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Background

A number of MI centres are choosing not to record some/all of what they perceive as simple enquiries on MiDatabank. The options being used are to not record simple enquiries at all or to record simple enquiries in a different way, e.g. daybook, spreadsheet etc.

The UKMi Quality & Risk Managment Group (QRMG) has considered the implications of this practice and recommended that:

  • all enquiries received should be recorded contemporaneously on MiDatabank.
  • UKMi enquiry answering standards should be updated to include this.
  • a revised paper should include suggestions of how to reduce the time taken to record simple enquiries on MiDatabank.

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What is an enquiry?

The UKMi QRMG has previously issued guidance on what should be documented as an enquiry. This states that ‘Any request for information or advice that requires any professional judgment/knowledge or access to recognised UKMi reference sources about medicines whether it is a general enquiry e.g. for a presentation/review or for a specific patient’. This guidance is not specific about where/how the enquiry should be documented.

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Why should enquiries be documented?

There are a number of reasons:

Enquirer Returns

If the enquirer forgets what you have said or loses your reply, and asks to be reminded of the answer, you have a record which means that you don’t have to do the enquiry a second time. In addition, the enquirer may come back to you with new details concerning a completed enquiry and ask you for new information.

Work-saving

If you are asked a similar enquiry by someone else at a later date, looking back at an enquiry you have already done can give you a head start.

Complaints

If an enquirer complains that you gave an incorrect or misleading answer, or were slow to respond, you have documentation to support how you acted. This is also important if what you did had any impact on a legal case.

Education

Recording enquiries gives MI staff a basis for training staff that are new to MI: completed enquiries can be used to show pharmacists and technicians ‘how to do it’ and illustrates the range of enquiries that are asked. Completed enquiries can also be used as articles in bulletins or at training events.

Workload Statistics

Documenting enquiries enables MI staff to provide workload statistics to support their value to the healthcare community. Some commissioners may make it a requirement of funding the service that such data are made available. Documenting workload may be even more important in the light of the recommendations of Lord Carter of Coles report and their implications for the provision of MI services.1 The RPS (now Royal College of Pharmacy) benchmarking metrics for acute hospitals (now archived but content noted as still supporting good pharmacy practice)2 highlighted that patient focussed medicines information enquiries were considered a clinical activity and time taken to complete these should be included in the metric “% pharmacist time spent on clinical activities”. This is very easy to report on if all enquiries are entered in MiDatabank.

Specialities

Provision of information on local custom and practice may not be recorded as it may be viewed as routine for the specific centre.

User Satisfaction Survey

May become unrepresentative of overall workload as questionnaires can only be sent out for recorded enquiries.   

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Why are some centres choosing not to document simple enquiries on MiDatabank?

Anecdotally this would seem to be because they perceive that the time taken to document the enquiry on MiDatabank is disproportionate to the amount of time spent answering the enquiry. 

There would also appear to be a concern that only documenting one resource e.g. own knowledge on MiDatabank is inappropriate and that additional resources would need to be consulted and documented if the enquiry was to be entered onto MiDatabank. 

Related to the above is a view that only documenting one resource on MiDatabank e.g. own knowledge may be viewed unfavourably in an audit.  This is not the case; as long as this approach is justifiable. It may be helpful to consider adding a standard statement that the one resource was considered appropriate at the time of answering. 

There may also be a view that simple enquiries are unlikely to have a significant impact on patient care. However anecdotal evidence from published studies of the impact of MI on patient care, clinical outcomes and medicines safety3,4 found that some, apparently, simple enquiries were considered by expert panels to have a relatively high positive impact.

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What are the risks associated with simple enquiries not being documented on MiDatabank?

The risks are mainly (but not wholly) associated with the reasons for recording enquiries given above. 

Enquirer Returns

Applies to simple enquiries although it could be argued that the length of time taken to redo/add to the enquiry is still less than documenting it originally on MiDatabank.

Work-saving

As for enquirer returns above.

Complaints

This applies equally to simple enquiries as to more complex ones. 

Education

This applies to simple enquiries – it is arguably more important for trainees, rather than experienced MI staff, to enter all their enquiries on MiDatabank.

Workload Statistics

Having an accurate record of all enquiries handled is important for a number of managerial reasons.

There are additional potential risks associated with not documenting simple enquiries in MiDatabank. These include:

Practice extension

It is possible that MI staff will inadvertently, or deliberately, extend the practice of not recording enquiries in MiDatabank to more complex enquiries.

Inappropriate classification of enquiries as simple

This may be a particular problem for trainee or junior staff.

Enquiry becomes more complex during research

It is sometimes the case that what, at the time of receipt, appears to be a simple enquiry becomes more complex when it is being researched. In this instance the enquiry would need to be entered on MiDatabank during the research stage. 

Errors

Evidence from UKMi incident reporting shows that a common cause of errors is not documenting the enquiry as it’s being undertaken ie a number of incidents have come to light when the enquiry was documented in MiDatabank retrospectively. It would be reasonable to assume that similar incidents may occur when enquiries are not documented in MiDatabank at all but as they aren’t documented the incident doesn’t come to light.

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Suggestions to improve recording of all enquiries in MiDatabank

  • Use of headsets allows enquiry to be recorded straight onto MiDatabank at the time of receipt.
  • If it is time-consuming to put information into correct boxes on MiDatabank when enquiry is received – put all information in question box at the outset and copy and paste it to correct position later.
  • Using generic enquirer titles e.g. ‘Junior Doctor’. The specific enquirer’s personal and contact details are recorded in the ‘Contact for this enquiry’ box. This saves time looking for an enquirer and checking that they haven’t moved organisation. It also reduces the number of duplicate enquirers entered. 
  • It is usually necessary to confirm the information/answer provided in more than one resource. However on occasions when an individual, using their professional judgement believes that one resource, including ‘own knowledge’ is sufficient to provide an answer to an enquiry – it is acceptable to do so and to document as such in MiDatabank.
  • Consider drafting ‘standard paragraphs’ using the ‘insert special fields’ button on the answer page on MiDatabank – to cover why brief search and/or only one resource was appropriate.
  • Awareness that the purpose of an enquiry assessment is to ensure that the analysis, resources used and answer given were appropriate to the enquiry asked and the situation/circumstances at the time. Standard statements/paragraphs could be used at the time to indicate this to anyone looking at that enquiry at a later date.

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Implications of not recording enquiries on MiDatabank

  • MiDatabank/MIDBOnline has been adopted as the standard electronic enquiry management system by UKMi for use in MI centres in the UK.
  • This decision was made because MiDatabank/MIDBOnline offers functionality that was deemed to be critical to practice in MI centres.
  • Key functions/features of MiDatabank/MIDBOnline include robust audit trail, secure access (login/password), backup facilities, search facilities, SSPs, statistical analysis, security of logged patient and enquirer details, DM+D coding and a core library of resources.
  • Any other system used for recording enquiries should at least have the same functionality to ensure all information governance issues are met.
  • If an alternative system is used which does not meet these requirements a risk assessment will need to be undertaken locally.
  • Any alternative system used will need to be regularly reviewed to ensure that it is still being used appropriately and that it continues to meet the requirements of the risk assessment. 

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References

  1. Lord Carter of Coles. Operational productivity and performance in English NHS acute hospitals: Unwarranted variations. February 2016.
  2. RPS benchmarking metrics for acute hospitals. March 2018 (archived).
  3. Innes AJ, Bramley DM and Wills S. The impact of UK Medicines Information services on patient care, clinical outcomes and medicines safety: an evaluation of healthcare professionals’ opinions. Eur J Hosp Pharm 2014;21:222–228.
  4. Bramley D, Innes A and Dass N. Impact of Medicines Helplines on patient satisfaction, patient outcomes and medicines safety for hospital patients: the development of a rating scale and an evaluation of patients’ opinions. Eur J Hosp Pharm 2019;26:301-307.

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Last Reviewed - Oct 2026