The Summary Care Record & Medicines Reconciliation

1. The Summary Care Record&Medicines Reconciliation Andy Carr NHS CFH SCR Clinical Advisor October 2012

2. Summary Care Record (SCR) • What is the SCR? • National Rollout • Experiences of using the SCR in Medicines Reconciliation • Questions

3. What is the SCR? The SCR is an electronic summary of key health information. It will hold limited essential information (medication, adverse reactions and allergies) derived from the patient’s GP record Additional information (e.g. care plans) may be included at the request of (or with the explicit consent of) the patient

5. 19 million people have an SCR Records created by 2700 GP practices in 109 PCTs 39.7 million patients contacted in 139 PCTs Opt out rate 1.3% National Rollout of the SCR

6. SCRNational RolloutOctober 2012

7. SCR Benefits – High Level Patient Safety reducing the risk of prescribing errors & adverse reactions to prescribed medication Increased efficiency and effectiveness reducing time, effort & resource required to share information across different NHS organisations Increased Quality of Patient Care enabling the most appropriate care to be delivered in the most appropriate setting

8. Hospital Pharmacists NICE patient safety guidance: ‘The aim of medicines reconciliation on hospital admission is to ensure that medicines prescribed on admission correspond to those that the patient was taking before admission.’ SCRs can play a key role in medicines management for patients SCRs have the potential to free up time for both hospital pharmacists & GP surgeries

9. The SCR & Medicines Reconciliation • Taunton & Somerset • Medway • Basildon & Thurrock • Southend • Mid Essex • Kettering • Norfolk & Norwich • Northern Lincolnshire & Goole • Warrington & Halton

10. The SCR & Medicines Reconciliation • Sheffield • South Yorkshire • Mid Yorkshire • Leeds • South Tees • North Tees & Hartlepool • Darlington • Durham • Hull & East Yorkshire

11. Medway Maritime SCR Pilot: • 69% of patients were admitted without medication information • 18% reduction in time taken to reconcile medications • Approx 1 error per patient found e.g. an inconsistency discovered between hand written notes & the SCR when reconciling medications • Supports clear communications • Between GP & hospital • Between pharmacy staff & ward doctors • Reducing the risk of transcribing or communication errors • Reduces delays e.g. lunchtime, weekends when surgeries are closed • Expedites discharge process when prescriptions information known

12. Taunton & Somerset SCR Pilot: • Musgrove Park Hospital 400 reconciliations/week • 80 calls to GPs • 10 minutes per call ~ 700 hours p.a. • For 40 SCR Views • 5 minutes per view • Saves 173 hours p.a. • SCR Surgeries may also reduce time spent faxing

13. Sheffield SCR Pilot: • Patients admitted to the MAUs • The introduction of the SCR reduced average time for medicines reconciliation from 2 hrs 9 mins to 19 mins • Pharmacist is able to complete medicines reconciliation for the patient without having to break off & wait for the information to become available from the GP. This allows a more systematic approach with fewer interruptions & reduced errors • The pilot has shown the SCR to be an effective & valuable source of information for reconciling medications. Recommendation that this is rolled out team by team across the pharmacists and MMTs within Sheffield Teaching Hospitals NHS Trust

14. Leeds SCR Use: • Pharmacists now spend less time waiting to get hold of a GP practice, or for a fax to arrive to confirm the patient’s medicines when an SCR is available • In the 4 months since the new way of working started, time taken to complete medicines reconciliation has reduced by 55% - now only taking 19 minutes • The team are now meeting the 24 hour target for completing medicines reconciliation 87% of the time (previously this was 57%) • “Pharmacists love the SCR because it makes their life a lot easier. This translates into a better service for patients, more accurate patient notes and as a result improved patient safety.”

15. South Tees MAU, Acute Stroke & Elderly Units

16. Enabling Viewing of the SCR isn’t hard • SmartCards for authorised staff • SmartCard readers on computers • Secure N3 connection (which all hospitals have) • Some training - mainly the IG aspects • Patients need to be asked for Permission to View their SCR (if unable to give permission because not mentally competent, confused or unconscious – staff should use ‘Emergency Access’ in the patient’s best interest) • The Trust needs to identify a ‘Privacy Officer’ who can audit emergency access & any self-claimed access to ensure that there is no malicious or inappropriate viewing •  And that’s it . . . !

17. My questions to you • Are you using the SCR? • Are you fully realising the benefits? • Have you signed up for our newsletter? • Do you follow us on Twitter? • Do you want to get involved – locally or nationally? • Do you have any questions for me?

18. Useful Links SCR Website: www.connectingforhealth.nhs.uk/systemsandservices/scr SCR Deployment Map: www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/impguidpm/deploy Clinical use of the SCR: www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/clinusejul.pdf Subscribe to our Newsletter: www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/bulletin/maillist Follow us on Twitter: www.twitter.com/NHSSCR