Patient records have yet again hit the headlines, as both Jeremy Hunt and Andrew Lansley acknowledge that the lack of access to records can act as a blockage to pharmacy service development. Indeed, achieving access to records has become a sort of holy grail for the past decade as community pharmacy tries to push forward with services.
In certain parts of the country some patient information has already started to flow through pharmacies with local enhanced services and the like. For some time now we have been able to access a patients’ Emergency Care Summary in Scotland by contacting NHS 24, our version of NHS Direct. This patient summary is pulled from the doctor’s computer and gives a basic summary of the patient and their key medical information. Critically, it has a list of recent and repeat medicines. Though I have to say that, personally, I have only ever used this service a couple of times to check a patient’s medicines when being asked to use the Scottish Urgent Supply PGD.
Records can be difficult to trawl through and don’t always offer much more relevant information than the patient can provide him or herself
This PGD allows pharmacists to write a prescription of up to three months for a patient who has run out of their repeat medication. Interestingly, it’s not a prerequisite of the PGD that the surgery is closed, but rather that it wouldn’t be possible to request and receive a prescription before the patient would run out of their medicine.
Of all the services that we have in Scotland, this is the one that seems like the biggest ‘no brainer’ to be emulated south of the border. At one point I recall a quote suggesting that 25 per cent of out-of-hours calls to NHS 24 were related to patients running out of medicines or medicines-related queries. It makes absolute sense for pharmacy to manage this, not only in what is a more efficient process but also a safer one. I say safer because the formal nature of the PGD means that doctors are informed when a pharmacy uses the PGD for one of its patients. It soon becomes apparent if someone is playing the ‘emergency’ systems and indeed a few who have abused the previous five-day emergency supply system were quickly caught out.
Here’s a really tangible requirement for accessing patients’ data that improves access to medicines. It reduces NHS costs and most importantly directly benefits patients. So, it’s great to see that both the current and previous Health Ministers appreciate the good use to which pharmacy can put patients’ records.
However, I really don’t think we should get too hung up on patients’ records. In my own experience of working in GP surgeries, records can be difficult to trawl through and don’t always offer much more relevant information than the patient can provide him or herself.
In addition, you have to remember that records are usually another person’s interpretation or analysis. So, while it may be comforting to see someone else’s take on things, it doesn’t replace your own responsibility to take decisions for a patient’s care.