N3 connections needed say community pharmacists

Lack of access to smartcards and the N3 network by community pharmacists is jeopardising the roll out of the electronic prescribing service (EPS) and important elements of the new pharmacy contract, according to the Pharmaceutical Services Negotiating Committee (PSNC).

But NHS Connecting for Health has rejected the claim, saying that the EPS is rolling out in a controlled way.

Sue Sharpe, chief executive of the PSNC, told EHI Primary Care that only a handful of England’s 10,500 community pharmacists had so far been issued with smart cards or received N3 connections. She says they are therefore unable to communicate electronically with GP surgeries.

Not only is this the rate-limiting factor in rolling out EPS but it is also hampering Medicine Use Reviews (MURs) – an advanced service under the new contract in which patients review their medication with their pharmacist who then sends a record of the review and any recommended changes to the patient’s GP.

Sharpe said: “Community pharmacists tell us that GPs will not accept a paper record. They cannot send an electronic record via email as it is not secure but they do not have secure N3 connections.”

She added: “This is threatening the proper use of the new contract. It is also very dispiriting for pharmacists who are doing this to improve patient care.”

She accused PCTs of holding back smartcards in order to save money. “Most PCTs are not remotely considering pharmacists for smartcards because it will be a hit on their budgets,” she said.

The PSNC has raised this issue repeatedly with the Department of Health and the relevant parts of NHS Connecting for Health but has yet to receive any answer about when pharmacists will see either smartcards or N3, claimed Ms Sharpe.

The All-Party Pharmacy Group (APPG) last week wrote to health secretary Patricia Hewitt warning that community pharmacists must have access to the national care record system if medicine use reviews and independent prescribing are to operate successfully.

In his letter APPG chair Howard Stoate MP, warned: “Failure to achieve IT connectivity will hamper service developments.”

Under the new contract, implemented in England in April 2005, community pharmacists pay for their own IT. It is envisaged that pharmacy computer system suppliers will probably provide independent pharmacists with an all-in-one package that will include a commercial N3 connection.

Pharmacists will reclaim a £200 monthly charge for their N3 from PCTs but only when they have a smartcard, N3 connection and approved software in place.

However, NHS Connecting for Health said roll out of EPS was not jeopardised by lack of smartcards.

Sources suggest however that pharmacy software compliance is the limiting factor in community pharmacy. Only one pharmacy system supplier’s software – AAH Link Evolution version 7 – has been approved as compliant with EPS. Software by the other 20-or-so GP and pharmacy suppliers is currently being developed and tested.

Tim Donohoe, group programme director for EPS, said that the EPS web page showing the status of pharmacy systems and their compliance is now being developed and is expected to go live in the next few days.

Meanwhile, guidance is being prepared for community pharmacists as well as for PCTs and SHAs on regulation policies.

He emphasised that MURs and independent prescribing were not part of NHS CfH’s remit.

According to EHI’s sources, none of the pharmacy system suppliers has yet developed a commercial N3 connection although they are in discussion with the LSPs and expect to do so within the next two months.

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