GPs to see automatic records updates from pharmacists, spec confirms

GP Connect is to add a functionality for pharmacists to automatically update medical records, without additional action from the patient’s GP.

The new functionality has been confirmed as the specification for the Pharmacy First scheme was published last week.

As it stands, the opt-in scheme will allow community pharmacies to consult and prescribe for seven common conditions from 31 January, although the Government has made clear the timeframe is contingent on the relevant IT being in place.

According to a letter sent to pharmacy contractors last month, from the launch of the scheme community pharmacies will have access to more parts of the GP record (medications, observations and investigations) and use the new Pharmacy First consultation record to capture the consultation.

Now the service specification has clarified further details on how pharmacists will be able to edit patients’ records.

The pharmacy contractor will ensure that a notification of the provision of the service is sent to the patient’s general practice on the day of provision or on the following working day, the specification said.

Where possible, this should be sent as ‘a structured message in real-time’ via the NHS assured Pharmacy First IT system, but in absence of an automated digital solution or if there is a temporary problem with the system, this should be sent via NHSmail or hard copy.

The specification also clarified that GP Connect Update Record ‘will provide the functionality to automatically update a patient’s GP medical record’.

Pharmacists will send an action message or alternative form of an ‘urgent action’ communication to the practice, where an action is required by the GP team, such as booking the patient in for a follow up or appointment.

If a problem occurs with the electronic notification system, the pharmacy contractor will need ensure a copy of the paperwork is sent or emailed to the general practice.

Dr Neil Bhatia, a GP and records access lead at his practice in Hampshire, told Pulse that the ‘write-back’, where consultations held outside of the surgery (for example at pharmacy or walk in centre) are automatically filed in the GP record, is becoming ‘increasingly common’ but carried multiple risks.

He said: ‘Currently we receive an electronic document from such organisations and read them, then file them.

‘That way, they are always looked at, and actions needed are spotted, and we can decide whether to “hide” that document – that is, make it not visible online to the patient.

‘The risks with write-back are multiple. I, as the GP, won’t necessarily know that one of my patients has been seen.

‘I therefore won’t know if any follow-up action is needed unless some other form of communication happens – an external/internal email is sent to me.

‘What if the external consultation is sensitive and should not be visible to the patient (or their parent/guardian/proxy)? Can the pharmacy “hide” it at their end, and make it not visible?

‘If they do hide it, that might mean that the consultation is not filed at all in the GP record. That’s what happens with EMIS Web cross-organisational consultations, for example across a PCN.

‘Personally, I would still much prefer to receive an electronic document as I do now. I then have control – I can read it, I can note any actions needed, and I can decide whether to make that visible to the patient or not.’

Dr Euan Strachan-Orr, a GP in Liverpool and spokesperson for the Rebuild General Practice Campaign, told Pulse: ‘The possibility for pharmacies to directly task GP surgeries for appointments, queries and follow ups within electronic GP Records will undoubtably result in increased workloads for general practice.

‘The scheme was advertised as helping move work away from GP, when in reality this will result in increased unfunded workloads being dumped into already struggling surgeries.’

Following the scheme’s announcement, the Doctors’ Association UK urged the Government to urgently review why pharmacies are paid ‘more than double’ per consultation compared with GPs.

And GPs told Pulse they believed that the Pharmacy First money would be better off spent in general practice.