The below comment piece was published in The Times (Scotland edition) newspaper on Tuesday 10 December, 2024.
Community pharmacists prescribe medication multiple times a day, but they could do more with access to patient data.
Community pharmacists play a crucial role in caring for patients. In today’s stretched healthcare environment, being able to access a pharmacist, without an appointment, who can diagnose, treat and care for people close to their homes is increasingly essential to the viability of the NHS.
As demand for healthcare is increasing, the role of the community pharmacist is changing. Community pharmacists are now seeing people living with multiple long-term conditions and who are taking multiple medications every day. This year’s YouGov Big Survey on Drugs highlighted that around a fifth of Britons over 60 take more than five prescription drugs. Routine management of these patients and their medicines is carried out in the community, closer to home, and pharmacy teams play a pivotal role in this. A focus on prevention rather than treatment means community pharmacists are recognising and acting on early warning signs for potential chronic conditions. Welcome initiatives such as NHS Scotland Pharmacy First are encouraging people to visit their community pharmacy as a first port of call for minor ailments and medicines advice. The extension to this service, Pharmacy First Plus, means pharmacist prescribers, when appropriate, are diagnosing, prescribing and supplying treatment to the patient; saving onward referral. From 2026, all pharmacists will qualify as prescriber ready, vastly increasing the numbers of community pharmacists who are prescribing.
However, there is a problem.
Community pharmacists do not have access to full patient records. Most community pharmacists can only see a partial record, the Emergency Care Summary (ECS), but this can be an incomplete or inaccurate summary designed for emergency situations rather than for healthcare professionals who are making multiple complex prescribing decisions every day. There is also not enough information to fully support the prevention work that community pharmacists are taking on. Furthermore, ECS does not provide the ability for community pharmacists to write into the patient’s record, to provide information about what has been discussed with the patient, highlight issues or concerns, and if relevant, note anything prescribed for them. This means that after every interaction between a community pharmacist and a patient there is an incomplete data set.
Pharmacists rely on multiple different sources, including patients’ knowledge, pharmacy records, ECS access and contacting other healthcare professionals, to identify diagnoses, and clarify what medicines a patient is currently taking. As well as being extremely inefficient, this requires a high level of risk management and can mean a patient’s access to care being delayed or necessitating a referral to another health professional with access to the required information.
It is essential that we recognise the limitations this places on the care patients access in the community, move away from providing limited access to patient’s data via an emergency record and provide community pharmacists with full access to patient data. This would allow pharmacists to see a complete picture of a patient’s medical history, allow them to make informed clinical decisions with all necessary information at their fingertips and potentially expand the range of services that could be offered in community pharmacy.
In England, a huge £3.4bn investment in NHS digital transformation has been announced. As part of this, the UK Government has committed to making the NHS in England the world's largest digitally integrated healthcare system. Royal Pharmaceutical Society would like to see a similar commitment from Scottish Government so community pharmacists can make the most of their skills, knowledge and experience to improve and enhance patient care in the community.
Laura Wilson is the Director for Scotland at Royal Pharmaceutical Society