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Embrace records access despite increased liability, says legal expert

Pharmacists should ensure they take the time to read through the patient's record before taking any action, says healthcare lawyer John Fitzpatrick

Higher risk should not deter pharmacists from making the most of information if appropriately managed, according to John Fitzpatrick, associate at healthcare law firm Hempsons

EXCLUSIVE

Pharmacists should "embrace" the opportunity of access to patient records despite the increased risk of liability for mistakes, a legal expert has told C+D.


Access to a patient's summary care record, which is currently being trialled in pharmacies in five regions, carried "an additional risk of liability", confirmed John Fitzpatrick, associate at healthcare law firm Hempsons, in response to concerns from pharmacy leaders.


Pharmacists accessing a patient's SCR should "take the appropriate time" to read it and consider all the relevant information before they provided treatment, Mr Fitzpatrick said on Monday (November 10).



Pharmacists would "continue to be professionally accountable" for their "actions or omissions", he stressed. But as long as the risk of increased liability was "appropriately managed", it should not deter pharmacists from making the most of records access, he said.


The Royal Pharmaceutical Society's guidance on SCR access - which advises pharmacists to only access the records if they have consent and there is a "legitimate clinical need" - was "sensible and prudent", Mr Fitzpatrick added.




The General Pharmaceutical Council told C+D last week (November 5) that "the extent of any liabilities arising" from SCR access was a "wider legal question" about what advice might be required from a lawyer or insurer.


'Welcome and positive'


Pharmacists' access to patient records was a "welcome and positive step" towards improving patient outcomes and anyone accessing this information should apply the principles of "conduct, ethics and performance" to the additional information, the regulator added.


The NPA, which provides indemnity insurance to pharmacy contractors, said its insurance would cover members who were accused of failing to consult the SCR when they should have, or who made a wrong decision after accessing the record.


In September, the head of the SCR pilot predicted that all pharmacists would be able to amend patient records within five years. The news prompted pharmacy leaders to call for clarity about whether greater records access would increase pharmacists' liability for patient harm, and warn the sector to "look closely" at the legal implications of viewing a patient's SCR.



How do you feel about increased liability connected to records access?

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10 Comments

Anthony Cox, Academic pharmacist

Was there similar opposition to PMRs in the past? They also arguably increased the legal liability of pharmacists.

I think we need to decide if we as profession want to live in the past, and the risk that we hang onto a model of working that may die, or whether we are going to accept that greater responsibilities that we have spent years lobbying for come with increased risk. We have in recent years removed many risks, such as extemp prep, it seems somewhat backward to turn our noses up at patient records.

Without access to patient records the opportunities for community pharmacy to take on new roles is going to be limited, if not knee-capped, while others such as nurses and physicians assistants step into the role we decide to leave empty.

This is not to say that we shouldn't be concerned about the potential liability we are exposed to, but we need to make a sensible risk assessment of what access to notes brings both the profession and the public.

[email protected], Community pharmacist

@Anthony Cox.
I am stunned at your attitude. Yes access to patient records will allow the development of new roles within community pharmacy but it will kill community pharmacy before the new roles can be developed.
We typically have 5 mins to dispense, label, clinically check and offer advice on a two or three item Rx. You want to add more in to this!! Are you really thinking that we can fit more in? Really?
I don't know what time management course you have done, but sign me up. Patients do not have time when they visit a pharmacy. They want it now. Any delay and they are off to a pharmacy where they can get the meds quicker.
I hope I don't even have to point out that increased pressure, time constraints etc lead to an increased chance of errors occurring.

If access is to be forced upon us, then pharmacy needs to be in a place where it can utilise it. We need to have time to check the notes, read the latest letters from consultants, the bloods etc.

Ideally a second pharmacist would allow more time. What will fund this? This is the NHS we are talking about. We will get funding through one door and have it and more taken away via another.

@John Fitzpatrick.
How many cases do you deal with in 5 minutes? Come back and comment when you deal with 100-200 different people/ cases per day with criminal charges held above your head, or maiming/ killing someone if you make a mistake.

/rant

Paul Mayberry, Community pharmacist

Currently my clinical check involves looking at the Rx, PMR & patient.
In future I will have to check the SCR as well.
Although the RPS says only to view it if there is a "legitimate clinical need". How will I know until I check it?
And when I do check it what will I see?
If test results or patients stats are available it would be negligent of me not to look at them, analyse them and then make a decision on whether I should dispense the Rx or not while "taking the appropriate time" because "Pharmacists would "continue to be professionally accountable" for their "actions or omissions".
Unless the SCR gives me very limited information this will bring my pharmacy to a halt!
Be careful what you wish for.

William Downey, Non Pharmacist Branch Manager

I'm in one of the pilot pharmacies - and the only information you appear to get is medication history, nothing more detailed than that (unless I've not seen correctly!)

R A, Community pharmacist

No thanks given the fact that many of us are paid a paltry £15-21 per hour we don't need ADDITIONAL responsibilities anyways isn't this what the high and mighty GP are for?

John Schofield, Locum pharmacist

I have no objection to individual professional pharmacists seeing my records, but hell will freeze over before I allow them on the computers of large foreign owned multiples.

London Locum, Locum pharmacist

He's a lawyer. It's win win for them!

bhupendra lakhani, Community pharmacist

Extra income for Lawyers!

Clive Hodgson, Community pharmacist

“Pharmacists accessing a patient's SCR should "take the appropriate time" to read it and consider all the relevant information before they provided treatment, Mr Fitzpatrick said on Monday (November 10).”

In an ideal world that would be fine, however, in reality that “appropriate time” is most unlikely to be available in a busy Community Pharmacy. If more than a tiny percentage of patient's SCRs were thoroughly checked then the system would simply grind to a halt.

In which case, the only “opportunity” would be that of increased liability for which it is certain there will be no increased financial compensation or reward for the Pharmacist.

SP Ph, Community pharmacist

Just like saying -- Keep Smoking even if you know you Can get Cancer. Stupid.

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