Why shouldn’t pharmacists have access to patient records?

“Talk to your local MP and invite them to your pharmacy!” This was the advice given by Oliver Colvile, vice chair of the All-Party Pharmacy Group (APPG), at an evening of discussion hosted by the Royal Pharmaceutical Society (RPS) London Central Local Practice Forum (LC LPF) at Portcullis House on 6 January 2016.

The discussion centred around pharmacists’ read/write access to the electronic patient record and its impact on patient safety. Colvile, the UK government’s pharmacy champion, emphasised Westminster’s commitment to allowing access to pharmacy as a whole.

The LPF event was attended by around 150 pharmacists, as well as patient representatives and GPs. The event was also supported by MPs, including Kevin Barron, who has been chair of the APPG since 2010. He opened the evening’s discussions by highlighting that pharmacist access to medical records is crucial and that “inertia” was “holding back patient care”.

Another MP in attendance was Gisela Stuart, who was responsible for introducing electronic records in 1999. Now, 17 years on, progress still needs to be made. “We’re getting there,” said Sandra Gidley, chair of the RPS English Pharmacy Board.

James Cavanagh, a primary care GP and commissioner, was supportive of pharmacists’ access to electronic records, however, he recommended the pharmacy profession approach the changes with caution. “Be careful what you wish for. Beware your roles don’t become an enormous cornucopia of tasks that you find difficult to deliver,” he warned.

Cavanagh recalled when access to electronic records was blocked due to concerns about data being released to third parties. “Who do you think the responsibility lies with now? You. The individual [pharmacist] who is downloading the data,” he said. “Suddenly this information you felt was behind a firewall and you couldn’t discuss because you’d be struck off, is now open. There are unforeseen consequences from that.”

Concerns over confidentiality were also voiced by patient group spokesperson Annie Caulfield. Caulfield had carried out a survey with patients with long-term health conditions, both mental and physical; the main concerns that emerged from her discussions with the patients were in the use of the data and the potential for it to get in the hands of the wrong people.

Gidley commented: “We’d lose our jobs if that happened. Pharmacists take their jobs, their profession and their duty to patients extremely seriously and I wouldn’t want that to be a concern going onwards.”

However, Caulfield also reported that none of the patients she spoke to had said ‘no’ to read access for pharmacists and many saw the benefits in terms of quicker treatments, increased safety and less time and energy used to make appointments and recite their conditions to multiple health professionals.

Caulfield concluded that in her view as a patient, when it comes to pharmacist access to patient records “the question shouldn’t be why should we, but why shouldn’t we?”

Gidley described the summary care record (SCR) as being “absolutely essential” to delivering best possible care to patients. “We have to make sure it doesn’t stop here [and] it carries on to its logical conclusion – it’s much better for patients.”

“We can do better with more” was the message from Mohammed Hussain, a pharmacist and systems commissioning manager for NHS England. “Our destination is digital healthcare where patient information is available to any clinician at any time, in any place. But more importantly it’s about giving patients access.” Hussain went on to highlight the availability of Patient Online, an NHS England programme, allowing patients to see information in their medical records, “[Patient Online gives you] live access to information on your mobile device or your laptop, about 10-12% [of patients] have asked for this access.”

Last year the Health & Social Care Information Centre (HSCIC) released figures following a pilot of the SCR in 140 community pharmacy sites in England highlighting the benefits to patients. Harpreet Shergill from the HSCIC presented some of the results at the LPF event. In 92% of cases using the SCR, the pharmacist avoided the need to signpost the patient to further NHS care – they were able to fix the problem there and then. Some 85% of those surveyed agreed that the SCR saved time previously needed to ring the GP. One NHS trust’s average call rate dropped from 211 before the SCR to 35. While in 18% of cases, pharmacists were able to prevent a series of prescribing errors and in 82% of cases the wait time for patients was reduced. “Within 5-10 minutes the pharmacist had accessed the information and was able to make a decision about treatment,” Shergill explained.

“[A total of] 97% of patients in England have a SCR. The SCR has been around for two years and has been accessed in a number of care settings. Community pharmacists are now joining this journey,” he added.