SCR access widens again

Community pharmacists, end of life care teams and ambulance staff will gain access to the Summary Care Record in a series of pilot projects over the next few months, NHS Connecting for Health has revealed.

The expansion in the types of NHS staff who can access the SCR will be piloted in early adopter primary care trusts in Bradford, Bolton and Bury.

In Bradford, three community pharmacies are expected to be given access to the SCR in a “small, controlled pilot programme” that will evaluate the potential benefits of such an approach.

However, the British Medical Association said it had concerns about the impact on patient confidentiality. The plans were also criticised by Helen Wilkinson from the Big Opt Out campaign, who claimed it would mean patients’ medical records becoming widely available.

Dr Gillian Braunold, clinical director for the SCR, said CfH was “very well aware” of the concerns and that the pilots would ensure the governance issues were tackled, including robust access controls for pharmacists’ smartcards and discreet, confidential areas for viewing of the SCR.

She added: “Hospital pharmacy access to the SCR is already widespread in the medical assessment units in Bury and Bolton and is one of the most beneficial areas of the SCR. What we want to do now is look at whether the benefit of community pharmacists accessing SCRs is as it is hypothecated.”

A spokesperson for CfH said that it was insisting on “rigorous safeguards” to protect patient confidentiality. She added: “Access will be restricted to those healthcare professionals who need information to treat a patient safely.

“No patient records will be accessed by pharmacists without explicit consent from the patient and the patient is able to opt out of having a summary care record created altogether.”

The spokesperson said no decision about how the final system would work would be made until the pilots had been successfully completed and assessed.

David Pruce, director of policy and communications for the Royal Pharmaceutical Society of Great Britain, said he believed patients and doctors would experience a clear benefit from pharmacy access to records and that it would not present a risk to patient confidentiality.

He added: "Access to care records by pharmacists will improve patient safety because pharmacists will be able to view the patient record, and be fully aware of what care a patient is receiving elsewhere.

“Access to care records will strengthen pharmacists’ ability to make the best possible decisions for their patients, and will enable them to develop new health promotion and screening services, for the benefit of patients and doctors alike.”

Dr Braunold said NHS Bury and NHS Bolton would pilot use of the SCR for end of life care. She told EHI Primary Care that some GP practices in Bury were already adding information about terminally ill patients to the SCR for out-of-hours services to access.

She added: “The traditional method has been for GPs to send faxes to the out-of-hours service, which is labour intensive, has to keep being changed and therefore doesn’t always get done in a systematic way. “In this way, the information can be easily updated and those caring for the patient have immediate access to information about patients’ wishes and their exact medication.”

Dr Braunold said NHS Bury was also working on a project to give ambulance control access to the SCR although she said this was still in the planning stages.

She said all three projects were about using the SCR as had been intended, providing information to support care in urgent and emergency settings. She added: “The SCR is designed principally to be used where there is no other information available. It’s a torch where there is no light.”

In a paper presented to last month’s Summary Care Record Advisory Group James Hawkins, SCR programme Director, told the SCRAG that while the initial content of the SCR was a GP summary other clinical content already approved by the board consisted of inpatient discharge summaries, emergency department reports, outpatient clinic letters, out of hours reports and health and social care integration documents (Common Assessment Framework).

He said the roadmap for the SCR would see the roll-out of the GP contribution complete and fully operational by 2011 followed by inpatient and outpatient discharge summaries in 2012 together with patients’ contributions via HealthSpace.