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The Summary Care Record
The Summary Care Record (SCR) is an electronic summary of key health information. It will hold limited essential information derived initially from the patient’s GP record; this will include medication, adverse reactions and allergies and may contain additional information such as significant medical history. This will then be added to over time with content such as hospital discharge notes. The record will remain a summary and only contain significant aspects of a person’s care. Patients will be able to see the record via HealthSpace and a patient will be asked before their record is accessed, except in certain circumstances.
Background information can be found online at: http://www.cfh.nhs.uk/scr
National Roll-out of the Summary Care Record
The SCR is already live in several care settings including: GP Surgeries, Out of hours, emergency departments, acute admissions wards, ambulance trust and walk in centres.
As part of the consent arrangements, before any information is uploaded to the Summary Care record by GP Practices, there is a 12-week public information programme (PIP). Patients are sent a personally addressed letter along with a leaflet detailing what is happening and what their choices are. They will be told that they have a period of time to decide whether they wish to have a SCR stored for them.
If patients are not sure whether they wish to have a record, they will be encouraged to seek further information and support, to help them make their decision. The information they are sent includes a helpline telephone number (0845 603 8510) and web address (www.nhscarerecords.nhs.uk), where they can receive further information. The letter may also have details of any local events that the PCT may be planning as part of a public awareness campaign.
Over 40% of Primary Care Trusts have started their PIPs with more to follow. The NHS Operating Framework requires all PCTs to set out a timeline for the creation of Summary Care Records at all SCR-complaint GP practices in the 2010-11 financial year.
Status of the Pharmacy SCR Pilot
In the 2008 Pharmacy White Paper, the Government committed to undertaking further work with a (Summary Care Record) early adopter PCT to consider the benefits, governance and practical arrangements of community pharmacists having access to the SCR. Bradford has been chosen as the first site to pilot pharmacy access.
The pilot pharmacies will be accessing the SCR through the ‘Summary Care Record Application (SCRa)’, a secure internet portal by which patient information (both demographic and clinical) held on the Spine can be accessed. As with other Spine applications, access will be controlled by smartcard privileges. At this stage, it will be read only access to the record and won’t be integrated with PMR systems.
Bradford has been selected as the first pilot site. Work is currently ongoing to select and prepare the pharmacies that will be involved in the pilot.
At the national level, the RPSGB is leading on the development of professional guidance and the DH are co-ordinating the engagement of key stakeholders including the major insurers to discuss guidance on potential liability issues. For example ‘what are the consequences of having access to the record but choosing not to look on a particular occasion?”. There are a range of issues which still need to be worked through and will be steered by experiences during the pilot. The options for an independent evaluation of the pilot are being explored by the Department of Health.
The Benefits of Pharmacy Access
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Providing community pharmacists with appropriate role-based read and write access to both detailed and summary care records has the potential to greatly improve patient safety, support the development of new services for patients, improve interdisciplinary working and increase the quality and continuity of care provided to patients.
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To maximise patient safety, community pharmacists must have access to a pre-determined core data-set, for example the medication profile, active clinical conditions, allergies and previous adverse reactions. It would be beneficial for patients, the NHS and pharmacists if supplementary information, such as access to laboratory test results, is also available to pharmacists to use where appropriate and with patient consent, to support a particular role they are undertaking, for example, the provision of an anticoagulation monitoring service.
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All community pharmacies have robust systems in place for handling patient confidential information and are subject to a wide range of legal, ethical and professional requirements. PSNC, the NPA, the CCA and AIMp welcome the proposed additional safeguards to protect patient confidentiality including role-based access controls and the ability for patients to choose to dissent from their information being shared.
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Community pharmacists should be involved at an early stage in the implementation of the NHS Care Records Service to study the benefits and challenges that arise in joining-up care and to provide learning to support the wider roll-out of the Service to other professionals and organisations within the NHS.
The full submission can be viewed by clicking on the link below:
PSNC/NPA/CCA/AIMp Submission to the HSC on Access to Patient Records
More Information
CfH Site: SCR Information for NHS Staff
CfH Site: Key Statistics on the SCR
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