Smart Cards or Smart People?

The news that an estimated 200 000 patients are at risk because of inaccurate data in their Care Records has led to GP leaders calling for an immediate halt to the Governments Summary Care Record programme. What's worse, the majority of these care records have been created and uploaded without patients consent.

It appears that the gaps and innacuracies, such as wrong medication or allergies result largely from operators not having the required smart cards to gain access to the system.

Some PCT areas and some LPCs are promoting the requirement of smart cards for pharmacists as mandatory, others are not remotely interested, creating wide differences in day to day working practices accross the country. Add to this the shambolic approach to facilitating the issue of smart cards by different PCTs, it might just be that as the new government decides to save billions of pounds and scrap failing IT projects, this dislocated approach to smart card issue and use accross professions mirrors that of PCTs, may result in the whole project falling flat on ITs feet.

This is not because it doesn't work - it clearly does when set up properly and people get involved. It's that bad old bueracracy again. If only organisations like the NHS stopped running themselves to suit the organisations priorities and focussed on patients priorities, huge and expensive messes like the Summary Care Records fiasco might be avoided and nmore importantly, patients might feel the NHS is there for their benefit.

For years when we have been working with PCTs, Nightingale Pharmacy Services have always striven to get PCTs to understand that pharmacists work accross several PCT boundaries and they need to recognise that patients do too. Trying to get some of the PCT staff to understand that pharmacists can't deliver the patient care they want if the PCT doesn't understand that we work in this way and do nothing to support us and enable us to provide the services we want to.

At least with pharmacy we know where we stand - if we give poor service, the patient can always vote with their feet and go somewhere else. So people are smart and can react accordingly. Cards are not smart.

Swine Flu -where's the locum contingency?

We've worked hard as far as we have been able over the last two or three years to persuade many groups (Companies, PCT's, LPC's, locums, pharmacies) to have contingency plans in place should their pharmacy be affected by any pandemic, not just this current Swine Flu outbreak. Few people appear to have thought us relevant and so have either ignored us or, as we suspect, might not have given the remotest thought to community pharmacy.

If your manager, pharmacist or locum gets hit wirh Swine Flu, what do you plan to do? Call or -email us and assume we can fulfil demand? Have you considered the possible cost? We have enough of a fight getting the summer holidays covered for some pharmacies at a cost which they feel to be reasonable, what will happen to costs in a pandemic?

We might have to persuade people to work in your area from another part of the country. Such people will need accomodation in most cases. They might not want to come to work in an area where Swine Flu has taken hold in any case, irrespective of what they might want to charge.

If you're a locum, are you aware that you have a contractual liability to provide a replacement if you are unable to fulfil a locum booking? Swine Flu is no exemption from this obligation, but in real terms, could you obtain a replacement?

As usual, down at the coal face, too little thought has been given to keeping the pharmacy network going if and when things do go wrong. Some long days and nights look to be in store for those left holding the baby and thos of us who will do our best to help.