The U.K. government has admitted much more work has to be done on patient security and confidentiality concerns, associated with allowing pharmacists access to patient Summary Care Records (SCRs).
It said more discussions and assessment had to take place between various health bodies, in order for a decision to be taken on how to protect the data.
SCRs will contain basic information for healthcare providers on patients' details, prescriptions and allergies, but more information will be added to them as patients are treated, and this is an area where little detail has been provided.
It has also previously been proposed that the care records could be shared with social services.
In February, it was reported that thousands of smartcards that give NHS staff access to patient records had been lost or stolen.
Late last year the British Medical Association wrote to health minister Ben Bradshaw calling for a halt to the roll-out of patients' summary care records until the results of pilot projects have been reviewed.
But the government continued to push IT systems further into local pharmacies as part of the UK$12.4 billion Connecting for Health program. It said systems such as the Summary Care Records, electronic prescriptions and automated dispensing would play a key role in the future of local pharmacies.
The news came as the Department for Health presented a white paper to parliament, advocating the heavier use of local pharmacies as advisers to patients, enabling patients to have quicker treatment without a doctor's appointment in non-serious cases, and lifting some of the weight off GPs' shoulders.
In the paper, entitled 'Pharmacy in England: Building on strengths, delivering the future', Dawn Primarolo, minister of state for public health, said that in the future pharmacists would "use new technologies to expand choice and improve care in hospitals and the community."
But the DfH warned of "specific concerns" over pharmacists' use of Summary Care Records, designed to provide details such date of birth and address, allergies and current prescriptions to those providing treatment.
While SCRs would also help pharmacies treat patients by providing access to patient-specific information, the DfH said: "It is important that mechanisms are in place to fully address concerns about patient consent and maintaining patient confidentiality."
The DfH admitted that maintaining the security and confidentiality of this data could be a challenge. "The NHS Care Record Guarantee [which promises careful and secure patient data handling] has been drawn up and agreed by key parties as to what patients have a right to expect about how any information about them in the Care Record Service may be stored, used, shared and transmitted.
"However, there have been specific concerns about the use of the Care Record Service in community pharmacies, also often thought of as a retail setting."
It said the government, the Clinical Reference Panel, the National Advisory Group and Patient Advisory Group, together with professional and representative organizations, would examine the effects of this by monitoring an early adopting primary care trust. In addition, as pharmacists offered more advice, "Consideration will also be given to how community pharmacists may be able to utilize other services such as 'Choose and Book'," the DfH said.
On the Care Records website, the NHS says: "Each time you use an NHS service, more information may be added to [the SCR] ... As new information is added to your Summary Care Record, you can discuss what is being added and how sensitive information is handled. You will be told about this before your Summary Care Record is ready so that you have time to consider your options."
The DfH paper highlighted the importance of technology in also making sure patients received the correct medicines, in the right quantities and at the right time, and added that they would be able to go straight to pharmacists for repeat prescriptions.
The DfH said that the incorrect supply of medicine to patients was a serious issue, and that if no action were taken to stop it, it could cost the NHS more than B#750 million each year in England alone. "New technologies reduce mis-selection and misidentification," it stated.
The government said that 79 per cent of pharmacies and 64 per cent of doctors' surgeries were now operating the first release of the much touted electronic prescriptions service, and were experiencing efficiency gains as a result. The EPS is designed to eventually enable GPs and nurses to send prescriptions electronically to pharmacies.
It said that EPS would help as it would "improve patient safety by reducing illegible or incomplete prescriptions."
The report cited a case at Bournemouth and Poole Primary Care Trust, where a service to support patients at home had been assisted by technology making sure that medicine dispensers, such as pharmacists and treatment schedulers, collectively supplied the correct doses of medicine.
The DfH also said that work on the second stage of the EPS rollout had begun in 17 primary care trusts, and aimed to allow prescriptions to be transmitted between surgeries and pharmacists electronically. Work has begun with strategic health authority CIOs to assess how and when more PCTs are chosen to use the service.
The DfH is assessing how to further develop EPS, and one primary care trust was piloting the roll-out of NHS mail to local pharmacies, it said.
In its report, the DfH also made proposals for the disposal of medicine within hospitals, even suggesting the use of robots.
"For patients in hospital, the adoption of decentralized dispensing robots in clinical areas could improve care. This would include the ability of pharmacy staff to be permanently based in clinical settings, maximizing their clinical input and impact, and improving multidisciplinary communication."
"Technology has now developed to the extent that automated hubs for bulk storage and dispensing could control and supply medicines rapidly and accurately," it added.
Bar codes would play a crucial role in tracking hospital patients and matching their medication to them, the DfH said, following on from the February 2007 publication of a strategy for wider adoption of auto-identification and data capture (AIDC) technologies in healthcare.
The DfH said: "There is evidence of real improvements to patient safety when coding systems are used to match patients to their care: reduction in medication errors and dispensing errors; reduced risk of wrong-site surgery; accurate track and trace of surgical instruments, equipment and other devices; and much better record-keeping. Using coding to manage supplies and purchasing electronically can cut costs dramatically, as well as improve efficiency."
It added, however, that it would need to ensure that all parties worked to commonly agreed standards, such as the GS1 supply chain standard.
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