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Patient records

Pharmacy access to full patient records is more critical than ever

Pharmacists must be given full access to patient records to enable them to expand their role in the health service and provide better patient care.

open glass box with laptop showing patient record

Source: JL / Shutterstock.com

There are countless reasons why it makes sense for community pharmacists to have access to full patient records.

Promoting antimicrobial stewardship, encouraging adherence and ensuring the safe use of medicines is not just a job for GP practices. Community pharmacists have an opportunity to forge a vital connection with patients at the point when they receive their medicines and many are carrying out this work without all the information they require to support good patient care.

Yes, pharmacists have access to the summary care record (SCR). However, the basic information contained in this – name, address, date of birth, NHS number and information on current medication and allergies – is not detailed enough to support good decision-making.

Although work is ongoing to extend the information available, most SCRs lack vital details, such as indications and diagnostic results. This may be the reason why 85% of pharmacists are not accessing the SCR in a typical week. This would be regarded as unacceptable in secondary care, so why is it accepted in primary care?

As pharmacies carry out more clinical services for the health service, it will become even more pressing for them to be able to directly add information to the patients’ clinical record. NHS Digital promises that community pharmacies will be able send information about flu vaccinations they have carried out directly to GPs during the winter, to prevent duplication of effort. However, it is disappointing that only 40% of GP practices will be able to receive it.

A recent trial showed that allowing pharmacists the ability to see and update patient records in real time helped to eliminate errors with prescriptions

Progress elsewhere is glacially slow. In 2006, the Company Chemists Association told the Royal Pharmaceutical Society (RPS): “Unless full read/write access is granted to pharmacists, patient safety may be compromised.” And we have barely moved on since.

Some areas are taking this situation into their own hands. For example, a recent trial in one community pharmacy in Sheffield — funded by the National Association of Primary Care — found that allowing pharmacists the ability to see and update patient records in real time “helped to eliminate errors with prescriptions”, enabling interventions such as calculating a patient’s kidney function and more accurately adjusting the dose of an anticoagulant.

This evidence has not been published in a peer-reviewed journal, and it is in just one pharmacy, but it showed that read/write access to records was feasible under current structures and suggested it was a “key enabler to unlocking the potential of community pharmacy to deliver more advanced and holistic clinical care”.

Pharmacists in East London will soon have access to the East London Patient Record (eLPR) system, which exchanges patient information between GPs in five London boroughs and four NHS foundation trusts, as well as two local authorities and a hospice. The system uses two central “health information exchanges” to give clinicians a read-only view of patient information held by other providers, although write access may be permitted in the future.

An evaluation in 2018 found that the “the breadth and depth of the information accessible via the eLPR is of significantly greater use” when compared with the SCR. Of nearly 100 clinicians who were surveyed after using the system, 74% said it either increased or significantly increased patient safety.

Other health and care systems, such as in Bristol, North Somerset and South Gloucestershire, and in Wales, access to patient records is being opened up to ensure that primary, secondary and social care services can work in a more integrated way. But, in most areas of the country, pharmacy is left out in the cold.

Community pharmacists are effectively working with one hand tied behind their back, unable to provide meaningful input into some of the major challenges facing the health service. This situation cannot continue. It’s time pharmacists had the full records access that they need to keep patients safe.

Throughout July, The Pharmaceutical Journal will analyse the drive to use digital technology in pharmacy. Click here for more details.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206820

Readers' comments (1)

  • Darren Powell

    The above article fails to mention the "enriched" SCR when a patient consents at their GP to share their information. This has a much richer data set than the normal SCR. This can include: significant medical history (past and present), reason for medication,
    anticipatory care information (such as information about the management of long term conditions),
    end of life care information (from the SCCI1580 national dataset) and Immunisations.

    Look at the NHS Digital pages for information h
    https://digital.nhs.uk/services/summary-care-records-scr/additional-information-in-scr

    The prevalence of enriched/additional information SCR is on the increase, and just needs patient education to ask GPs to enable the sharing for other healthcare professionals.

    The developments in local care records such as one in Doncaster (iDCR) are to be welcomed to enable all healthcare professionals make informed decisions with the patient about their care in that particular setting - informed by the care given in others.

    Unsuitable or offensive? Report this comment

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