This month we have spoken to Stephen Goundrey-Smith, The Royal Pharmaceutical Society (RPS) informatics advisor and PRSB advisory board member, about the challenges of information sharing in pharmacy.
What challenges does the pharmacy profession face?
At present, there are around 11-12,000 community pharmacies in England, and some 54,000 pharmacists in England, Scotland and Wales. While a large number of these professionals work in community pharmacy, around 15-20% work in hospitals, and a small number also work in other areas such as primary care, industry or within GP practices. Hospital and community pharmacies do excellent work. As well as providing medications, they also offer clinical support to help people get the most out of their medications. However, pharmacists, particularly those working in the community, have been marginalised from the rest of the health and care services and information sharing has been lacking.
How is the role of pharmacy changing?
Over the past 20-30 years, pharmacists have taken on a greater range of clinical services. This includes medicines use reviews (MURs), to help patients understand and get the most from their medications and, more recently, the New Medicine Service, which educates patients on their latest medication to help them understand how it works and why it’s important to keep taking it. Pharmacists are also branching out to offer additional services such as help to quit smoking, disease screenings and flu jabs. This means that information sharing is more important than ever as pharmacists seek to gain more clinical data about the patients they’re helping to treat, and also record the interventions that they are making. Several systems are now in place to help hospital pharmacists communicate with community pharmacists concerning patients discharged from hospitals to ensure continuity of care. The summary care record has also been important for pharmacists, as it gives them access to the GP’s prescribing record out of hours. However, while there has been some work to improve communication, we have a lot more work to do and pharmacists require more detailed records to enable them to provide extensive clinical services.
What areas would benefit from improved information flows?
As the remit of pharmacy increases, we are faced with other challenges. For example, people who aren’t entitled to a flu vaccine on the NHS are able to have one in a pharmacy. But we are still looking for a standard solution for sending information on vaccines given back to the GP so that they have a record of their patients receiving the jab.
As well as poor information flows, there is variation in different areas in terms of how services are commissioned. I believe that better record formats and the widespread adoption of standardised information will put us in a better position to justify the provision of national service specifications. In addition, better records will lead to more consistency in care processes, which will enhance quality of care. A growing number of pharmacists are working in GP practices. Better records can also help to support information sharing between them and community pharmacies, which will be of benefit to the whole primary care sector.
In addition to communicating with GPs and hospitals, it is also important that we are able to share records with, and access records from, care homes, as many elderly patients have a set of complex needs and medications, which are regularly updated. At the moment, information flows are still limited and we would like to see this improve through the adoption of standardised records.
The PRSB is working hard to deliver standards for clinical records, which is essential for facilitating this information sharing. We have been keen to support the organisation from the outset and see its work as integral for the facilitation of good care across the whole health and social care sector.