Wider access to medical records is vital, says Harry McQuillan
Over the last ten years community pharmacists have been tasked with providing more clinical interventions and patient care. The community pharmacy contract remunerates pharmacy contractors for this activity but pharmacists, in most cases, do not have access to the patient’s medical history. This can impede the care a patient receives and is particularly problematic at times when GP surgeries are closed.
I believe the vast majority of patients are supportive of pharmacists having access to their records. In fact I have on numerous occasions faced puzzled questions from patients who do not understand why I can’t see their GP record or hospital discharge notes. NHS services and the primary care contractors still often work in silos despite the advances in technology over the years. We must recognise that as registered health care professionals the more our systems are integrated the greater the potential benefits for our patients.
Support also comes from our colleagues in the Third Sector. The Alliance, which advocates for patients living with long-term conditions has highlighted the difficulties associated with poor information sharing. A recent survey showed patients had reported delays accessing their medication due to poor communication channels between different areas of the NHS.
Consider a patient just discharged from hospital. A consultant may have changed their medication but often it can take over a week for this information to make it to the community pharmacy responsible for the patient’s regular prescription. This can lead to a patient running out of their discharge medication before the community pharmacy is even aware their therapy has changed. Another common issue is the patient who has run out of medication over the weekend. In Scotland, pharmacists can write prescriptions when an urgent supply is needed. However it is not uncommon for the patient to be unsure of the strength or dose of a medication. The ability to access key information held by the GP surgery could aid the pharmacist to ensure a safe supply is made.
As health professionals we are all now generating information which could aid our colleagues in other disciplines. In community pharmacy we hold the unique information of what medicines are actually dispensed to patients. Often this is different to what the GP prescribes as patients may choose not to collect all or any of their prescription. Since the introduction of the Chronic Medication Service, pharmacies are now recording care issues patients have relating to medicines and working to resolve them. I’m sure this information would be beneficial for colleagues both in the hospital sector and GPs but currently there is no way to share it.
The NHS has also supported non-medical prescribing meaning that now many professionals including pharmacists may be prescribing medication for the same patient. The ability for all practitioners to work from the same record will become more import as prescribing by those who are not doctors becomes the norm. It would be to the detriment of all professionals and most importantly patients if the expertise of all NHS professionals cannot be utilised because of a failure to share data.
Healthcare professionals such as pharmacists, doctors, dentists, nurses and opticians are all regulated to high levels to ensure public safety and confidence. There appears to be no legitimate professional barriers to all disciplines working together with relevant information shared. With the huge advances in IT systems this should be a realistic goal.
It may be useful to put ourselves in the position of a patient. When accessing NHS services CPS believes patients have a right to expect the healthcare professional to have up to date and accurate information to assist in their care. If we empower patients and give them control over who accesses their records I’m confident they would trust all the NHS’s professionals to deliver their care.
• Harry McQuillan is chief executive of Community Pharmacy Scotland www.communitypharmacyscotland.org.uk