Access to Records – Supporting Patients over the festive period and beyond

By Malcolm Clubb, MRPharmS

This year in my pharmacy we are planning to open for the morning on Boxing Day to increase patients’ access at a time where many other health services are closed. However, I am acutely aware that we are still unable to support patients who are not from our pharmacy safely and easily due to lack of access to the Emergency Care Summary (ECS)/Key Information Summary (KIS) records in pharmacies across Scotland. Community pharmacies were promised this by 2014 – it is inconceivable that we still do not have this at the end of 2015. Community pharmacists remain the only health professionals with direct patient contact who do not have access.

Dispensing prescriptions without a full history can be risky if the patient is a poor historian or the medicine is being collected by a relative or a neighbour. For example, being able to advise a patient on ceasing simvastatin whilst co-prescribed clarithromycin is only possible if you know that they are taking simvastatin. Access to the patient’s record would give pharmacists this essential information. Currently, with patient consent, we have to contact NHS 24 to get this information, which is a drain of time for NHS 24, the patients and pharmacists.

The Scottish Government recently distributed Medicine Safety Cards designed to reduce hospital admissions and deterioration in the patients’ health when they are experiencing sickness and/or diarrhoea. That is welcome, but crucially the cards can only be effectively used if we know which medicines the patient takes when they present in the pharmacy. Again, without direct access to the ECS/KIS, this is unsafe.

I noted that the recent joint submission by the RPS in Scotland, Community Pharmacy Scotland and Directors of Pharmacy group to the Primary Care Out-of-Hours review urgently called for community pharmacy to have access to the emergency care summary. This recommendation has been adopted by the lead of the review, Sir Lewis Ritchie, but we now need Scottish Government action on this recommendation as previous strategies have also made this pledge to pharmacy. It is long overdue that pharmacists across Scotland have increased access to patient medical records to support us in our day to day work – it is a matter of patient experience, patient safety and effectiveness. Scotland lags behind what has been delivered in England with access to the Summary Care Record and I call upon the Scottish Pharmacy Board to ensure access to records is delivered for community pharmacists as their number one priority in their discussions with political parties prior to the Holyrood Elections in 2016.

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