Community Pharmacy Integration

Community Pharmacy Integration was a pilot study conducted by NHS England East of England Region from November 2022 to December 2023 across the East of England. The pilot gave selected community pharmacies a TPP SystmOne Community Unit (SystmOne) giving them full read and write access to consenting patients’ primary care records. The pilot was intended to improve communication and integrated working between community pharmacies and general practice.

We evaluated the feasibility, acceptability and impact of providing community pharmacies with read-and-write access to a shared EHR (SystmOne) used in general practice across selected sites in the East of England, in the same way other health professionals do including community nursing teams and staff within Primary Care Networks (PCNs). The evaluation report was completed at the end of 2024.

The evaluation was a collaboration between the evaluation team at Health Innovation East; academic experts, Hamde Nazar Professor of Pharmacy at Newcastle University and Michael Twigg Associate Professor at the University of East Anglia; and the NHS England East of England Regional project team who were responsible for implementing the pilot.

In 2022, the Professional Record Standards Body (PRSB) (2) reported on the importance of community pharmacists having full read-and-write access to patient’s healthcare records, identifying:

• the critical role community pharmacists have as a first point of contact for many patients regarding medicine-related enquiries;
• the vital role of community pharmacists in supporting patients with long-term conditions;
• improvements in patient safety and care, audit trail and communication between pharmacies and other healthcare professionals; and
• the reduction in chance of prescribing errors and waiting times; as a result of providing full access.

The importance of providing integrated, real-time digital communication between care settings and healthcare professionals to ensure community-based care is coordinated, safe and effective, and work such to evaluate these changes is further highlighted by recent shifts, including:

• increasing numbers of pharmacists becoming independent prescribers, with all newly qualified pharmacists able to prescribe from 2026 (3);
• increased commissioning of more advanced services from pharmacies (4); and critically
• the shift to provide more patient care in primary care and community settings as part of the plan to reform the NHS (5) and further emphasised in the Darzi report (6).

Findings from this pilot highlight key considerations for future developments and provide a foundation for policy and practice discussions aimed at leveraging digital integration to enhance community-based healthcare delivery.

The pilot demonstrated that the shared access and functionality of an EHR can improve integrated working and service delivery.

A total of 35 community pharmacies and 19 general practices actively used SystmOne to share and record information throughout the pilot. These practices booked over 19,000 patients into community pharmacy appointments directly through the system. 13 pharmacies actively used SystmOne to directly record over 16,000 patient consultations and clinical interactions, using templates and clinical coding aligned with general practice standards.

Staff reported enhanced interprofessional communication, improved clinical decision-making, and better service coordination, all contributing to enhanced quality and safety of patient care.

“It significantly reduced our time contacting GPs. I’m not looking for email addresses, I’m not sending it to an old practice manager. I get it tasked to the right team and then it gets actioned.” (P04)

“So we have embedded SystmOne into our like daily practice. So now we pretty much can’t live without it […]. So it has been a real game changer, changed our practice completely. We have expanded and excelled our clinical services because of this, it is just great.” (P04)

The use of SystmOne reduced the need for additional communication channels, such as NHS mail, provided real-time documentation, and reduced duplication – streamlining workflows, improving efficiency and reducing administrative burden for both sectors.

The pilot also highlighted areas for consideration in adoption and scale up:

1. Understanding how existing platforms, systems and ways of working will impact engagement and use
2. Careful consideration of how to prioritise functions and functionality so these meet user needs, and optimise engagement and potential efficiencies
3. Coordinated training
4. System interoperability, and alignment with national service reimbursement processes to minimise workload duplication and maximise engagement
5. Addressing technical barriers and streamlining data entry processes.
6. Fostering greater engagement from both pharmacies and general practices.

Whilst broader adoption requires addressing interoperability, system usability, and policy alignment, scaling such initiatives may support the evolving clinical role of community pharmacists.

These findings can be applied to help inform future initiatives, and these have been mobilised through reporting and the NHS East of England regional project leads. Many of the pharmacies that participated in the pilot felt strongly about the need to retain access beyond the pilot.