Linking up to the NHSnet in London
| Many community pharmacists feel
left out of the National Health Service fold by being unable to
access the NHSnet. Debbie Andalo describes a pilot where that link
has now been forged |
Debbie Andalo is a freelance
writer
|
In south London, a primary care trust is putting government
proposals to link community pharmacies to the NHSnet to the test.
The scheme is being run by Lambeth Primary Care Trust as part of the
medicines management collaborative and comes as the debate continues
about funding for access to the NHSnet by pharmacists.
This has to be resolved if government plans for England to put pharmacists
at the centre of the expanding primary care team are to be
implemented.
Linking in Lambeth
Neil Selby, the medicines management facilitator from
the national collaborative working with Lambeth PCT, said funding is
not the fundamental question.
In his view, information technology is a tool. “If all the pharmacists
in the country were linked to the NHSnet, but didn’t have the
right competencies or the right professional relationships, then it
would create more problems than it solved.”
The Lambeth scheme is still in its infancy and details of how it will
work in practice are being ironed out.
The intention, however, is that community pharmacist Ramesh Bhadresha,
whose Medirex pharmacy is a one-minute walk away from the Mawbey Brough
health centre in north Lambeth, will be linked to two practices — one
single-handed and one with four partners. The link will give him access
to patient records and enable him to carry out medicines
reviews in the pharmacy. He will also have e-mail contact, which means
that daily queries with GPs and other
practice staff about prescriptions or other medicines can be dealt with
electronically. E-mail efficiency
Mr Bhadresha estimates that on average he has to go to
the surgery once or twice a day to sort out one kind of prescribing issue
or another.
He said: “Having e-mail will make it much more efficient in dealing
with the everyday problems we get such as wanting to substitute drugs
or queries about dosage.
“It’s sometimes difficult to sort out problems over the phone when
the patient is there. Often we are left to second guess what was going
on in the doctor’s mind — maybe he has prescribed an unusual
dose and we have to assess whether that was a mistake or was a deliberate
clinical decision. Having e-mail will help improve risk management and
is going to make it much easier.”
Undertaking medicines reviews in the pharmacy will also be more efficient
because he will be able to access patients’ records rather than
waiting for the GP to pass on the relevant information.
“It’s going to make it much easier to get information from the surgery.
It means I won’t have to take time out of the pharmacy to go and
see the GP and get the information instead,” he explains. Consent and access
Mr Selby admits that the PCT is still “working in the foothills” and
developing the details of the initiative. But it is expected that around
700 patients will be involved in the electronic link and their consent
will have to be sought before the scheme can start. The decision about
whether the pharmacist will have computer access to the entire patient
record has also not yet been taken.
Mr Selby said: “Whether they have access to the full record is
still a question for further discussion. It may be when we go through
this that it is felt that to get the best out of the medicines review
the pharmacist will need to access the whole record.”
Mr Bhadresha outlines the minimum information he feels he needs to carry
out a medicines review. “We will need things like the diagnosis
and a little bit of their history at least.”
Discussions are also continuing about whether the pharmacy will have
a separate dedicated computer for the NHSnet link, rather than having
the link set up on the existing pharmacy system. Paying the bill
The PCT has promised to fund the computer costs, which
include the bill for any new computer or terminal and its running costs.
It has also
agreed to pay for a screen so that Mr Bhadresha can create a confidential
area within the pharmacy to carry out consultations with patients as
part of the medicines reviews.
Although the Lambeth scheme is in its early days it is stimulating
to be at the forefront of the changes, said Mr Bhadresha. “I am very
excited. It’s a whole new way of doing things, it’s moving
everything up one level in terms of information. The key to its success
will depend on how we use the system in practice. But I think the advantages
are so obvious for the profession that I don’t think it can go
wrong for pharmacy.”
|
