Summary Care Record

Summary Care Record (SCR) is a national database that holds electronic records of important patient information such as current medication, allergies and details of any previous bad reactions to medicines

It is created from GP medical records - whenever a GP record is updated, the changes are synchronised to SCR.

It can be seen and used by authorised staff in other areas of the health and care system who are involved in the patient's direct care but do not need access to the patient's full record.

Benefits of SCR include:

• makes care safer
• reduces the risk of prescribing errors
• helps avoid delays to urgent care

For more information about the benefits and uses of SCR, visit Benefits and uses of Summary Care Records in community pharmacy - NHS Digital.

This service is for authorised clinicians, health and social care workers and/or administrators, in any health or care setting based in England who need to access a patient's information to support their direct care.

SCR does not have a user interface - users must access it indirectly via user-facing applications, namely:

• local point-of-care applications for health and care workers, such as a Patient Administration System (PAS) in a hospital
• the National Care Records Service

Who is included

The original scope of SCR was to provide access to key information in urgent and emergency care settings. Through close consultation with the Expert Advisory Committee, NHS Digital have progressed a number of proof of concepts, to see whether it is beneficial to patient care, to allow other care settings to have access to the SCR. 

The approved care settings to view SCRs are:

• 111
• accident and emergency
• acute assessment
• ambulance
• community care
• GP out of hours
• GP (for temporary or non-registered patients)
• hospital pharmacy
• minor injury units/walk in centres/urgent treatment centres
• scheduled care
• mental health
• health and justice (custody suites)
• hospices
• primary care
• community pharmacy
• substance misuse
• maternity

Who is not included

The care settings that are currently being discussed, or have an active proof of concept but are not approved for further rollout are:

• dentistry (minor oral surgery and community dental providers)
• domiciliary care and care homes
• optometry
• private GP providers
• private hospitals and privately funded healthcare services
• adult social care

• sexual, contraceptive and reproductive healthcare services

Any care setting not listed is currently out of scope for SCR. However, if there is a use case for a new care setting to access the SCR, complete the online expression of interest form.

SCR holds information for anyone who was born in England, or who has registered for NHS care in England.

Who is included

SCR holds information for:

• anyone born in England
• anyone else who has registered for NHS care in England

What information is held for each patient

At a minimum, the SCR contains important information about:

• current medication
• allergies and details of any previous reactions to medicines
• the name, address, date of birth and NHS number of the patient

In addition, details of long-term conditions, significant medical history, or specific communications needs, is now included by default for patients with an SCR, unless they have previously told the NHS that they did not want this information to be shared. For more information, see Additional Information in the SCR.

An SCR should only be viewed if the health or social care worker is involved in the patient's care. This is called a 'legitimate relationship'.

The patient should be asked for their permission before their SCR is viewed.   

Where it is not possible to ask for permission to view the SCR, health and social care workers may act in the patient's best interests.

Further details can be found on View Summary Care Records (SCR) - NHS Digital.

For patients

1. Your SCR is created automatically when registered with a GP practice in England. 98% of practices are currently using the system.

2. You can talk to your practice about opting out of including Additional Information about long term conditions, care preferences or specific communication needs.

For more information for patients, see Summary Care Records - information for patients.

GP information on creating SCRs and including additional information

1. SCR is created automatically through clinical systems in GP practices and uploaded to Spine.

2. It is then updated automatically.

3. When new patients are registered, the practice must check if the patient consents to a SCR.

4. Additional information will be added to the SCR, unless a patient wishes to opt out, which they can do by filling out a SCR patient consent preference form.

5. If a health care professional already has access to view SCRs, they will not require further RBAC activities or smartcard changes to view the additional information included on the SCR.

How to record medicines prescribed elsewhere into the GP practice record

This guidance explains why medicines prescribed separate to a patient’s GP practice must be recorded and the implications on the SCR when this has not been done. It also explains what steps GP practices can take to ensure that this information is recorded correctly.

Viewing SCRs

1. SCR can be viewed by health and care staff and is also available to community pharmacies.

2. SCRs can be viewed through clinical systems, including the National Care Records Service on the Spine web portal.

3. When viewing an SCR, the user must be using a machine logged in to the secure NHS network, using a smartcard with the appropriate Role Based Access Control codes set.

SCRs are also available to view in NCRS, using mobile or desktop devices connected to the internet using WiFi, mobile data or an existing Health and Social Care Network (HSCN) connection. NCRS offers multiple access options including biometric authentication, smartcards and multifactor authentication. 

Security and the SCR

1. Data within the SCR is protected by secure technology.

2. Users must have a smartcard with the correct codes set and each use is recorded.

3. A patient can make a Subject Access Request to find out the organisation that accessed their SCR and the date/time of the access.

4. A report is produced and sent to the requester which details Business Message Types including SCR views via NCRS and SCR retrievals via 3rd party viewing systems.

5. The requester is directed to the organisations that accessed their SCR, in case they have any questions or concerns. They can also request information to see if an end user viewed their SCR via a third party viewing system.

6. Patient data is protected by strict information governance rules and procedures.

7. Each organisation using the SCR has at least one privacy officer who is responsible for monitoring access and can generate audits and reports.

Using SCR with additional information to help treat an elderly patient out of hours

• A GP was asked to triage an elderly patient late one evening. The patient had been diagnosed and had been prescribed medication earlier in the day.
• The patient was concerned that they may be allergic to the medication.
• The GP was able to access the patients SCR which highlighted that previous medication had made the patient nauseated and confused, and that she was allergic to penicillin.
• However, as this was an SCR that included additional information, the GP was also able to establish that the patient had a complex medical history and had been prescribed cefradine previously, without any apparent ill effect. 
• The GP was therefore able to successfully reassure the patient to continue with their medication.

Using SCR with additional information to provide continuity of care to a new patient

• A GP saw a 45 year old man who was new to the practice and presented requesting a prescription for medication he had been taking for hypertension.
• Despite the patient appearing well, the GP asked for consent to view their SCR. The GP was able to establish that the patient was an ex-combatant with a history of severe depression and had in the past made a serious attempt on his own life.
• Understanding the patients previous problems helped build an early rapport with the patient leaving the patient impressed with the continuity of care he had received.

This service is live and has been in use since 2010. 

It has approximately 129,000 users per month. 

Approximately 58 million patients have an SCR with additional information.

Usage dashboards can be found at Deployment and utilisation hub - NHS Digital.

It is a gold service, meaning it is available and supported 24 hours a day, 365 days a year.

For health and social care workers

Health and social care workers can access SCR via:

• National Care Records Service (NCRS)
• a local point-of-care application that is integrated with SCR - available in approved care settings
• a local point-of-care application that uses NCRS integration to launch a patient record in NCRS - available in approved care settings

Patients can ask to view or add information to their SCR by visiting their GP Practice.

For healthcare software developers

Healthcare software developers can integrate their software with SCR via:

• Summary Care Record FHIR API  - currently only for GP software
• Summary Care Record HL7 V3 API 
• integration with National Care Records Service (NCRS)

National data sharing GP Connect and Summary Care Record Additional Information

The temporary changes made to GP Connect and Summary Care Record Additional Information in response to the COVID-19 pandemic will continue beyond the end of the Control of Patient Information (COPI) Notice.

Summary Care Records with Additional Information – user research report

Findings from a research project investigating the usefulness of Additional Information in Summary Care Records.

Summary Care Record in community pharmacy

NHS Digital is working to make sure all community pharmacies can view Summary Care Records (SCR). Discover the benefits of SCR and how to view them.

Information governance for Summary Care Records (SCR)

Information governance for Summary Care Records (SCR) is about making sure patient information is secure and only accessed appropriately.

Summary Care Records (SCR) - information for patients

Your Summary Care Record is a short summary of your GP medical records. It tells other health and care staff who care for you about the medicines you take and your allergies.

Additional Information in SCR

Guidance for GP practices to use SCR to make more information available across care settings.

View Summary Care Records (SCR)

Find out about viewing Summary Care Records (SCR), including ways to connect to SCR on the Spine and how to set up your healthcare organisation to view SCRs.

Recording medicines prescribed elsewhere into the GP practice record

The Summary Care Record (SCR) is an electronic record of important patient information created from GP medical records.

Summary Care Record (SCR): GDPR information

Why and how we process your data in the Summary Care Record system, and your rights.

Summary Care Record - FHIR API

Access a patient's Summary Care Record (SCR), an electronic record of important patient information, using our FHIR API.

Summary Care Record - HL7 V3 API

Access a patient's Summary Care Record (SCR) using our HL7 V3 API. Also previously known as PSIS query and GP summary.