Should all health professionals have access to patient records?

Community pharmacists in England are about to be given access to the patient summary care record, but the next step be full read and write access – and the campaigning has already started

Gone are the days GPs were instructing pharmacists not to include the name of the medicine on a prescription medicine label. As late as the 1980s, dispensed medicines could be labelled simply ‘The Tablets’. What was it that GPs feared about their patients knowing it was they were actually taking?

Nowadays, the better informed a patient is, the better the outcome. Indeed, the NHS England Patient Online programme has led the way in allowing patients in England to have online access to their records without having to be physically present in the GP surgery. Scotland has just announced that it will be starting to implement similar access over the next three years.

That’s all good news for patients. But is it enough? What about other health professionals’ interactions with these patients?

The winter pressures campaigns – this year it’s ‘Stay well this winter’ – have encouraged patients to consider self care, and self medication if necessary, with signposting to community pharmacy as a first option for colds and flu. It means GP or A&E time is not taken up with unnecessary appointments.

Pharmacy services also include minor ailment schemes and emergency contraception services, with medicines supplied on the NHS under patient group directions. Community pharmacists conduct medicines use reviews with patients to ensure patients are getting on with new medicines, all part of a drive towards medicines optimisation. And as of September this year, they can also administer seasonal flu vaccines as part of the winter flu campaign.

Wouldn’t it be helpful for the pharmacist to be able to check the patient’s medical history, what they may be taking already, or any conditions that might preclude the use of a medicine, to make sure the patient gets the best advice about medicines? Well, yes. And following a successful pilot, community pharmacist access to the patient’s summary care record (SCR) is now getting underway.

The HSCIC proof of concept report on community pharmacy access to the SCR noted: “There are significant benefits to be realised for patients, pharmacists, GPs, and the wider health economy by enabling community pharmacy to have access to SCR.”

It’s a great first step. At least pharmacists can give informed advice to patients taking into account the summary of the patient’s specific health details. But wouldn’t it be great if the pharmacist could see more than just the SCR and actually document their intervention on the patient health record?

The Royal Pharmaceutical Society (RPS) thinks so. It has launched a campaign with the backing of MPs, patient groups and other health professional bodies, including the Royal College of General Practitioners (RCGP).

The RPS campaign document, ‘Pharmacist access to the Patient Health Record’, cites YouGov data saying: “An overwhelming majority of the British public, 85%, said they want any healthcare professional treating them to have secure electronic access to key data from the GP record.”

In addition, “a recent survey of over 7,000 patients using a pharmacy vaccination service showed that 80% of patients are happy for the pharmacist to be allowed access to their GP record.”¹

Support from the RCGP’s Honorary Secretary, Professor Nigel Mathers, comes with a caveat, though: “It will be imperative that an individual patient’s consent is given before giving pharmacists access to their records – and patients will need to be assured that as healthcare professionals, pharmacists are bound by the same confidentiality rules as GPs.”

It all means more discussions about appropriateness of access, data security, and the biggie – interoperability. But it should also be seen positively as access to the patient record is not just about the patient having the opportunity to be more involved, but all health professionals involved in that patient’s care will benefit.

1. Mahmood H, Tse S, Chung Li W, et al. Community pharmacy vaccination services: customers’ perceptions of pharmacist access to GP records. International Journal of Pharmacy Practice. 2015;23 (Suppl 2):9

The Digital Primary Care Conference at EHI Live taking place at the NEC Birmingham on November 3 will consider the need for patient information to be available digitally to all healthcare professionals who require it, in order to maximise efficiency, lower costs and improve care at the primary level.