SCR is an electronic patient information system available to specific healthcare professionals both in hospital and community. It contains a summary of clinical information held by the patient’s GP.
NHS England advocates the use of Summary Care Records (SCR) by healthcare professionals to improve patient care. Rollout has started and should be complete by autumn 2017.
The patient must give consent to the GP who will update and include information about their treatment.
According to HSCIC the SCR consists of core information:
- Acute medicines - either 6 or 12 month history dependent on GP system
- Current repeat medicines
- Discontinued repeat medicines
- Known allergies
- Adverse reactions
- Patient details including NHS number, name, address, date of birth and GP practice
The SCR will update automatically every time this information changes on the patient’s GP record.
Extra information that may be included with the patient’s consent include:
- Reason for medication
- Blood test results, such as INR results or lithium levels
- Significant diagnoses/problems
- Significant procedures
- Palliative or End of Life Care information and patient preferences
- Other anticipatory care preferences, if recorded by GP
- Any other important information that the patient and GP agree
Sensitive issues are not included, unless the patient specifically asks for them to be. For example:
- Fertility treatments
- Sexually transmitted infections and treatments
- Gender reassignment
When to use SCR
During the trial with community pharmacies, SCR was used for the purpose of providing an emergency supply of medication out of hours. SCR can be used in situations where the pharmacist or technician considers it to be appropriate in their professional judgement.
Scenarios where SCR could be used include:
- When dispensing prescriptions to check the current medicines, medicine history, allergies or adverse reactions to support patient care.
- To confirm medicines prescribed after hospital in-patient treatment are current.
- To support self-care for public health services and promote healthy lifestyles- to confirm what medicines the patient is taking.
- During an MUR to confirm and compare medicines currently being prescribed for the patient and their known allergy status.
- During the provision of the New Medicine Service.
Locally commissioned services
- When supplying medicines under a locally commissioned service, such as a minor ailments service, to check the current medicines.
- Supply or administration of medicines on an NHS PGD.
- During minor ailments consultation to ensure OTC medicines are compatible with prescribed medicines, recognised allergies, and adverse reactions or diagnosed medical conditions.
- When making an emergency supply (at the request of the patient) to confirm the name, strength, form and dose of the medicines previously prescribed for the patient.
NHS England expects SCR to be used to support decision making.
It is not expected that SCRs will be accessed for every patient, or for every prescription, every time.
The decision to access the SCR is based on a clinical need at that time, determined by the pharmacist.
Pharmacists and authorised persons only can only use SCR:
- If you have a legitimate relationship with the patient ie you are actually involved in the patient’s care at that point in time.
- When you have the patient’s permission to view it, unless the patient is unable to give consent and you believe it is in the patient’s best interest.
You must record the reason for accessing the records.
How to use SCR
To get setup with SCR:
- Complete the CPPE online SCR training. Enable data sharing on the CPPE website so that the RA can confirm completion of the training.
- Request the correct Role Based Access Control (RBAC) added to your smartcard profile by the RA.
- Read and sign the SCR SOP for your pharmacy.
- Make sure you know who your SCR governance person ( previously Privacy Officer) is and their contact details and any associated process requirements specific to SCR.
To access SCR each time:
- Log in with your own smartcard on a computer system in the dispensary or consultation room
- Access the portal and then select 'Launch Summary Care Record'. It is advisable to save this to your desktop or favourites.
- Obtain patient consent.
- Search for the patient, ideally using NHS number but if this is not yet known, using surname, DOB, postcode etc.
- Select the right patient.
- Record permission to view.
- Remember: Locum pharmacists logged on with the locum ODS code (FFFFF) must ALWAYS select the “provide more information about the access” (optional) link and enter the ODS code of the site or branch where the access is taking place into the box before clicking yes.
- View SCR.
- Once the required information is obtained log off from the patient SCR.
SCR governance person
As part of the governance of SCR, pharmacies using SCR are required to have a SCR governance person. It is good practice for there to be more than one governance person to avoid a governance person auditing their own access alerts. It is the job of these governance people to validate any alerts that are generated in the course of the organisation accessing SCRs.
The purpose of the SCR governance person role is to manage alerts and to audit SCR viewing activity. The alert notifications are prompts to the governance person to investigate SCR access and to confirm justifiable use or to identify inappropriate access.
Check with your Professional Indemnity provider about accessing and using SCR. It is important to confirm and understand what their current policy covers.
Numark PI policy holders are automatically covered under the terms of the Numark agreement.
Your local Commission Support Unit will be directing the SCR rollout in your area. This will be done in conjunction with the LPC and Area Team. Please look out for your letter of invitation in 2016.
If you are awaiting the training you should complete the CPPE training.
Detailed guidance and training on how to implement SCR in community pharmacies is available on the HSCIC website.
A factsheet about SCR in community pharmacy [PDF] is available on the HSCIC website.