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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