Pharmacists may get access to patient care records

The government has announced it will investigate how community pharmacy access to the NHS Care Records Service could be achieved.

The news comes despite BMA concerns about the impact on patient confidentiality of extending access to an additional professional group working in the commercial sector.

The newly-published white paper on community pharmacy, Pharmacy in England: Building on strengths – delivering the future, outlines the government’s plans to look at pharmacy access to the CRS as part of its aim to extend pharmacists’ role within the NHS. It wants to give pharmacists a greater role in treating minor ailments, supporting patients with long term conditions and providing health promotion.

The investigation into pharmacy access to the CRS will include work with an early adopter PCT for the Summary Care Record (SCR) to look at the benefits, governance and practical arrangements of community pharmacists having access to the SCR.

The white paper adds: “This work and experience will be used to inform a key programme to consider how community pharmacy’s access to the Care Records Service might be achieved. This programme will include the Clinical Reference Panel, the National Advisory Group and Patient Advisory group, together with professional and representative organisations.”

Pharmacy bodies and MPs have been pressing for role-based read and write access to the CRS which they argue would enable better coordinated care between hospitals, GPs and pharmacies.

However the BMA has expressed reservations about the potential impact on patients’ confidentiality, particularly in a commercial environment.

The white paper acknowledges that there have been specific concerns about pharmacy access to the CRS and says it will be important to ensure mechanisms are in place to address concerns about patient consent and maintaining confidentiality.

The white paper also says that the government will look at how community pharmacists can access other parts of the NHS IT programme such as Choose and Book as they offer more clinically-orientated services.

It says further work is also exploring how the Electronic Prescription Service (EPS) could be developed to enable pharmacists to use it for other services that may involve the supply of a medicine, such as minor ailment schemes.

The white paper outlines the government’s intention to promote closer working relationships between GPs and pharmacists and says NHS Employers will set up a working group including pharmacy, medical and public representatives. The working group will start by looking at repeat dispensing and the EPS.

The white paper states that only 1.5% of prescriptions are currently issued for repeat dispensing which it describes as “disappointing.” It says that although prescribers may be waiting for release 2 of EPS before starting repeat dispensing there are issues that need to be tackled, such as patient recruitment and communication between prescribers and dispensers, whether prescriptions are issued on paper or electronically.

The white paper outlines a role for pharmacists in contributing to public health and says CfH will be asked to scope arrangements for electronically capturing information centrally about interventions made or advice given by pharmacists as part of the promotion of healthy lifestyles.

However it says electronic data capture will not be available immediately and adds: “Local work needs to start now on how best to support the recording of information using, for example, appropriate patients information where needed (such as the NHS number) and recognised clinical coding such as the Dictionary of Medical devices(dm+d) and Systematised Nomenclature of Medicines (SNOMED).”

The white paper further states that the government is also recommending that the GS1 system for radio frequency identification and barcoding should be adopted through the healthcare system in England for both products and coding systems used within healthcare settings such as patient identification codes on wristbands.

It says the use of auto-identification and data capture (AIDC) technologies in health care has been limited but that there is evidence of improvements to patient safety when coding systems are used to match patients to their care. Benefits include reduction in medication and dispensing errors, reduced risk of wrong-site surgery, accurate tracking and tracing of surgical instruments, equipments and other devices and much better record-keeping.

The white paper adds: “The case for coding is compelling but all patients need to work to commonly agreed standards if the benefits are to be realised fully.”

The government will now hold a series of public events on the white paper for patients and NHS professionals beginning on 1 May and intends consult on the key proposals later this year.

Related documents

Pharmacy in England: Building on Strengths-Delivering the Future