Access to patient records has long been a contentious subject for community pharmacy. It is often perceived that GPs are unwilling to share this information and patients have also been worried that their personal data would be at risk if it were to be shared digitally within the health service. However, a pilot scheme run by NHS England is looking to allay these fears.
Involving 135 pharmacies across five different regions – North Derbyshire, Northampton, Somerset, Sheffield and West Yorkshire– the scheme aims to show it is not only safe for pharmacies to have this information but also that it enables them to supply a better level of care. To reassure patients, the service uses a Summary Care Record (SCR) instead of the full patient record.
‘My experience of SCR in community pharmacy is it can reduce the time it takes to resolve a particular part of care or a particular issue,’ said Mohammed Hussain, systems commissioning officer at NHS England, in a recent webinar hosted by the Independent Pharmacy Federation.
‘At the moment I might have to ring the surgery. I could be on hold for 20 minutes and then, even if I do get through to someone, all they’re going to read out to me is the Summary Care Record. I can now access that and I can do that much quicker.’ Currently 49.7 million people in the UK have an SCR, with NHS 111 and Accident & Emergency services also able to access the record.
During the trial, participating pharmacies discovered that they were using the system for much more than they originally planned.
It was predicted that the main use would be supplying emergency requests, but pharmacists are finding they are using it for everything from dispensing repeat prescriptions to checking eligibility for a flu vaccination.
Patients are free to opt out of the system, but so far only 1.4 per cent have decided to do so. To view any patient’s medical information, healthcare staff need to be involved in their care and have a legitimate reason for looking, and each organisation is responsible for the security of its own access. All access is recorded and can be audited to stop misuse.
During the webinar some participants voiced concerns that access to the entire record, for example, would be too much information, preferring the SCR approach.
Mr Hussain was less concerned that this would ever be a problem, saying, ‘We have the ability to offer a more efficient service. We already access GP records, be it by fax, via telephone, ringing someone else and they read them out to us. I don’t think it fundamentally changes that.’
In a survey of all the pharmacies involved in the trial, it was discovered that 74 per cent of all patient encounters in which the SCR was accessed would have otherwise ended with the
patient being sent elsewhere. It was also noted that 20 per cent of all the consultations
prevented a prescribing error that could otherwise have gone unnoticed.
Despite these positive results, the trial hasn’t all been plain sailing, said Mr Hussain. Initial firewall problems meant that many users couldn’t access the SCR at all, as well as problems recording the access and logging on to the alerts system.
But, with the pilot scheme coming to a close in March, NHS England feels confident that the set-up should be pushed forward for parliamentary and regulatory approval, said Mr Hussain. If the system gets through each planned approval stage, pharmacies in England and Wales could expect to have access to the SCR by March 2017.