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Jeremy Hunt: Pharmacist access to records could prevent deaths

Granting pharmacists access to records could have saved 43 lives last year, says health secretary Jeremy Hunt

"Smart use of pharmacists" could have prevented 43 deaths last year that resulted from people taking the wrong medicine, health secretary tells C+D

EXCLUSIVE

More than 40 deaths could have been prevented last year if pharmacists had access to patient records, health secretary Jeremy Hunt has told C+D.  


"Smart use of pharmacists" – specifically granting them records access – could have prevented 43 deaths that resulted from people taking the wrong medicine, Mr Hunt said in response to a C+D question on the role of the sector.


The health secretary blamed the deaths on medicines being dispensed by "someone who didn't have access to [the patient's] medical records or know what their allergies were". Mr Hunt was having "very good ongoing discussions" with pharmacists about how this situation could be avoided in future, he said at a fringe event at the Conservative party conference organised by charity Age UK on Tuesday (September 30).


"If you went into Boots or another pharmacy and gave them permission [then] they should be able to access your records, see your allergies and your medical history," he said. "Pharmacists go through heavily detailed training and they would give very good advice without any appointment."


Although Mr Hunt told C+D that pharmacists had a "fantastically important role to play" in the health service, he failed to refer to the sector in his conference speech earlier in the day. He reaffirmed David Cameron's commitment - made on the same day - to extend a trial allowing patients to book a GP appointment from 8am to 8pm, seven days a week.


He also vowed that every patient would be able to access their own medical record online by April 2015 as part of the Conservative party's aim to give people "personal control" of their healthcare.


In his conference speech yesterday (October 1), David Cameron promised that "not a penny" would be cut from the NHS's budget.


Labour's shadow health secretary Andy Burnham told C+D at the Labour conference last week (September 23) that pharmacy had a "bigger role to play" in moving care away from hospitals and into communities.



Has Jeremy Hunt contributed enough to pharmacy during his time as health secretary? 

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20 Comments

Dilip Shah, Community pharmacist

My message to the Government is stop playing politics with patients lives and its evident that they do not understand what integration of services across all healthcare professions mean.
My Message come and observe at our pharmacy for one week and you will understand the failings of this Government.

Anton Sobala, Locum pharmacist

Given that all GP systems have a section where allergies and adverse drug reactions are recorded, perhaps FP10s could be updated to include a space for this information.... and GP systems updated to automatically print it in the appropriate box? A bit like hospital prescriptions really but done automatically by the prescribing software.

Pharmacists may then identify potential risks which were otherwise missed eg. a pharma might identify that the prescribed drug has a similar structure/pharmacology or mechanism of action to a drug which caused a serious reaction in the past.

Allergy boxes do cause their own set of problems though. In hospital, they are often filled with poor quality information (eg. no information on the date, type of severity of the reaction). In other cases, patients have end up with drugs in their allergy box because because they reported what appears to be a 'normal/minor side effect', often in the distant past, as being an allergic reaction. This can easily happen with antibiotics with the associated consequences of choosing a suitable drug when the pt is really unwell.....

Stomach pain on erythromycin years ago, patient claims allergy, junior doc writes on chart without too much investigation, perhaps forgetting to note that the reaction was dyspepsia not a definite allergy. Pt also reports possible allergy to penicillin when a baby? With no information. And remembers feeling sick on doxycycline, says must be allergic. Next time said pt is admitted with pneumonia there's a 'what shall be give' problem because none of the paper records were filled in properly and no one knows anything....

[email protected], Community pharmacist

43 preventable deaths is truly dreadful.

But why not try to save even more? There were 1,713 killed in road accidents last year. Here's an idea for you Mr Hunt. We should maybe, reduce the speed limit to 5mph and say, have a guy run in front of the car waving a red flag. You'd save way more people, increase fitness, give jobs to the jobless and even reduce obesity all in one fell swoop.

This access to patients' records seems to be some panacea that the varying political parties have swung behind as a way to gain more votes. Remember folks, it's that time of the cycle again. He/she who makes the most promises gets voted in.

We have to be careful or it will come to fruition and we'll be left with the difficulties of trying to dispense and check a prescription and also check patients' medical records to check for suitability and possible problems. All this in less than a minute per item for the princely sum of 90p odd per item.

Be careful what you wish for.

N O, Pharmaceutical Adviser

Forget about the Pharmacists, how many lives have been saved by GP access to patient records ??

Mike Bereza, Community pharmacist

Difficult to put a price on a life.

London Locum, Locum pharmacist

But the government seem to manage

Shaun Hockey, Community pharmacist

For anyone reading the comments from the outside it looks like most of the contributors are trying desperately to hold on to their production line manager role and avoiding acting as an effective healthcare professional. Just an observation.

Graham Phillips, Superintendent Pharmacist

Sadly, Shaun, I agree. Some colleages need to wake up and smell the coffee. Unless we add value to healthcare (Meds Optimisation plus Public Health) we can look forward to the Amazon model of pharmacy. It would be cheap, fast, safe and effective if ALL we do is "cash and wrap". That said most community pharmacists are wedded to a clinical role .. ie adding value to "safe supply". There are a few persistently negative posters here. I believe them to be unrepresentative. We certainly don't practice like that..

London Locum, Locum pharmacist

I agree with you. But that would be logical as that is where generally 80-90% of their income lies.

Gerry Diamond, Primary care pharmacist

Most GP prescribing systems such as emis scan for drug interactions, contra indications, allergies etc but have an override facility as the prescriber needs to make a valued judgement on the data. So, a pharmacist phoning up to challenge a prescriber when they have already weighed up the issue can be a double edged sword.

As a prescriber, I allways contact a GP to discuss the problem, record the discussion in the notes and either refer them of get the go ahead from the GP to stop or go.

Samantha Taylor, Hospital pharmacist

I agree the prescriber should be checking allergy status and current medication? But also, could the pharmacist (or technician) not ask the patient or carer about allergies before dispensing the prescription? Much quicker than accessing records and documenting consent...yes the patient may not know the exact reaction or specific drug name but would have an idea if there is something they cannot have?

[email protected], Community pharmacist

Ah that's why I get people coming to my pharmacy with hospital only Rx. They don't want to wait two hours for a prescription.

We don't have the luxury to check with every person. The GP has the info at hand. We don't. Why not make it part of the prescriber's job??

N O, Pharmaceutical Adviser

""could the pharmacist (or technician) not ask the patient or carer about allergies before dispensing the prescription?""

Do you mean every prescription we dispense? or there is a list of medications (other than the obvious penicillin) that we should be asking? How about knowing allergy to "any ingredients of this tablet" ??

All this allergy thing is blown out of proportion.

You know the simple way, educate the patients speak out and tell what all they are allergic to, before handing the prescriptions. That way the Pharmacist/ Dispenser can look out for such things in the pack even if it is not the main ingredient. Ex. lactose allergy & tablets.

Just don't be a clinical fanatic, you won't prove anything. If a GP cannot prescribe the right medicine even after having free access to the patient records, then it is not worth venturing out in to giving Pharmacists any access unless their records are merged with the PMR supplier of the pharmacy which can then pop up warnings automatically!!!

This whole access thing is used as a ploy to take away all the attention from funding settlement, and people are doing nothing about it. Sad.

Graham Phillips, Superintendent Pharmacist

N O.. why don't we develop your idea a little further. Lets abolish pharmacists altogether. We could replace them with Amazon deliver and vending machines and save you all that aggro? Because, in effect, that's what you are arguing for...
Or alternatively we could envision ourselves as clinicians and be paid accordingly? Nah.. on second thoughts too much hassle. Why leave the comfort of the dispensing bench..?
"The choice" as they say "is yours" !!!

Michael Stewart, Community pharmacist

"He also vowed that every patient would be able to access their own medical record online by April 2015 as part of the Conservative party's aim to give people "personal control" of their healthcare"

Problem solved - No need for us to wait 5 years to get access to records, just ask the patient to give you access to their own records. With a tablet and wifi available they can log on and show you their own records in the pharmacy.

Agreed though Max, more work, more liability, more risk, less pay..... but improved patient care.

Clive Hodgson, Community pharmacist

Agree with you Max & AA,

Superficially it may sound attractive however this has not been thought through.

I really have no idea how we would find the time to check more than a tiny percentage of records of patients passing through. The system would simply grind to a halt if any substantial number of records were consulted in a community Pharmacy during a typical working day.

Little doubt that our liabilities would increase with this access and it would appear that individual Pharmacists would be taking this risk and work on for no extra remuneration.

Z ZZzzzz, Information Technology

Doesn't the prescriber have access to the patient record before he/she prescribes products the patient is allergic to? Or am I being naive.

Sounds like GPs wanting to pass the buck - nothing new there then Mr Hunt!

max falconer, Superintendent Pharmacist

Not sure if we have fully thought this through........more work, slower dispensing checking records plus the potential for greater liability if anyone makes a mistake at the surgery that we don't notice. Sounds like more work, at a time of less pay, for our core role.

Sami Khaderia, Non healthcare professional

If you don't like the funding, sell up....

London Locum, Locum pharmacist

43 deaths - very sad, but it depends what price you put on each death. And for Pharmacists it wouldn't be very much. So likely next years the deaths will be the same or more

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