The Summary Care Record&
Medicines Reconciliation
Andy CarrNHS CFH SCR Clinical Advisor
October 2012
• What is the SCR?
• National Rollout
• Experiences of using the SCR in Medicines
Reconciliation
• Questions
Summary Care Record (SCR)
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
• 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
SCR National Rollout
October 2012
KEY
PCT Commenced Public Information Programme
PCT Commenced Record Creation
Over 60% Records Created
All Practices Have Created SCRs
SCR Benefits – High Level
• Patient Safetyreducing 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 Careenabling the most appropriate care to be
delivered in the most appropriate setting
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
• Taunton & Somerset
• Medway
• Basildon & Thurrock
• Southend
• Mid Essex
• Kettering
• Norfolk & Norwich
• Northern Lincolnshire & Goole
• Warrington & Halton
The SCR & Medicines Reconciliation
• Sheffield
• South Yorkshire
• Mid Yorkshire
• Leeds
• South Tees
• North Tees & Hartlepool
• Darlington
• Durham
• Hull & East Yorkshire
The SCR & Medicines Reconciliation
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
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
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
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.”
South Tees MAU, Acute Stroke & Elderly Units
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 . . . !
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?
Useful LinksSCR 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
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