Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
Dr Andrew Buist, chair of the British Medical Association’s Scottish GPs committee, said there was a “desperate need” for a more joined-up approach.
“Every day, I have a pile of up to 150 pieces of paper that I have to sign my name to,” he said.
“There is massive waste in that, it’s not a good use of the patient’s time and it’s not a good use of my time…I don’t think it’s a particularly safe system.”
Dr Buist was speaking at a healthandcare.scot online seminar, which can be viewed online.
He was joined by Scottish Parliament health committee convener Lewis Macdonald, Scottish Conservative health spokesperson Donald Cameron and Matt Barclay of Community Pharmacy Scotland.
They agreed that establishing a promised single digital platform for health professionals working in hospitals and the community that could facilitate sharing prescribing information would benefit people working in the health service but also patients.
After concluding there was no centralised recording of patients’ outcomes, the committee’s report had called for a ‘complete overhaul’ of the medicines system in the Scottish health service.
But the Scottish government’s response, which accused the MSPs of undermining trust in the NHS, was described as “quite thin” by committee member Donald Cameron MSP.
“We need a system that talks to each other, we need the electronic transmission of prescriptions,” said Dr Buist, who joined the meeting from his GP surgery in Blairgowrie.
“We need an electronic system that produces data and data can then be fed back to the prescribers, it can be linked to the actual prescribers, so you get data on what you are doing and that can be linked to patient outcomes.”
If companies like Amazon routinely ask customers about their product experiences by phone or email, Dr Buist asked, why can’t the NHS?
“If after they got their prescription they got a little message on their smartphone saying ‘did you get better, did you have any side effects, is there any feedback? Then you are going to gather that information,” he said.
“If it’s filling out a form and posting it to a PO Box, then it’s not going to happen. We need to make it easier – and the way to do that is through better IT.”
Representing Community Pharmacy Scotland (CPS), which speaks on behalf of every one of the nearly 1,300 high street pharmacies across the country, Matt Barclay agreed.
He said: “We need to move with the patient, we need to adapt our technologies and ways of delivering for patients, but absolutely with them in mind in terms of supporting them with their medication and getting the outcomes.”
Donald Cameron MSP, who returned to the role of Scottish Conservative health spokesperson last month, said there appeared to be “very little movement” in this area since he first served in the position in 2016 and 2017.
“I do feel that this has just got stuck, and it’s got stuck for a long time,” Mr Cameron said.
“Given how much is being done online and virtually, if there’s one outcome from covid that we can really drive, it just be to change IT and ensure we have a system that speaks across all various parts of the NHS, whether that’s pharmacy, whether that’s primary care, whether that’s secondary care.
“It seems like an ideal moment to change that. Let’s use this moment to really alter the delivery of medicines to people and put patients at the heart of that.”
One quick hit panellists agreed on was speeding up hospital discharges by sending a patient’s prescription to their community pharmacy, rather than waiting for the medicines to arrive from the hospital pharmacy.
Currently, patients can wait for hours while a prescription is being made up.
Lewis Macdonald MSP suggested simple changes like this could be made to happen through high-profile leadership.
The question of having 14 regional health boards for a country of 5.5m also featured.
Matt Barclay of CPS said health boards were doing “different things at times, or different variations on a theme at times,” leading to queries from pharmacists in different board areas even now after they were given access patient emergency care summaries for the first time early in the covid pandemic.
He added: “I’m not suggesting that we need to rationalise the boards, although I wouldn’t be against potentially doing that in some way shape or form, a national approach, we talk about once for Scotland, for me it has to be.”
The committee’s report referred to what it saw as the much more effective integration of health and social care for the population of Greater Manchester, home to 2.8m people.
Committee convener Lewis Macdonald added: “It is for government to drive this, government is responsible for the overall network of NHS Scotland.
“Just as it’s possible for everybody in Greater Manchester to be joined up if there’s a central drive in that metropolitan area, so in Scotland it should be possible too.
“We have one NHS, albeit delivered through several boards… this should not be beyond the wit of man, but so far it’s proved unachievable and there’s really no good reason for that, it perhaps is simply a case of giving it the priority it deserves.”
Clinicians in Scotland still have too little information on the effectiveness of the medicines they prescribe and dispense – and have to use data management systems that are still not fit for purpose, according to one of the leading voices for general practitioners.
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.