Nearly 70% of the public would be happy for their medical records to be shared between clinicians, a YouGov poll for The Times Health Commission has found.
Its report, published this week, proposed patient record sharing through digital ‘patient passports’ and incentivising pharmacists ‘to do more prescribing, consultations and community care’ to relieve pressure on GPs.
The report, which draws on research undertaken over the last year, also highlighted issues around community pharmacy funding, workforce and the cost and availability of medicines.
And it proposed raising the age of eligibility for free prescriptions in order to pay for social care provision.
‘Patient passport’ proposed
One of the report’s key proposals is a digital ‘patient passport’ accessed through the NHS App that would allow patients to ‘book appointments, order repeat prescriptions, view test results, read referral letters and, in time, arrange social care’.
It suggested that ‘GPs, hospitals, paramedics, pharmacists and social care providers should all have access to the data when necessary to provide seamless care for patients’.
A digital health account would be backed by more than 80% of the 2,000 respondents to a YouGov poll conducted for the health commission in January.
Some 68% would be happy for their medical records to be shared between clinicians, while 56% said it ‘was more important to them to be able to easily book appointments, order prescriptions and view their medical records than to protect the security of their records’.
The Times report called for a single system across the whole country, linking primary and secondary care, with data ‘owned by patients, with different bits of the NHS and social care system able to access it when necessary’.
Eventually, it could include automatic reminders about vaccines or screening programmes, receive information relevant to the patient’s health condition, and hold ‘everything from fitness advice to details of medication’, it noted.
‘Over time the health record could be connected to wearable technology such as a Fitbit or Apple Watch enabling people to receive individual health advice in real time based on their own heart rate, blood pressure or sleep patterns,’ The Times report proposed.
Fund social care with more paid-for prescriptions
The report also drew attention to the need for more social care provision, highlighting that a lack of social care was keeping patients in hospital without a medical reason.
The report proposed several ideas to fund increased social care, including ‘making more people pay for prescriptions’.
The report said: ‘At the moment only 11% of prescriptions are paid for because there are so many exemptions.
‘According to the Institute for Fiscal Studies, free prescriptions cost £17 billion a year in 2020-21 and 60% of those were for those aged over 60, at a cost of £10 billion a year.
‘Raising the age at which people became eligible for free prescriptions to the state pension age would be logical and generate significant revenue.’
The report added: ‘There are many options but to govern is to choose and whoever wins the next election cannot continue to ignore social care.’
Last year, the government committed to keeping prescriptions free for over-60s, following a consultation on whether the age limit for free prescriptions should be brought in line with the state pension age.
Meanwhile, a recent survey found that 97% of pharmacist respondents in England had encountered patients foregoing some of the medicines on a prescription due to cost, and as many as 90% reported cases where patients declined all their medicines.
Community pharmacy could manage more conditions
The report highlighted the role of different professionals within primary care.
‘Although GPs are the face of primary care, they are part of a bigger system that includes nurses, mental health specialists, pharmacists, physician associates, social prescribers, community link workers and health coaches,’ the report said.
It added: ‘Primary care works best when these health professionals work together and patients see the right person at the right time.’
In the report, Community Pharmacy England (CPE) chief executive Janet Morrison is quoted describing how community pharmacies are ‘funded to test blood pressure’ but then must ‘send everyone back to the GPs if they’ve got a problematic score’.
‘Why don’t we keep those people with us and then provide them with long-term management?’ she said.
And she suggested that community pharmacies could provide more ongoing support for other conditions such as diabetes, asthma and respiratory disease.
Public health messaging ‘essential’
Wider structural changes outside the NHS are also needed to tackle social determinants of poor health, the report suggested.
For example, it proposed expanding the sugar tax to other sugary and highly salty foods.
It also said that public information campaigns on vaccinations were ‘essential’ to keep vaccination levels ‘high enough for herd immunity’, adding that ‘more effort needs to be put into tailoring messages to communities that are traditionally sceptical about jabs’.
The report also set out proposals for new community health centres as well as more GP ‘super-practices’ to house multi-disciplinary healthcare teams, including pharmacists.
It also suggested that pharmacists could play a greater role in medicines optimisation and safety, reducing pressure on hospitals and saving the NHS money.