Patient records

Full pharmacist access to records is the key to better patient care

Only full read/write access to patient records will put pharmacists on a par with their peers both at home and abroad.

Computer nodes in the shape of a key; access concept

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Every four seconds a health or care professional in England accesses an NHS patient’s summary care record (SCR).

Medical history and immunisations can now be included on the SCR, alongside medication, allergies, adverse reactions and further information on long-term health conditions.

This extra information, which can be added only with patient consent, will help pharmacists carry out clinically focused medication reviews.

NHS Digital, which manages the SCR, has gone on record to say that the broadened tool is at its most effective when the NHS is under the greatest pressure, such as in the depths of winter.

James Hawkins, NHS Digital’s director of digital transformation and engagement, even said it could possibly prevent unnecessary hospital admissions.

At a time when the familiar winter pressures hitting the NHS have been ratcheted up at least a couple of notches, anything that eases the workload in the health service is surely to be welcomed.

And if pharmacists are to play an even greater role in a squeezed health service, then read/write access to the full patient record could make a huge difference.

A campaign for unfettered pharmacist access to the record has run for more than a decade, and there may now be at least a chink of light at the end of the tunnel.

In a letter to the All-Party Pharmacy Group sent shortly before Christmas 2017, pharmacy minister Steve Brine said he “fully supported” NHS England’s plans to give community pharmacies full read and write access to patient primary care records and that he wanted it to happen “as soon as possible”.

But dauntingly, he warned that it was a “complex process, with a number of challenges”, such as the completion of standardised datasets. He warned that it was dependent on a number of IT programmes already underway.

The UK’s world-renowned national health service should provide a head start in data sharing, but the NHS has a patchy history on large IT projects, so perhaps caution should be advised.

The International Pharmaceutical Federation (FIP) asked pharmacists around the world what access they had to clinical records. Singapore, uniquely, provides full read/write access to pharmacists. Austria, possibly the leading example of shared patient records in Europe, pulls a wide variety of information from sources including GP surgeries, hospitals, pharmacies and laboratories, and shares it across a secure network.

Estonia and the Netherlands have established medical data sharing systems that don’t restrict pharmacy access, and Belgium and France operate data-sharing initiatives instigated by pharmacy organisations.

Although other countries have to produce bespoke data-sharing models, without the NHS’s inbuilt advantage, the difference seems to be that there is little, if any, discrimination in access between pharmacists and other clinicians.

The NHS should aspire to remedy this as soon as possible, if only for its own sake.

Citation: The Salvadore DOI: 10.1211/PJ.2018.20204245

Readers' comments (2)

  • I agree to full access of patient records to pharmacists. this will improve the quality of prescribing, prevent waste whilst optimising medication use and review. Ultimately making patients safer and saving NHS money.

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  • ...NHS need to work swiftly towards developing an IT system fit for 21st century purpose.

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