A review by the Scottish government’s Chief Pharmaceutical Officer could end the longstanding ban on community pharmacists having access to patient records.

While the Minister for Public Health told Scotland’s Pharmacy in Practice conference that change is achievable, the Scottish Conservative health spokesperson told the conference that pharmacists have been waiting too long to access patient information crucial to them making safe decisions.

One community pharmacist and independent prescriber told the politicians’ panel at the conference in Edinburgh:

“We don't know what conversations that a patient asking us for antibiotics for an infection has had with their GP already.

“They’ve come to us after their GP has said they don’t need an antibiotic, but they don’t tell us that. So, we assess them and tell them what they’ve already been told.

“If we could see they’ve already spoken to their doctor, it would be a completely different consultation.”

The issue of having limited access to full patient records is a longstanding challenge for pharmacists working in the community.

The professional body for pharmacy, the Royal Pharmaceutical Society has been campaigning on the issue for several years.

Most community pharmacists can only see a partial record, the Emergency Care Summary, which the RPS Director for Scotland says “can be an incomplete or inaccurate summary designed for emergency situations rather than for healthcare professionals who are making multiple complex prescribing decisions every day”.

Last year one delegate to the Pharmacy in Practice conference likened it to prescribing blind.

This year, the question delegates put to politicians was not one of ‘if’, but when will access to full patient records be extended to Scotland’s community pharmacists.

Minister for Public Health and Women’s Health, Jenni Minto MSP said she was “absolutely supportive” of achieving the change:

“Anything that we can do to avoid delays, whether that's in a hospital or whether that's in the pharmacy itself, is really important. I'm really pleased that our CPO [Chief Pharmaceutical Officer] is leading work on this.

“You do have access to some patient records, but I absolutely appreciate that that's not enough and to have the full story, or more of the story, to provide the support a patient is needing is really, really important.”

Ms Minto added that she will be receiving a report in the next six weeks and hopes that there can be a rollout once “the various regulations boxes ticked”.

“Just not good enough”

Scottish Conservatives health spokesperson, Sandesh Gulhane MSP, who continues to practice as a part-time GP, told the conference that the inability of community pharmacists to update a patient’s record directly – and the risks posed to their registration as safe practitioners, is also a challenge for doctors:

“When a patient comes to me, I don't know that you have given them antibiotics for a urinary tract infection, a UTI.

“I rely on that patient telling me that this isn't the first presentation for this UTI that they've come to me with. That's not safe, and it's not safe the other way around either.

“It's not only a patient safety issue, but it's a professional registration issue.”

Dr Gulhane said the issue exemplifies how “basic” issues with digital infrastructure in the NHS is making it difficult for healthcare professionals to do their job:

“When I'm a GP, I don't know what the out of hours doctor has said, unless the out of hours doctor has got that to me. I don't know what the hospital has said, unless I get the discharge letter.

“We are talking about such basic things. For them to be the top priority 17 years later, it's just not good enough.”

Scottish Labour public and women’s health spokesperson, Carol Mochan MSP told the audience of pharmacists and pharmacy technicians that she too is fully supportive of all clinicians having the access they need to a patient’s information for the sake of patients:

“But it's delivery,” she said. “It's how do how do we get it delivered?

“It has been slow. It should have been done a while ago.

“We need to actively pursue the government. They clearly understand the issue, but we need to know how are they going to resource it? What are they going to do?

“And we need to keep an eye on how the timetable goes. Because it must feel, for you, a bit like swimming through treacle.”

Read more about pharmacy: Scots honoured in health, care and sciences; Government promises to up NHS activity; The PDA and Pharmacy Technicians; Why AI can’t replace pharmacy care;

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