What Community Pharmacy Access to Shared Medical and Social Records Could Mean for Patient Care

When the Dorset Care Record (DCR) launched in March 2018, it brought the many potential benefits of having patient information in one place and available to a wide range of health and social care professionals.

It is described as an electronic repository that provides a consolidated view of information from Dorset County’s health and social care systems, and currently includes information from hospitals and GPs.

Compared to a typical Summary Care Record (SCR), the DCR contains much more detail about hospitals, such as hospital “encounter” history, tests performed – from radiology to pathology – alerts, allergies, medications out, letters to GPs and referrals. Not all hospitals currently provide this information in full, but work is underway to increase the scope and consistency of information from hospitals.

In April 2020, Andrew Prowse, Chief Pharmacist at Dorset County Hospital, asked me to support the Dorset Integrated Care System team working on DCR ahead of a wider roll out to Dorset pharmacies later in 2020.

With the team, we worked on the practicalities of providing secure access to the system from my community pharmacy (Victoria Park Pharmacy in Dorchester) and how to establish read-only access for one or more users individual from there.

And after the preliminary training, which covered patient consent and confidentiality in the same vein as other pharmacy requirements, I got access to the DCR.

Although the pandemic has dampened the demand for clinical information, it is now picking up and my first impression of the DCR is very positive. For patients who have been discharged from hospital or for those who require regular hospital interventions, there is a wealth of information that provides a chronological overview of events and the ability to drill down into detailed findings. Medication history and related comments are also easy to find and track.

For most patients, only a small portion of the information available will be directly relevant to community pharmacy. But seeing the big picture, and if necessary taking a few minutes to take in the big picture, can enhance even a simple intervention, making it a little more personal, supportive and safer.

Access to this type of information will be essential for future national and local clinical services within the contractual framework of community pharmacy and for working in a primary care network.

Looking ahead, there is a lot of potential as DCR continues to grow. Work is underway to bring in additional information from hospitals, community health teams and Dorset council social services. Community mental health information is also expected to be integrated in 2020. Eventually, local health authorities expect information from wider sources – such as private hospitals, specialist clinics, maternity wards and even community pharmacies – to appear. in the DCR. For me, pharmaceutical interventions through NHS 111 and referrals from GPs would add significant value to the system.

As part of the wider Wessex Care Record – one of five government-funded local health and care records – the DCR is now part of the ‘One Medication Record’ project. This will give pharmacies access to a single patient medication registry, which is consolidated with the prescribing systems used across the health service. This should make it easier for pharmacists to spot and confirm medication changes, track repeat medications, and conduct clinical assessments.

The Wessex Care Record includes the Hampshire and Isle of Wight Health Record (Exchange of information on care and health), and is therefore an important tool for pharmacies and GP practices in East Dorset who can serve patients residing in Hampshire as well as Dorset.

These types of shared care systems are being developed across England, from Bristol, North Somerset and South Gloucestershire Connecting care project and north central London Digital file integrated into careto the Leeds Care Record and Kent and Medway Transforming health and social care.

From August 2020, community pharmacies in Dorset have access to DCR with training webinars and technical support. Given what is already available and what lies ahead of the system, I would wholeheartedly recommend that pharmacists and pharmacy teams invest the time necessary to access these systems and begin using them wherever possible.

Robin Mitchell, Owner, Victoria Park Pharmacy, Dorchester

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