Community pharmacy access to shared patient records is not being prioritised under the initial phase of its development, the Department of Health and Care (DHSC) has said.
On 9 February 2022, the DHSC published a white paper, ‘Joining up care for people, places and populations‘, which outlined its proposals for health and care integration, central to which was a new target for each integrated care system (ICS) to set up a ‘shared care record’ accessible by health and adult social care providers by 2024.
“Basic shared care records are now in place in all but one ICS,” the proposal document noted. “However, we must ensure that shared care records cover the entirety of a person’s life and include both health and care, which they currently do not.
“Every ICS will need to ensure that all constituent organisations have a base level of digital capabilities and are connected to a shared care record by 2024 enabling individuals, their approved caregivers and their care team to view and contribute to the record,” it added.
However, when asked by The Pharmaceutical Journal whether all community pharmacy teams can expect to have access to shared care records by 2024 as part of these plans, the DHSC said: “The initial phase of the shared care records programme has been to prioritise access for GPs and trusts.
“The potential is that many different healthcare professionals including pharmacists will be able to access shared care records; however, adding new partners is likely to be influenced by local priorities across the country.”
The government’s comments come after the ‘NHS long-term plan’, published in 2019, committed to moving the “functionality” of the summary care record (SCR) to within local health and care records by 2023.
SCRs, which contain important patient information, such as current medications and allergies, are currently able to be accessed by community pharmacies.
The DHSC said the local health and care record programme was replaced by the shared care records programme in early 2021 and confirmed that “no current record would be retired until another capability has been put in place”.
A spokesperson for the National Pharmacy Association said community pharmacy access to shared care records “will help to enable effective and complete patient care”.
“We need a network of local and national health and care records where inclusion of community pharmacy is normalised, even mandated,” they added.
Thorrun Govind, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, said: “We welcomed discussions with NHSX and NHS England on their digital strategy over the past year and there was a clear commitment to enabling community pharmacists to update a shared care record.
“Successive ministers have expressed their support and we continue to push for complete read-write access to healthcare records for all health and social care teams, so there must be a renewed drive to make this happen.”
Daniel Ah-Thion, IT policy manager at the Pharmaceutical Services Negotiating Committee, said that “while it is disappointing that pharmacy access to these records is not a priority contained in the recent White Paper, at a local level many ICS are keen to work with the sector to open up access as new records systems are put in place”.
“We are also working with NHSX and the Community Pharmacy IT Group to support the development of guidance for ICS and others on how to open up shared care records access to pharmacy teams,” he said.
What are shared care records?
At a Community Pharmacy IT Group meeting held in July 2021, John Farenden, senior programme lead at NHSX — the digital arm of the NHS — said the terms ‘shared care record’ and ‘local health and care record’ “may be used interchangeably”, with the terminology having changed over the course of the COVID-19 pandemic.
The local health and care records programme launched in 2018, with £7.5m in government funding allocated to five areas to set up record sharing systems, including Thames Valley, London, Wessex, Greater Manchester and Yorkshire and Humberside.
Community pharmacies in at least two of these areas currently have access to shared records.
For example, since 2020, pharmacy teams in Dorset and East London have been able to access information on why a medicine was prescribed, whether medicines have changed, and access blood pressure results through a care record shared with hospitals, GPs and local authorities.
The Pharmaceutical Services Negotiating Committee has said that shared care records could also include information on medicines, allergies, adverse reactions, reasons for medication, immunisations, significant diagnoses, significant procedures and end-of-life care information.