Summary Care Record (SCR)

The National Care Records Service (NCRS) is the interface, accessed through the Spine portal link directory, that provides national patient information for health and care staff. NCRS replaces the SCRa portal.

NCRS allows teams to view SCR information and also:

• personal demographics service data;
  • national record locator information;
  • locally held care plans (where available); and
  • Reasonable adjustments flag (RAF).

IT system suppliers can consume NCRS information so that it appears directly in their systems. Some NCRS items, such as the RAF, can be updated by authorised health professionals.

NCRS can be accessed on mobile or desktop devices using WiFi, mobile data or an existing Health and Social Care Network connection. Staff can log in using biometric authentication or NHS Smartcards. NCRS is being piloted in a range of settings, including within Weldrick’s pharmacies, with wider roll‑out expected.

Try NCRS:
Pharmacy teams are encouraged to try NCRS at:
https://portal.spineservices.nhs.uk/nationalcarerecordsservice/
Log in using your Smartcard on your IT system supplier device. Dummy NHS numbers for practice and training are: 999 040 2132, 999 025 2955 and 999 024 0272.

Professionals who have used NCRS can complete the short CP ITG feedback survey or email it to it@cpe.org.uk.

Read more: NCRS

Guidance on using SCR across multiple sites is available at: cpe.org.uk/scmultisite.

Community Pharmacy England worked with the NHS SCR team to support flexibility in Smartcard use while maintaining system security. Measures included:

• confirmation that the National Locum Pharmacy Agency code and FFFFF position could be used more widely, with RAs keeping logs to ensure access could later be withdrawn if required;
• automatic addition of SCR access for pharmacy staff using pharmacist and 5F codes for at an interim period, meaning staff moving across sites could continue to view SCRs;
• some flexibility for RAs to also support this type of flexibility within their areas

Guidance on updating Smartcards and applying the SCR code remains available: Updating Smartcard roles.

ICBs are responsible for issuing Smartcards and commissioning local Registration Authorities (RAs) to manage this. Pharmacy owners should report concerns about RA arrangements to their LPC. LPCs may escalate issues using this process.

The NHS Smartcard team provides policy and guidance for RAs.

Overview

More than 96% of people in England have an SCR; fewer than 4% have opted out. A standard SCR shows essential information, while an SCR with Additional Information includes richer detail to support more personalised care.

Since April 2020, NHS arrangements allowed authorised staff to view Additional Information without patients needing to request activation. This change supported care during the emergency and is subject to review.

Comparing standard SCR and SCR with Additional Information

See Community Pharmacy England’s factsheet on Comparing standard SCR to SCR with Additional Information.

Local campaigns

Some areas run campaigns to support wider use of SCR with Additional Information. Pharmacy teams and LPCs are encouraged to participate in local or national awareness efforts.

Patient resources

NHS SCR team materials include:

• consent form for SCR with Additional Information;
  • consent form for new GP patients;
  • printable poster for GP practices;
  • SCR with Additional Information leaflet;
  • easy‑read leaflet.

Survey findings

The NHS SCR team found that seventy‑one per cent of clinicians using SCR with Additional Information said it helped them make better use of consultation time because:

• less time was spent locating information;
  • fewer calls were needed to GP practices or other services;
  • information supported quicker decision‑making;
  • fewer onward referrals were required.

Patients reported they enabled sharing so that professionals would understand “why I take a particular medicine”.

Pharmacy use of SCR and SCR with Additional Information

Pharmacy teams are encouraged to use SCR and SCR with Additional Information (when available) to support safer, more informed care, such as delivering services or providing emergency supplies. Increasingly, patients can view parts of their health information in the NHS App, depending on their GP practice settings.

A screenshot example of SCR with Additional Information is shown below.

See also:

• SCR additional information (NHS England)
• Patient leaflet regarding additional information

Core information in the SCR

The Summary Care Record (SCR) automatically includes core information from a person’s GP record. This covers:

• all known allergies and adverse reactions recorded in the GP system; and
• all medications that fall into the following categories:
• acute medicines (held for six or 12 months depending on the GP system);
• current repeat medicines (with the last issue date recorded by the GP system); and
• discontinued repeat medicines (kept for six months where the GP system captures this).

Additional information in the SCR

A person may ask their GP practice to add useful extra details to their SCR. If the GP has entered this into the correct record fields, the SCR will also show:

• the reason for each medicine;
• immunisations;
• significant diagnoses or ongoing problems;
• significant procedures;
• end-of-life care information and preferences;
• other anticipatory care preferences recorded by the GP; and
• any other agreed important information that the patient and GP feel should be included.

Some information is only added if the person specifically requests it. This includes:

• fertility treatment;
• sexually transmitted infections and treatments;
• termination of pregnancy; and
• gender reassignment.

SCR access checklist

The steps for pharmacy owners, pharmacists and pharmacy technicians to gain and use SCR access are set out in the SCR checklist. This also applies to newly opened pharmacies.

CPPE online training

All pharmacists and pharmacy technicians who will use SCR must complete the Centre for Pharmacy Postgraduate Education e‑learning and assessment before accessing SCR.

CPPE has an SCR programme for pharmacists, pharmacy technicians and pre‑registration trainees. Although it can be completed any time, the best time is shortly before your pharmacy goes live so SCR can be used immediately afterwards.

Once you pass the e‑assessment, select the tick box under ‘Summary Care Records assessment registration process’ in the “My CPPE” profile. This enables the Registration Authority to confirm completion and allow SCR access on your Smartcard.

SCR Governance Person training

(Previously known as the Privacy Officer role.)
See the “SCR Governance Person” section of this webpage for details.

Using the NHS England portal

To access SCR:

1. Launch the NHS Spine portal (Smartcard required): Select your login method
2. Select ‘Launch SCR’.
3. Search for the patient.

To practise, use NHS test patient numbers such as:
999 040 2132; 999 025 2947; 999 025 2955; 999 024 3271; or 999 024 0272.
Practising helps pharmacy teams become confident before using SCR for real patients.

Where known, pharmacy teams often use the NHS number (taken from their EPS module or IT system supplier system) and paste it into the SCR application.

When to use SCR

Pharmacy teams report that SCR can sometimes be used instead of phoning the GP practice.

SCR may also be helpful for pharmacy owners who do not have access to more detailed local record systems (e.g. Local Health and Care Records). Some IT system suppliers also integrate SCR medicines information so it displays in the pharmacy clinical system.

The Royal Pharmaceutical Society provides a one‑page factsheet on when to use SCR or another electronic record. The choice is a professional one.

Examples of when SCR is useful

Checking medication details

• unclear prescriptions
• patients unsure about their medicines
• emergency supplies
• new patients
• investigating possible prescribing or dispensing errors
• checking interactions with prescribed or over‑the‑counter medicines, herbal products or supplements

Checking patient information

• allergies
• previous adverse reactions
• additional information such as care plans, immunisation history or test results

Other reasons

• confirming eligibility for pharmacy services (e.g. NHS flu vaccination)
• supporting self‑care
• accessing clinical information out of hours
• avoiding delays when GP practices are busy

FAQs: using SCR

1. Will SCR let me check whether a prescription is eRD?
   A. No. The EPS Tracker provides this information, but SCR does not. Many pharmacy teams use Tracker and SCR together.
2. Will locums using SCR have their access counted against our pharmacy?
   A. Yes. If their Smartcard has only the FFFFF multi‑site code and SCR rights linked to that code, they will be asked to select the pharmacy they are working in. The access will count for that site.
3. Can pre‑registration pharmacists and pharmacy technicians use SCR?
   A. No. Only pharmacists and pharmacy technicians can access SCR. Pre‑registration trainees may complete the CPPE training in preparation, ideally shortly before qualifying.

System supplier integration

Pharmacists and pharmacy technicians can use the NCRS/SCR 1‑click feature in systems which have done the integration development work. This allows a Smartcard‑logged‑in user to go straight to the selected patient’s SCR without logging in separately or re‑entering the NHS number.

SCR may be accessed through:

1. the standalone SCR application (SCRa), which needs no extra software;
2. an integrated viewer developed within the pharmacy clinical system;
3. one‑click functionality created by system suppliers (e.g. Lorenzo or Servelec RiO); or
4. the orQestra® SCR Spine Mini‑Service Provider from Quicksilva, which can integrate with any IT system supplier system.

How this supports pharmacy services

This supports services such as NUMSAS and the Pharmacy First Service . It reduces delays, avoids unnecessary calls to GP practices, and improves out‑of‑hours support.

Community Pharmacy England and the Community Pharmacy IT Group encourage all IT system suppliers to adopt SCR 1‑click.

List of suppliers that have integrated

The NHS SCR team publish a list of system suppliers which have integrated:

https://digital.nhs.uk/developer/api-catalogue/national-care-records-service-integration 

System suppliers wishing to integrate may contact the NHS IT live services team at liveservices.operations@nhs.net.

The consent framework introduced in 2017 was agreed by the NHS SCR team, Community Pharmacy England and others. It may be updated as SCR use becomes more routine.

Obtaining permission to view

Before you access a person’s SCR, they must give “permission to view” (PTV), unless an emergency access route applies (see below).

When seeking consent, explain:

1. What SCR is – for example, “it includes key information from your GP record.”
2. Why it will be accessed – for example, “to support your care.”
3. How often it will be accessed – this can be a one‑off or ongoing while they are under your care. If ongoing, note this in the patient’s record.
4. That consent can be changed at any time.

Verbal consent is usually best, though some pharmacy owners choose written consent for ongoing access. A sample form is available below.

Opting out

Everyone with an SCR has been informed of their right to opt in or out. If a person wants no SCR at all (not just to refuse access during a visit), they should contact their GP practice.

Emergency access

If the patient or their representative cannot give consent and you judge that viewing the SCR is necessary for safe care, you may use the “Emergency Access” option.

Record the reason, as this supports the SCR Governance Person’s oversight. Examples include:

• a person with significant language difficulties; or
• a person with dementia who cannot provide informed consent.

Refer to GPhC guidance, which advises that if a person cannot decide for themselves, you must work with those close to them and other healthcare professionals.

Access for children

Children can have an SCR. If the child understands the request, they should decide whether to allow access. If not, a parent or guardian decides. This is a professional judgement.

Patient consent form template

Verbal consent is often the simplest route. A template is available:

• NHS SCR team sample form (PDF)

FAQs about the SCR consent model

Q. Our pharmacy supports a large care home. How can residents give consent?
The RPS advises:

• The care home informs residents or carers on arrival that the preferred pharmacy may access SCR. This should be in admission documents.
• Residents or carers must tell the home if they do not want SCR accessed.
• The home and pharmacy should agree a process so the pharmacy is told if permission is refused.
• If forms are not yet completed, the care home may give proxy consent where appropriate.

Q. What if I believe access is needed for a care home resident but cannot obtain consent?
Follow the consent model, and where an emergency situation applies, consider using emergency access.

Q. How long should written consent forms be kept?
This is a local decision. Consider audit needs alongside data protection requirements, including not keeping information longer than necessary.

Q. Can SCR consent be bundled with another consent request?
No. Consent must be informed. If using a written form, keep SCR consent separate (e.g. through its own tick box).

Using the SCR can help pharmacy teams make safer and more informed decisions. Pharmacists and pharmacy technicians can view it when it is needed for patient care, and only with the right consent and safeguards in place. Each pharmacy must also have a named Governance Person (SCRGP) who monitors SCR activity.

Read below if you are responsible for SCR governance or assigning this role within your pharmacy.

Who can access SCR and when?

Once your pharmacy is ‘SCR live’, SCRs can only be accessed:

• by pharmacists and pharmacy technicians;
• once all SCR requirements have been met;
• when the patient has given permission to view (PTV), unless it is an emergency; and
• when there is a legitimate relationship with the patient, meaning the team is involved in their care at that moment.

How patient data is protected

Several measures are in place to keep patient information secure:

• Smartcard users must follow the Smartcard user policy;
• Standard operating procedures for SCR use must be in place;
• Professional codes of conduct and employment contracts must be followed; and
• Pharmacy owners must complete the Data Security and Protection Toolkit each year.

How SCR access is audited

• Every access to an SCR is fully auditable and linked to the Smartcard being used at the time.
• Privacy alerts are generated for each access, including when the emergency access option is used.
• Reports show every record viewed by every Smartcard.
• Patients can request an audit of all SCR accesses for their record.

Who audits SCR access?

Each pharmacy must appoint an SCR Governance Person (SCRGP).
This person reviews SCR usage, investigates privacy alerts, and ensures SCR is used appropriately.

How the SCRGP carries out audits

If you use NHS.net Connect, privacy alert notifications can help you identify which accesses to review. The Alert Viewer tool is also available.

The SCRGP should look for patterns or unusual activity, such as:

• a high number of emergency accesses;
• repeated access to the same patient’s SCR;
• activity outside the pharmacy’s opening hours;
• missing reasons for viewing the record;
• access by a branch before it is live with SCR;
• one staff member accessing more than expected; or
• any activity that appears unusual.

If access is legitimate, the privacy alert is closed with no further action.
If illegitimate access is confirmed, local procedures apply. The Care Record Guarantee states that if someone has accessed a record without permission or good reason, the patient will be informed and appropriate disciplinary or legal action may follow.

Glossary

SCRGP – The Governance Person responsible for SCR oversight.
Older documents may refer to this role as the Privacy Officer.

Frequently asked questions: SCRGP

Q. I accessed the NHS England ‘SCRa’ portal demographics screen to check for a Shielded Patient Flag. Will this generate a privacy alert?
No. NHS England has confirmed that accessing only the demographics screen does not generate a privacy alert.

Q. How many SCRGPs should be appointed?
This varies by pharmacy organisation. Consider factors such as how often SCR is used, how many team members access SCR, and how many branches are live. SCRGPs must ensure appropriate SCR use across the organisation.

Q. How much time does the SCRGP role take? How many alerts need checking?
There is no set number of alerts to investigate. Some pharmacies initially check around 10% each month, but the approach should reflect your pharmacy’s circumstances and trends. Some pharmacies spend a few minutes each week; others review alerts quarterly. Processes can be adapted over time or increased if problems are identified.

Q. Who can be an SCRGP in community pharmacy?
A. Each pharmacy must have a nominated SCRGP before accessing SCR. It is helpful for at least two people to hold the role, providing cover for annual leave or sickness. Ideally, SCRGPs should not have SCR access for the same branch they oversee. In small pharmacies this may not be possible, so a second SCRGP should review the first SCRGP’s activity, and vice versa.

Read more: SCRGP guidance, user guides and training materials (NHS England).

Your pharmacy privacy notice should explain that pharmacy professionals may consult records such as SCR and Shared Care Records:

“Our pharmacy professionals may consult relevant records to support your care, such as NHS Summary Care Records or local Shared Care Records. We follow NHS protocols for using records. We may also ask for your permission to consult these records while you remain under our care. Allowing us to see this information helps ensure relevant medical details are visible to our professionals.”

A template privacy notice is available at: cpe.org.uk/dstemplates.

If you plan to create local SCR communications that use the NHS logo, follow the NHS brand guidelines.

Patients can increasingly view their SCR and other health information (for example, from their record held by the GP and their Shared Care Record) in the NHS App, if GP practices have enabled these features.

Pharmacy owners: general SCR statistics
NHS hosts SCR stats on its main SCR page and at the Deployment and utilisation hub.

Pharmacy-level SCR statistics by LPC area usage – legacy sample  (Excel, approx. 2MB)

NHS Power BI dashboards:

• SCR stats dashboard

Several organisations support SCR implementation and technical oversight.

NHS IT teams
NHS IT teams manage national infrastructure for multiple NHS IT services, including SCR.

NHS IT operating model
NHS IT teams undertake tasks that help pharmacies access and use national NHS IT applications. Securing excellence in IT services sets out organisational responsibilities for IT.

GP IT services are managed by ICBs. Business continuity and feedback
If SCR or Smartcard access is unavailable, revert to the usual alternative: contact the GP practice.

Sign up to receive Spine alerts so you are notified about national incidents that affect SCR. For more on SCR and NHS IT business continuity, read here.

Depending on the issue, you may need to contact:

• your local project contact;
• your usual IT helpdesk; or
• the national SCR programme.

Community Pharmacy England recommends using NHS IT business continuity tools such as:

• System alerts: register for text or email alerts if national services that support SCR are experiencing issues (Spine alerts).
• Service status checker: visit the NHS England service status checker for information about national systems (EPS checker).

Note: Spine alerts differ from SCR privacy alerts.

Pharmacy teams can also contact Community Pharmacy England at da@cpe.org.uk to escalate technical issues to NHS IT teams or share feedback about SCR.

Top tips

• Add the SCR web address to favourites: add the SCR URL to your desktop, browser favourites, or homepage opening tab, to speed up access.
• Patient information: display patient information materials (posters, leaflets) in your pharmacy and on your website (see ‘Patient communications’ section of this webpage)

SCR views from pharmacy / pharmacist

• P&S Chemist: clip from the full webinar.
• This discusses the opportunities for regular use.

Clip from the full webinar about scope for regular usage:

The NHS SCR team will continue to explore developments that support health and care staff and improve patient care.

If you have suggestions, please email da@cpe.org.uk.

Consistent access to SCR: regulations and responsibilities

The terms of service have required NHS pharmacists with SCR access to use it where, in their clinical judgement, this is in the patient’s best interests (since 2016).

Pharmacy owners must ensure staff can access the SCR consistently and reliably during opening hours, as far as this is within the pharmacy owner’s control (since 2020).

SCR access must follow The NHS Care Record Guarantee.

Only pharmacists and pharmacy technicians may access SCR; this change did not alter that. Subject to normal consent requirements, registered professionals should access SCR when providing services if, in their clinical judgement, it is appropriate.

Most pharmacy owners had already enabled SCR for pharmacists and pharmacy technicians, as required by the Pharmacy Quality Scheme.

Examples of situations outside the pharmacy owner’s control include a national SCR outage, internet failure or power issues that have been reported and are being resolved. In contrast, failing to ensure a new staff member or locum has a working Smartcard with SCR access is within the pharmacy owner’s control.

If you also have access to a more detailed record (for example, a Shared Care Record (ShCR), continue to maintain SCR access. SCR is a useful back‑up if the LHCR is unavailable.

Liability
National Pharmacy Association statement to NHS records team:
“NPA indemnity Insurance will cover members’ access to the SCRs (and associated liabilities) where the pharmacist/pharmacy technician considers it necessary to do so… provided that this is done in line with published guidelines, the pharmacy’s SOP governing consent and access to SCR and use of the information therein.”

Numark Ltd statement to NHS records team:
“Numark Insurance… will provide cover to pharmacists and technicians utilising and operating within approved guidelines and continuing to act with due regard to patient safety, care and consent.”

General Pharmaceutical Council statement:
Access to patient medical records supports better outcomes. Pharmacy professionals must put patients first and apply standards on confidentiality, consent and obtaining sufficient information to assess needs. Pharmacy owners must meet GPhC Standards for Registered Pharmacies. Standard 1.7 requires information to be managed to protect privacy, dignity and confidentiality. Inspectors may review record use as part of their assessment.

Use of other health records
In some areas, pharmacy owners can access ShCRs (for example, the Dorset Care Record), which include more information than SCR. The ambition is for ShCRs to offer read and write access to pharmacy teams. Owners may use ShCRs where appropriate, with SCR as a back‑up if the ShCRs is unavailable. Consistent SCR access remains required.

Read more: cpe.org.uk/shcr.

Q. What do I need if my pharmacy is new or I am going into the community pharmacy sector, how do we (or I) prepare to use SCR?

Use the checklist at cpe.org.uk/scrlist.

Q. What is the process for staff working at multi sites and using a 5F Smartcard, and what if 5F permissions are delayed?
Staff can use the 5F code on the Smartcard, which is often issued for those working at two or more pharmacies at short notice. Pharmacy staff should also add regular premises to their Smartcard so they can log in using those locations rather than a generic F code.
If SCR permissions are delayed by more than two weeks after submitting the paperwork, follow the Smartcard escalation route or contact your SCR implementation manager for your area (details at the end of the original guidance).

Using SCR and practising usage

Q. Is there a test patient I can use to practise SCR without a real patient waiting?
Yes. You may use these NHS numbers to practise:
• 999 040 2132
• 999 025 2947
• 999 025 2955
• 999 024 3271

Q. I have SCR access. Do I have to use it, and when?
Since 1st April 2016, pharmacy owners delivering NHS community pharmacy services must access SCR in certain situations if, in their clinical judgement, it is in the patient’s best interests. All use must follow the NHS Care Record Guarantee.

Consent, auditing and emergency access

Q. If I have a query about a repeat prescription for a patient who is not present, can I call them to gain consent?
Yes. Consent can be given in person or over the phone. For regular patients, one consent conversation can cover ongoing access. Record this consent in the patient’s notes.

Q. What is SCR emergency access?
This is when a pharmacist or pharmacy technician accesses SCR without patient consent because all reasonable attempts to obtain consent have been exhausted, and doing so is necessary for safe care. You must be able to justify that accessing SCR was in the patient’s best interests.

Q. Could I be challenged for using SCR too often?
SCR use is monitored, but decisions about when to access it rest with the healthcare professional. Pharmacies may access SCR many times each day. Auditors generally check that there was a related patient, not the clinical reasoning.

Q. How can care home residents give consent? Can care home staff do this?
The Royal Pharmaceutical Society advises:
• Care homes should tell patients or carers at admission that their preferred pharmacy may access SCR.
• Patients or carers should inform the care home if they do not give permission.
• Information materials must be available to meet data protection requirements.
• If consent is refused, the care home must notify the pharmacy.
• Care homes may provide proxy consent where appropriate if the admission process is not complete.

Q. What if I believe a care home resident needs SCR access but I cannot get consent?
If the situation is urgent and you cannot obtain consent, you may consider emergency access. The General Pharmaceutical Council’s guidance states that if a patient cannot decide for themselves, you must work with those close to them and other healthcare professionals.

Q. Can I access a patient’s SCR without consent?
Yes, in emergencies. You must document the reason. Examples include:
• A patient with significant language barriers
• An elderly patient with dementia
This must always be justifiable as being in the patient’s best interests.

Creation and updating of SCR

Q. How is an SCR created?
SCRs are created and updated by GP practices. GP IT systems upload summary information to the NHS Spine whenever relevant changes occur. As soon as a practice begins uploading SCRs, it is considered live.

Q. How is the SCR updated, and are GP practices required to do this?
From April 2014, GP practices have been required to upload daily updates to SCR. The core SCR includes medicines, allergies and adverse reactions under implied consent. Any additional information requires explicit consent and must support urgent or emergency care.

Shielded patient list (SPL) and flag

Q. Is the shielded patient flag still visible in SCR?
No. The flag was linked to the shielded patient list used during the COVID‑19 pandemic. National shielding ended in September 2021, and the SPL closed soon after. Data updates stopped in late September 2021, and the flags were removed during June 2022 as part of the managed closure process.

Resources

• SCR checklist
• SCR and multi‑site Smartcard briefing
• SOP template

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