Community Pharmacy: an untapped patient data resource

As community pharmacy services become more patient centred they will be increasingly reliant on access to good quality patient information. This paper describes how the information which is currently available in community pharmacies can be used to enhance service delivery and patient care. With integration of community pharmacy and medical practice records on the horizon the opportunities this will provide are also considered. The community pharmacy held patient medication record, which is the central information repository, has been used to identify non-adherence, to prompt the pharmacist to clinically review prescriptions, identify patients for additional services and to identify those patients at greater risk of adverse drug events. Whilst active recording of patient consultations for treatment over the counter may improve the quality of consultations and information held, the lost benefits of anonymity afforded by community pharmacies needs to be considered. Recording of pharmacy staff activities enables workload to be monitored, remuneration to be justified and critical incidents to be learned from but is not routine practice. Centralisation of records between community pharmacies enables practices to be compared and consistent problems to be identified. By integrating pharmacy and medical practice records, patient behaviour with respect to medicines can be more closely monitored and should prevent duplication of effort. When using patient information stored in a community pharmacy it is however important to consider the reason why information was recorded in the first instance and whether it is appropriate to use it for a different purpose without additional patient consent. Community pharmacies currently have access to large amounts of information which if stored and used appropriately can significantly enhance the quality of provided services and patient care. Integrating records increases opportunities to enhance patient care yet further. Whilst community pharmacies have significant amounts of information available to them this is frequently untapped

Measuring access: how accurate are patient-reported waiting times?

Introduction: A national audit of waiting times in England’s genitourinary medicine clinics measures patient access. Data are collected by patient questionnaires, which rely upon patients’ recollection of first contact with health services, often several days previously. The aim of this study was to assess the accuracy of patient-reported waiting times. Methods: Data on true waiting times were collected at the time of patient booking over a three-week period and compared with patient-reported data collected upon clinic attendance. Factors contributing to patient inaccuracy were explored. Results: Of 341 patients providing initial data, 255 attended; 207 as appointments and 48 ‘walk-in’. The accuracy of patient-reported waiting times overall was 52% (133/255). 85% of patients (216/255) correctly identified themselves as seen within or outside of 48 hours. 17% of patients (17/103) seen within 48 hours reported a longer waiting period, whereas 20% of patients (22/108) reporting waits under 48 hours were seen outside that period. Men were more likely to overestimate their waiting time (10.4% versus 3.1% p<0.02). The sensitivity of patient-completed questionnaires as a tool for assessing waiting times of less than 48 hours was 83.5%. The specificity and positive predictive value were 85.5% and 79.6%, respectively. Conclusion: The overall accuracy of patient reported waiting times was poor. Although nearly one in six patients misclassified themselves as being seen within or outside of 48 hours, given the under and overreporting rates observed, the overall impact on Health Protection Agency waiting time data is likely to be limited