospital pharmacists but when customers are not used to waiting this will be an issue in the community.

I can see increased pressure on already busy and stressed pharmacists.

I can also see that patients will start going to pharmacies where they can get what they want quicker rather than have to wait 30 minutes while the pharmacist deals with the three customers already waiting. This happens already if I am caught up giving advice to one patient. If there is a queue..

@Gerry Diamond.
"Let's give it a chance".
Are you still enjoying the new contract? You know the one that gave us more work, less pay.

We need the specifics first, then we test to see how it works. Just like any experiment, nail down the criteria, then carry out the experiment. You don't do it the other way round.

Gerry Diamond, Primary care pharmacist

Lets give it a chance!

[email protected], Community pharmacist

I've been saying this for ages. This is so obvious, and how long has it taken for it to be made an issue worthy of our leaders ??

PSNC said any increase in responsibility should be "clearly set out" ..

Well that fills me with no confidence at all. We will bear all responsibility with no extra payment. After all, we are accessing patient records for private gain. They may even charge us as we are making money from this access. Anybody care to place a bet? It will happen, it'll just take time.

As the astute ,Pre-reg graduate has pointed out, comparing access to records by hospital pharmacists to that of their community colleagues is a little disingenuous. We are not the same.

Ask your customers how long they have to wait for a prescription from a hospital pharmacy. It now becomes obvious why it takes so long. If we have to do the same for every prescription, every sale then I want danger money. Riots, pitchforks and brands will be the least of it. If you miss something scribbled on the dog-eared corner on the 5th page of the records, then lawsuits, criminal charges and worse still the GPHC will be after you. We know the GPHC only want one outcome.

I am no Luddite. I am all for progress. But, this needs to be thought out and discussed before hand. Not afterwards.
The PSNC and whatever organisations that misrepresent us need to remember if the NHS push something on to us without specifying everything up front then we are getting the short end of the stick.

Ash Pandya and Fiona Castle should not be pushing for access without details. We are not ready.
1) We do not know what is being offered.
2) We do not know how much work and time will be involved.
3) We do not know where and how responsibility will be placed.
4) We do not know if we will be paid for this.

That's only for starters.

It scares me that these people actually think to represent us and do so without thinking.

Nick Hunter, Community pharmacist

I appreciate Mike Keen's reservations and they are very valid, but there comes a point where the profession must "grasp the nettle", and all such clichés and get on with being professional, otherwise we will never make the transition from the perceived shop-keeper to the healthcare professional embedded in the primary care family.
What needs to happen is that the giving of advice and patient care is properly resourced and not a side line of the supply function.

[email protected], Pre-reg graduate

""Pharmacy Voice chief executive Rob Darracott said the sector should not be "too concerned" over the issue, pointing out that hospital pharmacists already managed to use SCRs "judiciously and appropriately".""

Well sir, with due respect to you, Hospital Pharmacists work under a completely different environment to what community Pharmacists do. Moreover their access is based on their trusts policies and not universal. Added to that they have all the time in the world to access these SCRs with no waiters/ patients in the que !!

[email protected], Pre-reg graduate

Well Samuel,

""before the sector "jumps in with both feet".

This takes us back to my questions, that are still un-answered. And C&D still went ahead with a survey in this regards with another article where it looked like Pharmacists were desperate for both Read & Write access. What is going on? Why we don't get the clarity on basic facts before we jump in?

Samuel Horti, Other healthcare professional

Thanks for the comment. As the SCR will be accessed locally in the pilot (in 5 areas), I presume there will be no national guidance on this and will be handled locally - certainly NHS England has not released any. The sites that will have access to SCR have not yet been decided, and I presume pharmacies who are taking part will receive guidance as part of that process.

They have said there will be an event so that we can see exactly what the SCR contains and how pharmacists will use - but this has not happened yet. We know the pilot gives pharmacists the ability to read the summary care record, which is essentially an uploaded copy of the GP record. It does not give them extra powers, it will just help them make better clinical decisions (according to most pharmacists I've spoken to). Some may feel that it doesn't benefit, and that's what NHS England is trying to decide.

I am waiting on NHS England to get back to me on how the project will be evaluated, and what measures they will use to gauge its success, and I plan to cover this in a story online.


Samuel Horti
Reporter, C+D

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