A Patient Care Record (PCR) is a document or electronic record that contains important information about a patient’s health, treatment, and care. Its main purpose is to ensure that healthcare professionals have accurate and up-to-date information to provide safe and effective care. NHS guidance describes a patient record as information created in connection with a person’s diagnosis, care, or treatment.
A Patient Care Record may include:
- Patient demographics (name, CHI number, date of birth, contact details)
- Medical history and diagnoses
- Current and past medications
- Allergies and adverse reactions
- Clinical assessments and observations
- Treatment and care plans
- Test results and investigations
- Records of medicines administered
- Communications between healthcare professionals
High-quality patient records are essential because they support clinical decision-making, continuity of care, patient safety, and legal documentation.
In a community pharmacy or palliative care setting, a patient care record might also include details of medicines supplied, pharmaceutical care plans, interventions made by the pharmacist, and any discussions with patients or carers. For example, NHS Highland documents refer to recording patient details, administration of medicines, and care-related information in the patient record or notes.
If you’ve used PCR before but need a new password, contact the ePharmacy Helpdesk: 0131 275 6600 (Mon–Fri)