SCR and patient consent
SCR and patient consent
Permission to view
Each patient must provide for you their “permission to view” (PTV) before you access their SCR. The key information to pass on when obtaining this is:
- What is SCR? It is your responsibility to explain what is in an SCR. Patient leaflets and resources are available to provide more information.
- Why will the pharmacy access their record?
- Who will access it? e. registered professionals; pharmacist or pharmacy technician.
- How often will the pharmacy access? If you have a regular patient for whom you think you will need to access their SCR frequently, you could ask them once for permission to view their SCR while they are in your care. Consent needs to be gained for each patient, at each pharmacy, on a need-by-need basis. If you decide to do this it is recommended that you put a note referring to the discussion and what was agreed in that patient’s PMR. You should also regularly review the decision with them.
- PTV can be withdrawn by the patient: The patient should also be informed that they can change their decision at any time
It is not essential to have written permission. This is a local, organisational decision (there is a sample form for recording this further below). It is also acceptable to get permission to view a patient’s SCR over the phone.
Opting out of having an SCR
All patients in England have been communicated to with regards to having an SCR; they have the ability to opt-in or opt-out at any time. If a patient wishes to opt-out of having an SCR altogether (as opposed to just not letting you view it) then they should be advised to contact their GP practice who will record this preference.
Accessing SCR without a patient’s consent (emergency access)
The ‘Emergency Access’ option can be used if a patient or the person acting on their behalf is not able to give their consent, but you believe there is still a clinical requirement to view their SCR.
In this instance you should use professional judgement and if you decide that accessing the SCR is necessary and in the patient’s best interests (i.e. there is a possibility that without accessing the patient’s SCR the quality or safety of the decision would be compromised), then you should use ‘emergency access.’
As with any professional decision you need to be confident that you can justify to any future investigation that the decision was made in the patient’s best interests. Whenever the “Emergency Access” option is selected it is strongly recommended that you enter the reason why you are accessing the record without the patient’s permission. This will assist the Privacy Officer’s work investigating the legitimacy of emergency accesses.
Examples of when this option could be seen as appropriate in community pharmacy are:
- a patient with language difficulties; or
- elderly patients with dementia.
See also, the GPhC guidance on consent which mentions: “If the patient is not able to make decisions for themselves, you must work with people close to them and with other members of the healthcare team.”
SCRs for children
Children can have an SCR, and in instances where the child understands what is being asked of them,
permission to access SCR is their decision. If the child does not understand then it is the parent or guardian’s choice. This is at the Pharmacy professional’s discretion. Refer to GPhC guidance on consent.
Patient consent form templates
Consent can be obtained verbally, however there is a template:
Frequently asked questions
Q. My pharmacy serves a large care home. How can the patients provide their consent to SCR access or could this be done by care home staff?
A. Community Pharmacy provides services to patients in care homes, mostly without communication with the patient; with the care home requesting services for patients ‘by proxy’. The RPS advise that the process for obtaining consent to be used is for:
- The care home informs patients/their carers upon arrival that their preferred pharmacy may access SCR. This could be added to admission forms. The patient/carer must inform the care home if they do not give their permission for the SCR to be accessed.
- Patient information, leaflets and posters should be made available at the care home – examples can be found on the patient materials (SCR) page.This is required to meet Data Protection Act rules on fair processing.
- The pharmacy and care home have an understanding where any patient/carer refuses permission, they will inform the pharmacy NOT to access SCR. Otherwise, the pharmacy can access SCR based on the above.
- If the patient has not completed the arrival process, then care home can give permission by proxy, as appropriate.
Q. What if I believe that accessing the SCR for a Care Home patient is needed, but I cannot obtain consent?
A. There is a consent model as explained above. In emergency situations where this model is not applicable, pharmacy may consider emergency access (described earlier).
Q. How long should I keep an SCR consent form that has been signed by the patient?
A. Pharmacies must have processes for obtaining explicit consent from the patient or their representative before accessing a patient’s SCR. This may involve SOPs. Written consent is not required but it can be obtained. It is for a contractor to judge how long forms should be kept for, balancing the need for an audit trail against the fifth Data Protection principle of not keeping information longer than necessary.
Q. If I am obtaining SCR consent in writing, can I ‘bundle’ together the request for SCR consent, with the consent being requested for another activity?
A. Obtaining informed consent is required and therefore we do not recommend that SCR consent be ‘bundled’ with another written request for consent, if this could risk the patient not noticing that they may have ‘granted’ consent for SCR accesses. One way to avoid unintentional ‘bundling’ of a request for SCR consent, is for a separate ‘tick’ (or an equivalent) on a written form or equivalent. Obtaining informed consent is necessary.
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