Q. What is a Summary Care Record (SCR)?
A. SCR is a fragment of the patient's GP medical record. At the moment the information is divided into:
1. Core Information:
- Allergies
- Adverse Reactions
- Medication
2. Additional Information (that may include laboratory and test results)
3. Significant medical diagnosis
4. Vaccination history
Q. Can I look at a summary care record that is not live?
A. There are a number of test patients set up to allow Pharmacists and Technicians to view examples of the SCR for training purposes. The test patient NHS numbers are:
- 9990402132
- 9990281025
- 9990252955
- 9990252947
Q. Where can I find the portal details for SCR?
A. The portal for Summary Care Records can be located on the NHS Spine using the N3 Service Portal. https://digital.nhs.uk/services/spine You will need your username and password provided by your local NHS IT team. Your PMR provider may also provide a seamless integrated access point within the dispensing software environment.
Q. How to explain SCR to patients to gain consent
A. As your patient(s) may not understand the term ‘Summary Care Record’ it may be less confusing for them if you phrase the question as:-
"Can I access your GP medication record? It will help me to...”
You can explain that you can access a summary of their GP medication and adverse reactions records which will show:-
- Medicines: Acute, repeat and discontinued repeat items (discontinued items will be dependent upon the GP system which created it)
- Allergies
- Adverse reactions
Explain to your patient(s) that this information will be beneficial to providing care to them especially when the GP surgery is closed.
You can use the NHS Summary Care Records patient leaflet to help in your explanation.
Q. What if a patient does not have a SCR or does not wish to have a SCR?
The patient should be advised to return to their GP practice to discuss this with the GP. Provide the patient with an SCR information leaflet to give them some information to take away.
Q. Do I need to obtain patient consent each time I want to access their SCR?
A. Patient's permission must be obtained to view their SCR on each occasion unless you have received long term consent. If you receive long term consent from the patient you must document this on the PMR to include the details of who obtained the consent and the date consent is obtained. A patient can change their mind regarding access to their SCR at any time. A proxy permission form is available to download from NumarkNet.
Q. ls verbal consent sufficient?
A You are strongly advised to obtain written consent. Verbal consent for accessing patients SCR can only be given under certain circumstances e.g. in an emergency. You should consider the GPhC guidance on consent. http://www.pharmacyregulation.org/sites/default/files/guidance_on_consent_08.09.14_2.pdf
Q. What if the patient is unable to give consent?
A. If the patient is unable to give their permission, for example an unconscious patient, select the emergency access button and give a full explanation as to why access is being made without the patient's permission. The Pharmacist or Technician accessing the records without the patient's permission must use their professional judgement to ensure this is the most appropriate source of information to use, and must be able to justify accessing the SCR.
Q. What can I use the SCR for?
A. SCR could be used in any situation where the Pharmacist or Technician considers it to be appropriate, in accordance with their professional judgement. This means it is your professional decision to access the records.
Q. Do I need to access the SCR for every prescription that I dispense?
A. 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 or technician. Pharmacists or technicians who decide not to access SCR should consider the impact of a dispensing error occurring as a result of not accessing the SCR. This could be considered “error by omission”.
Q. Does my professional indemnity insurance cover the use of SCR?
A. Current professional practice involves pharmacists performing routine tasks (such as straightforward over the counter sales or the supply of repeat medication) without referring to additional sources of information. (See above). The SCR service is one of many sources of information for health professionals to use in the course of their practice. Therefore access to the summary care record is not expected to radically change pharmacy practice. Numark Professional Indemnity will include SCR within the cover.
Q. Date and time stamp on the SCR
A. It is vitally important to check the date and time stamp on the SCR as the information held is a summary of information from a patient's GP practice at the time it was created. Users should therefore check the subsequent information as part of their normal history taking.
Q. What to do if details in the SCR are incorrect
A. If you identify out of date information for a recent record update, contact the patients GP practice to inform them.
Q. I do not have the branch ODS code on my Smartcard
A. In order to access patient SCR, your Smartcard will need to be updated by your local registration authority (RA) with the branch ODS code and SCR roles. Please contact your RA directly to have your smartcard updated with the ODS code. Locum pharmacists must select the “provide additional information” option and enter the pharmacy ODS code before accessing a patient’s SCR.
Q. I do not have the SCR role on my Smartcard
A. In order to access patient SCR, your Smartcard will need to be updated by your local registration authority (RA) with the branch ODS code and SCR roles. You will need to contact the RA with a copy of your CPPE SCR training certificate, Smartcard number and GPhC number. The pharmacy will also be required to complete the Acceptable user agreement before SCR access is allowed.
Q. Can I use another persons Smartcard to access SCR?
A. In line with the terms and conditions of use of Smartcards, you MUST NEVER use someone else’s Smartcard; you must only use your own Smartcard. Similarly you must never allow another person to use your smartcard.
Q. What is the process for Locum Pharmacists to access SCR?
A. Locum Pharmacists should have their Smartcards updated with the SCR roles as well as the ODS codes for the pharmacies they work at on a regular basis. When accessing Summary Care Records, Locum Pharmacists are to follow the Shared Care Records SOP.
Q. I selected the wrong patients SCR what should I do?
In the event of accessing a patient's SCR by accident an IG report must be submitted using the standard IG incident report available with the SOP
Q. What is a Privacy Officer?
A. The Privacy Officer (PO) is responsible for reviewing SCR access to ensure that a legitimate relationship exists with the patient. The Privacy Officer is also responsible for investigating any instances of SCR access without a legitimate relationship, such as access under the emergency access option.
The PO is usually the IG lead for the pharmacy. There is usually two PO’s per pharmacy where one PO can investigate the other in case of a SCR breach or review issue.
Q. I need help and/or advice about SCR, who should I contact?
A. Contact the Numark Information Services team on 0800 783 5709 (option 2) in the first instance.
Alternatively vist the HSCIC SCR web page for more detailed information.
Q. Do I need to obtain consent from every resident in a care home?
A. Each resident should provide permission for the pharmacist or technician to view their SCR. Where residents do not provide permission the care home should inform the pharmacy NOT to access the SCR.
Pharmacists can use the emergency access option where they cannot obtain permission and believe it is in the best interest of the patient to access their record.
We would encourage pharmacies who supply medicines to care homes to ask the care home manager to include obtaining written permission to access the summary care record as part of the resident’s admission process. A proxy permission form is available to download from NumarkNet.
Patient information, leaflets and posters should be made available at the care home to ensure that Data Protection Act rules on fair processing are met. Examples of suitable information materials are available from HSCIC website.
Q. Can children have a SCR?
A. Children can have a SCR. In situations where the child understands what is being asked of them they can give consent to access their record. If the child does not understand then it is the parent’s choice. Access to the child’s SCR in this situation would be at the discretion of the pharmacy professional.
Q. Does the Privacy Officer need to investigate every alert?
A. It is not mandatory for the privacy officer to investigate or reconcile every alert; it is permissible to investigate only a percentage of the alerts provided this is documented in the privacy officer business process or SOP.
Initially each pharmacy is expected to have only a few alerts each week. In this circumstance it would be advisable to investigate each alert.
Q. Who can act as a Privacy Officer?
A. Any member of staff can act as the Privacy officer. They will need to have a smartcard with the appropriate RBAC. Because of the requirement to reconcile alerts within the pharmacy an understanding of the basic operation of the pharmacy would be beneficial.
The member of staff should also be able to act independently to investigate alerts if they believe a pharmacist or technician has accessed SCR inappropriately.
Q. How many Privacy Officers are needed for each pharmacy?
A. Each pharmacy should have a minimum of two privacy officers as a pharmacist cannot investigate their own alerts.
Q. How will the Privacy Officer know there are alerts awaiting investigation?
A. The privacy officer can be alerted to the presence of alerts by e-mail if they have an NHS.net e-mail. Alternatively they can view the alerts using the alert viewer on the NHS spine.
Q. Will the hospital update the SCR when patients are discharged?
A. The SCR can only be amended by the patient’s GP. The hospital will not amend the patient’s SCR when they are discharged from the hospital. The hospital will send a discharge summary to the GP surgery to update the patient’s SCR.
Q. How can I record the use of a SCR for an OTC sale?
A. It may be helpful to set up a PMR to record OTC sales which required SCR access. This PMR record will enable the privacy officer to easily confirm the legitimacy of the relationship with the patient and confirm appropriate SCR access.
Q. Can I look at my own SCR?
A. No. It is not possible to demonstrate a legitimate relationship with yourself which would render access to the SCR inappropriate.
Pharmacists wishing to look at a SCR should use the test patients.
The test patient NHS numbers are:
- 9990402132
- 9990281025
- 9990252955
- 9990252947