Shared Care Records (ShCR)

ShCRs (formerly sometimes referred to as ‘local health and care records’) contain more detail than SCR with additional information, for example vaccinations, clinic letters and test results. Record programmes aim to include data from acute and community hospitals, specialist clinics, community teams and social care, giving pharmacy teams a fuller view of medicines and care plans. This reduces the need for patients to repeat their stories and helps protect them from risks caused by missing medicines information.

Community Pharmacy England and the Community Pharmacy IT Group collated sector feedback showing why timely ShCR access is critical for pharmacy teams.

Why ShCR access is critical for pharmacy

Case study information:

• Records case study: Community pharmacies accessing the Dorset Care Record ShCR system

See: List of Electronic health records: local and national initiatives.

This section may be of interest to ShCR teams, LPCs and those supporting ShCR expansion.

Engagement and next steps

Community Pharmacy England encourages organisations running local record‑sharing initiatives to contact local pharmacy owners and LPCs to discuss how community pharmacy can participate. See our briefing: principles for implementing pharmacy access to local records.

Pharmacy owners or LPC representatives attending records‑related events may wish to read the briefing above in advance.

LPC chief officers and members, and pharmacy owners supporting pharmacy access to records, may request to join the Community Pharmacy Digital records sub‑group. Email the Community Pharmacy England IT team with ‘Records group’ in the subject line.

Technical challenges

If record portals are hosted on the ‘nww’ network (and community pharmacies do not have blanket access), the supplier’s aggregator may need to mark the relevant nww addresses onto the ‘allow list’. See: HSCN aggregators. If your IT system supplier manages your HSCN connection, ask them to contact the aggregator to allow the nww addresses. Your IT system supplier may also need to add web addresses to the ‘allowed list’. For a template form, contact da@cpe.org.uk. ShCR managers should provide a complete, stable list of nww addresses for aggregators to use.

Upcoming events

No other upcoming events have been reported to Community Pharmacy England recently.

Please contact the da@cpe.org.uk if there is an open records event for volunteers that should be listed or considered by LPCs and the community pharmacy sector.

How LPCs might opt to inform Community Pharmacy England of ShCR initiatives

• Step one: identify your local ShCR project team using the list of records systems.
• Step two: confirm the ShCR details internally within the LPC and add them to the CP ITG/LPC ShCR spreadsheet (shared with LPCs by Community Pharmacy England).
• Step three: review case studies such as Dorset Care Record pharmacy access, East London Patient Record (eLPR) pharmacy case study, and Somerset Shared Care Record (SIDeR).
• Step four: review the ShCR request letter (Community Pharmacy England/RPS letter to NHS organisations about records access).
• Step five: contact the ShCR project team and local partners to discuss involvement and the right contacts (a template letter is available from da@cpe.org.uk).
• Step six: use the ‘planning pharmacy access’ briefing and this webpage to inform engagement.
• Step seven: request technical details for the ‘allowed list’ (ShCR web addresses; IP address; and port number) from the local ShCR technical lead, then share with da@cpe.org.uk, suppliers and aggregators.
• Step eight: attend local or national ShCR events and opportunities.

If you have questions, please contact da@cpe.org.uk.

PRSB has published guidance on using the core information standard in community settings, including pharmacy, to complement local ShCR development.

Frequently asked questions on PRSB’s ShCR work are available via PRSB’s joined-up care and ShCRs FAQ webpage.

IG framework for ShCRs
NHS IT teams, with a ShCR IG steering group, developed a ShCR IG framework. It helps ICBs, ShCR teams, LPCs and others demonstrate compliance with the law, build public trust and provide consistency. Community Pharmacy England has pressed for the framework to align with the principle that clinicians can access necessary information at the right time.

If an LPC is told in writing that IG issues are delaying pharmacy access, please share examples with Community Pharmacy England’s IT lead. We can raise these with NHS IT and data policy teams.

Data sharing agreements
The ShCR framework advises that data sharing agreements can support organisations that populate or use local ShCR systems. Signatories might include the ShCR project team, the ICB and health and care organisations. An LPC may consider approving an agreement on behalf of pharmacy owners in its area; however, use of ShCR would remain voluntary for each pharmacy and some programmes may require individual signatures.

The Information Commissioner’s Office advises that data sharing agreements should use clear, concise language that is easy to understand. Feedback indicates this is not yet always the case in every ShCR area. The framework references an NHS template data sharing agreement that can be adapted for ShCR.

Top tips for LPCs drafting agreements

• Use clear, concise language.
• Avoid repeating existing legal duties.
• User‑test the document with health and care staff.
• Keep it short and accessible. Pharmacy teams are extremely busy.
• Recognise that documents may need to suit sectors that do not yet use the Data Security and Protection Toolkit.

Beginning to access local records
Community Pharmacy England recommends that:

• pharmacy owners in areas with ShCR access take up access promptly; and
• pharmacy owners and LPCs continue to support pharmacy access.

Community Pharmacy England and the Royal Pharmaceutical Society wrote to NHS England to request that all pharmacists can access ShCR systems wherever they exist and whichever clinical system is used. Read the letter in full here.

Liability
General Pharmaceutical Council (GPhC)
Access to medical records can enable improved outcomes and better collaboration. Pharmacy professionals must keep patient care as their first concern and apply standards on confidentiality, consent and obtaining all information required to assess needs and provide appropriate care.

Pharmacy owners must meet the GPhC’s Standards for Registered Pharmacies. Under principle one (governance), standard 1.7 requires information to be managed to protect privacy, dignity and confidentiality. Inspectors may look at how record access is used as one evidence source when assessing performance.

National Pharmacy Association (NPA)
NPA indemnity insurance will cover members’ access to ShCRs and SCR (and associated liabilities under PI/PL policies) where the pharmacist or pharmacy technician considers it necessary, and for any permitted amendments when those functions are enabled in future, provided this is in line with published guidance and the pharmacy’s SOPs on consent and record access.

Local records and SCR access
If ShCR is available locally, pharmacy teams may choose to use ShCR instead of SCR for relevant scenarios because ShCRs usually contain more detail. However, SCR remains a vital contingency if the local records portal is unavailable. Ability to access SCR also forms part of the pharmacy terms of service.

ShCRs usually provide more information than SCR. Pharmacy teams report many scenarios where viewing ShCRs is a safe, efficient alternative to accessing SCR or contacting the GP practice.

The Royal Pharmaceutical Society has published a one‑page factsheet that explains when to use health records. Deciding when to use a record is a professional judgment.

Common scenarios

Checking medication details

• Prescription unclear.
• Patient unsure about medicines.
• Emergency supplies.
• New patient to the pharmacy.
• Checking possible dispensing or prescribing error.
• Checking interactions with prescribed medicines, over‑the‑counter medicines, herbal products and supplements.

Checking information about the patient

• Drug allergies.
• Previous adverse drug reactions.
• Additional information such as care plans, blood test results, immunisations and intolerances.

Other

• Check eligibility for other pharmacy services (e.g. NHS flu jab).
• Supporting self‑care.
• Access to clinical information out of hours.

Safe and efficient alternative to contacting a GP practice for clinical information.

In the future, pharmacy IT system suppliers — as well as other clinical IT system suppliers — will be able to show information directly from Shared Care Records (ShCRs). At first, many local ShCR programmes will still rely on online portals for some health care settings, including community pharmacy. But over time, the clear direction of travel is full integration within clinical systems.

The Professional Record Standards Body (PRSB) has confirmed that the Core Information Standard is suitable for use in community settings, including pharmacies. Their work shows that the standard supports and complements the growing use of local Integrated Care System (ICS) shared care records.

Community Pharmacy England has fed back to relevant stakeholders several ShCR principles:

1. GP Connect record standards should align with the standards used by Shared Care Record systems.
2. PRSB should be commissioned to extend the Core Information Standard to include a clear community pharmacy subset, helping GP Connect and ShCRs to sit under one shared standards framework.
3. PRSB, working with partners including the NHS Transformation Directorate interoperability team and NHS Digital, should support the coding of ShCR standards so that system suppliers can integrate more easily.
4. Shared Care Record systems should follow aligned IT standards and be required to use PRSB-coded standards.
5. Shared Care Record systems should follow consistent processes. Health and care staff should use the same information governance (IG) processes, training and sign‑up routes wherever they work.

Integration standards
CP ITG has stressed the importance of a single standard approach for supplier integration with ShCRs. This would allow an IT system supplier that integrates with one ShCR to integrate with others more easily, rather than adapting for many separate local models. This feedback has been shared with NHS IT teams to inform future standards work.

Q. What clinical information is included in a patient’s Shared Care Record, and why would I use it?

ShCRs usually contain more detailed information than the Summary Care Record (SCR) with Additional Information. They may include medicines, allergies, adverse reactions, reasons for medications, immunisation history, significant diagnoses and procedures, end of life preferences, and other anticipatory care information.

PRSB has developed a structured template for this information, and future systems may increasingly support more structured fields rather than free‑type notes.

Q. Does accessing a patient’s ShCR replace the need to access their SCR?

If ShCR access is available in your area, you may choose to use it instead of SCR in many situations.

Pharmacy owners must ensure that relevant staff can access SCR consistently and reliably, as required since 9th November 2020. This requirement remains because:
• SCR is an important contingency if a ShCR system is unavailable;
• many pharmacies still do not have ShCR access; and
• some teams may still prefer SCR depending on their systems and workflows.

Pharmacy owners have also said they would like clinical systems in the future to integrate with SCR and ShCRs so separate portal access is not needed.

Q. My service specification or SOP says I must check SCR, but I have access to ShCR and it includes the same or more information. Can I use ShCR instead?

Yes. Many specifications still reference SCR because ShCRs are new and not available everywhere. As ShCR access expands, specifications are expected to update to allow use of the relevant record — SCR or ShCR.

Q. Am I required to use ShCR if it is available locally? Do I need to use it for the Discharge Medicines Service (DMS)?

No. There is no regulatory requirement to access ShCRs.
ShCR access varies, and information is not yet integrated into clinical systems.
Although ShCR access is helpful, NHS England requires trusts to send DMS referral information directly to the pharmacy team. Simply directing a pharmacy to check a portal does not meet the required dataset for DMS.

Local Pharmaceutical Committees may explain locally that ShCR access is not a DMS requirement.

Pharmacy owners should decide whether and when to access ShCR systems, and usage is likely to expand as Integrated Care Boards (ICBs) adopt more standardised approaches.
Some organisations still do not have the technical capability to access ShCRs due to varied local arrangements. NHS England’s Transformation Directorate is expected to support progress toward a more consistent national model.

Q. Are there standard information governance and data security arrangements for using ShCRs?

Yes. The NHS Transformation Directorate has created a ShCR IG Framework to support safe, appropriate operational and technical arrangements while ensuring staff can access the information they need for patient care.

Q. Will IT system suppliers be able to read and write ShCR information?

Initially, ShCR access in many settings will be through online portals. Over time, pharmacy IT system suppliers and other clinical system suppliers are expected to integrate ShCR information directly into their systems, including the ability to record auditable data.
Suppliers have asked NHS Transformation Directorate and NHS Digital to explore a standard integration model so system suppliers can connect to multiple ShCR projects more easily.