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Better pharmacy summary care records access, PSNC and RPS urge NHS

Improved pharmacy access to SCRs would help both patients and staff, PSNC and RPS said
Improved pharmacy access to SCRs would help both patients and staff, PSNC and RPS said

Giving pharmacies better access to summary care records (SCRs) would improve patient safety and help pharmacy teams “fulfil their professional potential”, PSNC and RPS have said.

Community pharmacy teams should be given ongoing access to SCRs with additional information, Pharmaceutical Services Negotiating Committee (PSNC) CEO Simon Dukes and Royal Pharmaceutical Society (RPS) English board chair Professor Claire Anderson argued in a letter to NHS bodies at the end of last month (November 27).

Additional information in SCRs, such as extra detail relating to the patient’s medical history or the management of long-term conditions, can help “with enhancing patient safety”, the PSNC said in a statement yesterday (December 7).

However, to date, pharmacy teams have only been able to access this additional information if patients have consented to it being added to their SCR, the PSNC said. Exceptions to this rule have also been permitted during COVID-19, under pandemic legislation, the negotiator added.

In the letter, Mr Dukes and Professor Anderson argued that in order for pharmacies to offer person-centred services to support the NSH long-term plan – as outlined in the community pharmacy contractual framework – they need “comprehensive access to electronic health records”.

Access to SCRs with additional information and to local health and care records (LHCRs) are “key steps” in achieving this comprehensive access, according to the letter, which was addressed to NHS England & Improvement chief pharmaceutical officer Keith Ridge; NHS Digital CEO Sarah Wilkinson; and NHSX CEO Matthew Gould.

 “Consideration should be given” to introducing legislation giving pharmacy teams access to LHCRs and SCRs with additional information beyond the COVID-19 pandemic, the letter said. This would be a “significant move” towards giving community pharmacy teams access to the information they need to “fulfil their professional potential in a digitally connected NHS”.

“Help us help patients”

Giving pharmacy teams access to comprehensive patient records would reduce the risk of “important information about the patient not being available at the point of care” and help ensure patients receive the best possible pharmacy care, Mr Dukes and Professor Anderson said in the letter.

PSNC director of NHS services Alastair Buxton said yesterday that pharmacy needs “the NHS to do more to help us help patients”.

“Pharmacy professionals should be able to easily access relevant patient information so they can support patients to make the most of their medicines and identify any possible concerns, thereby reducing the likelihood of problems escalating,” he added.

It would be “a retrograde step” if the degree of detail available to pharmacy teams returned to pre-pandemic levels, he said.

The RPS “supports the ongoing work to set common clinical standards, which allows crucial information to flow across the health system,” Professor Anderson said. “Ensuring that community pharmacy is part of that system is critical in providing better patient care,” she added.

Do you agree with the PSNC and the RPS on this?

Kevin Western, Community pharmacist

The other part of the equation is a Pharmacy model that allows the time to look at SCRs regularly. Currently this is something that is the exception rather than the rule and the time taken to access is silly.

Getting Shorter, Community pharmacist

I agree; once we have full access to the SCR, we will ~have~ to check it for every single patient. If you don't think this is so, just imagine the court case:

"If you had checked the SCR, would you have seen the problem that resulted in this patient's death?"

"Yes, probably."

"So, why didn't you check the SCR, when you would be aware that it might contain information relevant and vital to the safety and efficacy of the prescription in front of you?"

"Oh, we don't normally bother as it takes too long."

Not going to go well, is it?!

While we have some issues with the current system, as soon as we have regular access to the SCR we will effectively have a duty to use it for every single dispensing - if nothing else, as there is not patient registation for community pharmacy, we are never going to know if our PMR reflects the full medication history of the patient, even if they are "regular" or "always use us".



What will, of course, happen is pharmacists will only use it when they have time to chase a suspicion, as it will otherwise be totally incompatible with the workloads to read and digest each SCR. And then the RP will be thrown under the nearest bus when the incidents inevitably occur (see court extract above). 

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