Select Committee on Health Written Evidence


Evidence submitted by Alliance Boots (EPR 27)

INTRODUCTION AND EXECUTIVE SUMMARY

  Alliance Boots is Europe's largest pharmacy-led health and beauty group, created following the merger in 2006 of Alliance UniChem and Boots Group. We operate 2,300 pharmacies across the UK, through our Boots The Chemists and Alliance Pharmacy stores.

  We believe pharmacists' access to patient care records is important for the benefit of patients; to enhance patient safety; to benefit other health professionals; for pharmacists to fulfill their responsibilities under the new contract; and for pharmacists to reach the full potential of their professional role. This memorandum explains why pharmacists require access to certain data, how this access will enhance joint working with GPs and benefit patients, and how we envisage the system will work, including protection of patient data and secure access.

What patient information will be held on the new local and national electronic record systems, including whether patients may prevent their personal data being placed on systems

  1.  The new NHS community pharmacy contractual framework is enabling pharmacy to develop beyond its traditional role of dispensing medicines into a more service-orientated role. The development of new health services in pharmacies is highly beneficial for patients and the NHS, and it is clear that pharmacists require access to sufficient data to enable them to provide a safe and effective service to the patients under their care.

  2.  While local computer systems already provide a full and comprehensive record of the service that an organisation has provided to the patient, or Patient Medication Record (PMR), there is most likely to be relevant information held within other healthcare providers' systems that would be of benefit in providing effective care to the patient. Conversely, information about the service that we provide to a patient would benefit other healthcare providers (eg GP or hospital) and so should be uploaded onto the summary care record.

  3.  The record needs to include all information about medication that has been prescribed and dispensed to a patient both in primary and secondary care. It should also include details of any allergies, active clinical conditions and any previous adverse reaction information. The care record could also include information regarding the supplies of selected prescription only and non-prescription lines supplied from a pharmacy, for example under a Patient Group Direction.

  4.  Having access to the full patient medication history would enable pharmacists to perform a full drug interaction check with all medicines prescribed and dispensed for a patient and thus improve the overall safety of the patient. If access to basic clinical condition information were included, this would further improve safety by allowing the pharmacist to check that the dosage was appropriate for the condition being treated.

  5.  A practitioner will not be in a position to provide treatment to a patient without access to relevant information but patients should be entitled to prevent their information being shared with other healthcare providers or restrict it to a limited number of individuals through use of controlled access rights and sealed envelopes. If a patient chooses to limit the sharing of their information, the implications of doing so should be made clear to them. Likewise, patients should be made aware of their responsibility to provide any relevant information at the point of care.

  6.  Many members of the public already volunteer personal data, regarding lifestyle, body weight and health-related purchases, as part of our company initiatives. For example, over 1.5 million people are signed up to the Boots "HealthClub" and there are 15 million Boots Advantage Card users. High take-up for initiatives such as these suggests broad public acceptance of data holding in a patient's own interest.

Who will have access to locally and nationally held information and under what circumstances?

  7.  The NHS care record should incorporate the patient's medical record, accessible to the healthcare provider, at the point of care and whenever required. Within community pharmacy, all pharmacists must have access to a core set of clinical information as detailed above. This must include a full record of the patient's medication history and any adverse drug reactions, to support the pharmacist in conducting a Medicines Use Review (MUR). In addition, certain pharmacists such as independent prescribers or pharmacists providing a specific service to a patient, such as Chlamydia screening, should have access to a fuller data set to include relevant information, for example laboratory test results. In pharmacies there will be role-related access, so that healthcare assistants will only be able to access a patient's records if this is a necessary part of their job.

  8.  When providing a repeat dispensing service to a patient, it is the duty of the responsible pharmacist to ensure that nothing about the patient has changed since the last time they made a supply. Having access to the care record would facilitate the pharmacist carrying out this check rather than relying solely on information provided verbally by the patient.

Whether patient confidentiality can be adequately protected

  9.  This information needs to be stored and accessed securely to protect the confidentiality of the patient. Pharmacy contractors and pharmacy systems are already subject to the controls of the Data Protection Act. Existing security measures (physical and technical) ensure the security of any patient information held locally on these systems.

  10.  Pharmacists already have NHS Smartcards and PIN numbers to enable them to access the Electronic Prescription Service (EPS). These same Smartcards can be used to enable access to the NHS care record and provide a full audit trail of who is accessing and updating confidential patient information.

  11.  Should a patient not want their information shared, he or she must have the ability to limit who sees what information or to authorize the user to view the information during a face to face consultation for that one time only.

How data held on the new systems can and should be used for purposes other than the delivery of care eg clinical research

  12.  Unable to comment on this.

Current progress on the development of the NHS Care Records Service and the National Data Spine and why delivery of the new systems is up to two years behind schedule

  13.  Unable to comment on this.

Alliance Boots

March 2007





 
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Prepared 25 April 2007