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Pharmaceutical Services Negotiating Committee

Electronic Health Records

The future lies not in one electronic patient records solution but in inter-operability between multiple solutions, which may be managed by the NHS or private providers. This section of the site summarises current government policy on electronic health records and provides an overview of the Summary Care Record programme. 

Current Policy

Third Party Providers of Electronic Health Record Solutions

Summary Care Record (SCR)

HealthSpace and Patient Access to their SCR

Pharmacy Professional Guidance on Sharing Records


Current Policy

The Department of Health Information Strategy - The Power of Information– set out a vision for how information could facilitate joining up care within the NHS. A key commitment set out in the strategy was providing all NHS patients with secure online access, where they wish it, to their personal GP records by 2015. As part of a Directed Enhanced Service under the GP contract, GP practices are being financially incentivised to deliver patient access to records. Click on the link below to download a copy of the service specification:

Improving patient online access: GP Contract Enhanced Service Specification  (external link)

The Information Strategy also indicated that the Government would enable an infrastructure to support patients to share electronic copies of their records with people and organisations of their choice who can help in understanding and managing their health and care. PSNC is supportive of this goal; with patient consent, providing community pharmacists with appropriate role-based read and write access to electronic patient records has the potential to greatly improve patient safety, support the development of new services for patients, improve interdisciplinary working and increase the quality of care provided to patients. Equally, allowing other professionals to have access to the records made by pharmacists could support the continuity of patient care.

PSNC is supportive of the commitment made in the Information Strategy to set common standards to enable information to flow effectively around the health system, however given that healthcare services are provided in a competitive marketplace, there is also a need for controls to ensure equitable access to information, where patients consent. Where access to information is needed to provide a particular service, blocking access, for example using technical or financial barriers, could be used as a tool to preclude competition. Controls need to be put in place to ensure that information about NHS patients can be effectively accessed by different providers where a patient has consented.


Commercial Providers of Electronic Health Record Solutions

There are already a range of providers marketing shared electronic health record solutions including GP system suppliers, EMIS and InPs , suppliers serving the broader healthcare market such as CSC and providers that have traditionally been known for marketing solutions direct to consumers, for example Microsoft. We would be keen to hear from community pharmacists involved in pilots to access patient health records through solutions provided by commercial suppliers.

Recent initiatives to support sharing of electronic health records:

Medical Interoperability Gateway (MIG) Established

The medical interoperability gateway already enables the sharing of data between two GP clinical systems, EMIS and INPS; in January 2013, it was announced that this would be extended to link patient records held on TPP’s SystmOne and Microtest’s Evolution software.

Patient online: Guidance for GPs

"Patient Online", a guide to support GP practices in providing online access for patients was published by the Royal College of General Practitioners in March 2013.


The Summary Care Record

The Summary Care Record (SCR) is an electronic summary of key health information. A patient’s SCR will contain essential information about any medicines, allergies and adverse reactions derived from their GP record. Where a patient and their doctor wish to add additional information to the patient’s Summary Care Record, this may be added with the explicit consent of the patient.

The SCR is already live in several care settings including: GP Surgeries, Out of hours, emergency departments, acute admissions wards, ambulance trusts and walk in centres.

Approximately 25 million patients - almost one third of the population in England - have a Summary Care Record. Information on individual GP practice plans to implement the SCR can be found on the SCR deployment map and national deployment statistics can be found on the HSCIC website.

The SCR Public Information Programme (PIP) informs patients and the public about SCRs and the choices they have. A PIP will precede the creation of SCRs, to allow patients to express their preferences – patients can choose not to have an SCR and it is through this process that they can advise their GP of this.

If patients are not sure whether they wish to have a record, they will be encouraged to seek further information and support, to help them make their decision. The information they are sent includes a helpline telephone number (0300 123 3020) and web address (www.nhscarerecords.nhs.uk), where they can receive further information.

Pharmacy Access to the SCR

Pharmacists in a number of secondary care trusts are using the SCR and identifying benefits including efficiencies in medicines reconciliation. In a video published by NHS North East, clinical pharmacist Laura Smith explains the benefits it has brought to her practice - Video: Summary Care Record - the pharmacist's perspective 

To date, there has only been very limited implementation of the SCR in community pharmacy. The previous Government committed to undertaking work with a Summary Care Record early adopter PCT to consider the benefits, governance and practical arrangements of community pharmacists having access to the Summary Care Record. Whilst Bradford was chosen as the first pilot site, in late 2010,  following the publication of two reviews on the SCR, the focus of the SCR project shifted towards emergency and urgent care and the pharmacy pilot was suspended. Since then, the SCR has been implemented in a handful of community pharmacies in Wigan. This project has provided an opportunity to identify the technical requirements for pharmacies accessing the SCR including the relevant roles that need to be added to NHS smartcards, however as the pharmacies involved to date serve a very stable customer-base, there has been limited need to use the SCR; the pharmacies already have access to relevant information via their PMRs.  

PSNC believes that there is value in further community pharmacy SCR pilots, particularly in settings where there are transient patient populations. As well as planned service provision, for example the provision of annual Medicines Use Reviews, pharmacies also need to respond to unscheduled requests from patients, for example in certain circumstances, pharmacies can provide prescription only medicines in an emergency to patients. Access to information about patients in this scenario, for example a list of all medicines that the patient has recently been prescribed, has the potential to improve patient safety.

Patient Access to the SCR

Patients were previously able to register to access their SCR via the HealthSpace service. There was less demand for this service than expected therefore the service was closed in December 2012. The Department of Health Information Strategy - The Power of Information set out a commitment to provide patients with secure online access to their health records - until alternative solutions to HealthSpace are put in place, patients that wish to view their SCR are being advised that their GP can print a copy.   

Keep up to date with the SCR 

The HSCIC are sharing information on the SCR deployment through a number of social networks and electronic channels. Click on the links below for more information:

Email BulletinTwitter / YouTube


 

Guidance on Sharing Records

The Royal Pharmaceutical Society and the National Pharmacy Association have developed guidance for pharmacists on the use of shared records; this is available online on their respective websites. Shared record guidance developed by the Royal College of General Practitioners can be found on their website.


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