Two-thirds of GPs have turned off Update Record, survey suggests

Almost two-thirds (61%) of GPs have said their practice has turned off the Update Record functionality that allows community pharmacies to send Pharmacy First consultation information in a format that can easily be added to patient records, a survey has shown.

The snapshot survey, carried out by our sister title Pulse, saw a further 16% of respondents report that they were still considering whether to turn off the functionality in the future.

Just 12% said they were not planning to take this action.

The snapshot survey, which represents about 5% of GP practices across England, asked GPs whether they were participating in 'work-to-rule' collective action launched by the British Medical Association (BMA).

Turning off Update Record was originally proposed as part of collective action due to start on 1 August, but this particular move was initiated early amid GP concerns about 'unintended consequences' of the software.

Community pharmacy leaders warned at the time that without the Update Record functionality, pharmacies would have to revert to using old systems or even paper-based solutions.

And Dr Amanda Doyle, director of primary care at NHS England (NHSE), had said it was 'odd' for GPs to choose to turn off a time-saving functionality introduced 'to make GPs' working lives easier and improve patient outcomes’.

Other actions proposed by the BMA for GPs to choose from as part of collective action were:

• Limiting daily patient contacts per clinician to a maximum of 25
• Stopping engaging with the e-Referral Advice & Guidance pathway
• Serving notice on any voluntary services currently undertaken that plug local commissioning gaps
• Stopping rationing referrals, investigations, and admissions​
• Withdrawing permission for data sharing agreements that exclusively use data for secondary purposes (i.e. not direct care)
• Freezing sign-up to any new data sharing agreements or local system data sharing platforms
• Switching off medicines optimisation software embedded by the local integrated care board (ICB) 'for the purposes of system financial savings and/or rationing'
• Deferring signing declarations of completion for 'better digital telephony' and 'simpler online requests' until further GPC England guidance is available
• Deferring making any decisions to accept local or national NHSE pilot programmes whilst the BMA explores opportunities with the new government

The Pulse survey suggested that up to half of GP practices were currently participating in other forms of collective action, with one in four (26%) putting a limit on the number of patients they see in a day, and 41% refusing to ration referrals, investigations, and admissions​.

Meanwhile, 18% have switched off medicines optimisation software embedded by the local ICB, while a further 42% were still considering it.

And 30% said they would defer making any decisions to accept local or national NHSE pilot programmes while the BMA explores opportunities with the new government.

Alastair Buxton, director of NHS services at Community Pharmacy England (CPE), raised concerns about the potential impact of GP action on pharmacy owners and their teams - while acknowledging that the action was still in its early stages.

'If patients can’t access their GP practice many will turn to their local pharmacies, but any unplanned surge in people seeking their help will exacerbate a sector that is already working at full capacity.

'A significant concern is that even more patients will be informally signposted to pharmacies rather than being electronically referred to the Pharmacy First service, transferring workload to community pharmacies which will be unfunded by the NHS.'

'We have already shared our concerns with NHS England  and GPC England and will monitor the effects of the GP action on pharmacies, including through our Committee Opinion Poll,' Mr Buxton added.

CPE has previously urged that the safe supply of medicines must be the ‘key priority’ for pharmacies amid the GP action.

Meanwhile, Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), told The Pharmacist that the action undertaken by GP practices 'will only place a heavier burden on already stretched community pharmacies'.

And Nick Kaye, chair of the National Pharmacy Association (NPA) reiterated warnings that collective action by GPs was 'bound to have a ripple effect on community pharmacies', which he said have lost much of their ability 'to be a shock absorber' for disruption elsewhere in the healthcare system due to 'persistent underfunding' causing 'serious capacity challenges' in the sector.