Community pharmacists will be able access and add to patient records currently maintained by GPs from January next year, in a bid to free up millions of GP appointments.
The Government, NHS England and Community Pharmacy England said they agreed that the Pharmacy First scheme will launch on 31 January 2024, subject to the ‘appropriate digital systems being in place’ to support the services.
This will include investment to ‘significantly connect and improve’ the digital infrastructure between general practice and community pharmacy to ‘streamline referrals’, ‘increase access’ to more parts of the GP patient record and improve how GP records are updated following the provision of pharmacy services.
It will also include the development of a clinical triage system to send electronic referrals from NHS 111 and urgent and emergency care settings to community pharmacy that may otherwise go to a GP practice, for the seven common conditions targeted: sinusitis; sore throat; earache; infected insect bite; impetigo; shingles; and uncomplicated urinary tract infections in women.
The organisations said that they are working with all pharmacy IT system suppliers currently assured for the Community Pharmacist Consultation Service (CPCS), blood pressure check service and Pharmacy Contraception Service (PCS) to update their clinical systems to support the launch of the scheme.
According to a letter sent to pharmacy contractors today, from the launch of the scheme community pharmacies will:
- have access to more parts of the GP record (medications, observations and investigations)
- use the new Pharmacy First consultation record to capture the consultation which will then send automatic structured updates to the GP record and to the NHS Business Services Authority (NHSBSA) to support payments and reporting on the service
The letter added: ‘We are working with NHS Pathways to develop the clinical triage system to send electronic referrals from NHS 111 and urgent and emergency care settings to community pharmacy that may otherwise go to a GP practice for the seven common conditions highlighted above, and with existing IT suppliers to streamline referrals from GPs moving away from NHSmail.
‘These will create additional step changes to further integrate community pharmacy and paves the way in the future for commissioning a wider range of clinical services at neighbourhood, place, integrated care board and national level.’
Community Pharmacy England Director of NHS services Alastair Buxton said that one of the elements that is been developed as part of the launch is to give pharmacists access to GP connect.
In a briefing attended by The Pharmacist, Pulse’s sister title, he said: ‘So the IT systems are developing that GP connects functionality with the GP Connect team within the transformation directorate at NHS England.
‘And the way that works is, NCRs, we are used to seeing that in a separate window as such, but actually GP connect to uses APIs to pull the data into the IT system you’re using, so there’ll be able to see relevant parts of the GP record that way.
‘So that’s one of the IT developments that’s been worked on for the new year.’
The ability of community pharmacies to access and add to GP patient records was initially announced as part of NHS England and the Government’s GP recovery plan in May, which had targeted for the combined measures to free up 10 million GP appointments a year by next winter.
But at the time, while GPs acknowledged that a level of access to records will be required, they highlighted the importance of maintaining patient confidentiality.
RCGP chair Professor Kamila Hawthorne said: ‘Our pharmacist colleagues do an excellent job for their communities and are providing invaluable support to many GP practice teams against a backdrop of huge workload and workforce pressures.
‘It is right that they are given the support they need to help patients most effectively.
‘However, pharmacists and GPs are distinct health professionals, and neither should be seen as a substitute for the other.
‘While we are keen to see initiatives that will ease the pressure on our struggling family doctor service, patients will in many cases, need the expert diagnostic skills and expertise of a GP.’
Dr Neil Bhatia, a GP and records access lead at his practice in Hampshire, told Pulse that it is important that any information from a pharmacy ‘comes into a document inbox, identical to hospital letters, and can be read first, then filed in the GP record’.
He said: ‘GPs would be unhappy if letters or blood pressure readings from the pharmacy were automatically filed in the GP record.
‘It is singularly important as patients now have access to the GP record and, rarely, we might need to hide communication from the pharmacy from online access, either to the patient or a proxy.’
Healthwatch England head of policy, public affairs and research William Pett said: ‘Being able to see your GP in a timely manner remains the public’s top concern.
‘If this initiative is effectively communicated and delivered, it will make a real difference to patients and relieve the pressure on hard-pressed services.
‘There could be potential problems, such as pharmacists not being able to see enough of people’s GP records or the ability of different communities and areas to access the new service.
‘However, if evaluated well, the NHS will be able to ensure that this promising new service really works for patients.’
The ‘Pharmacy First’ scheme was supposed to launch before the end of 2023.
Sore throat and earache is not a diagnosis. He is pulling his ear so mother thinks he has ear infection. Often wrong.
Shingles is not always straight forward. Recurrent uti need further investigations.
In what sense is the GP record a private record any more? It has been, or is being, opened up to so many outside bodies. My record is rather dull – but as a patient I really only want it shared between me and my GP and no one else. I don’t want it opened up to pharmacies and social care, and god knows who else. Do we think our patients really want this? Will everyone’s records be treated similarly?
It would be interesting to know if SCR opt out code still applies across the board or has that been overridden?
What is the point? You have high BP go and see your gp. You have an ear infection. Go and see your gp. You have shingles. Go and see your gp . Unless they can prescribe is there any point. My pharmacy has increased the workload and number of emergencies who want to be seen on the day, often with marginal blood pressures. Ffs
So NHSE have decided to share confidential identifiable patient data with a third party organisation, without obtaining individual patient consent or the permission of the Data Controller (GP Practice). Is this not a breach of the DPA and GDPR?