The BMA has written to the government calling for a suspension of the programme to upload summaries of patients’ medical records in England to a national database.
In December, the Department of Health announced that the roll-out of the summary care record (SCR) would be accelerated, and doctors have raised concerns that the process is being carried out too quickly.
The SCR is a centrally stored electronic patient health summary to support emergency and unscheduled care. It consists of an initial upload of a patient’s medication and allergies from the GP record.
Anyone who does not want to have a SCR has to opt out by informing their GP or by completing a form either downloaded from the internet or requested from a national call centre. The BMA believes patients are receiving insufficient information about the choices they can make.
GPs have reported that the rushed implementation of the programme means they do not have time to support patients in making an informed choice, and that in some cases records are being created without even implied consent from patients.
The letter, to health minister Mike O’Brien, expresses concern that the roll-out of the SCR has been accelerated before sufficient independent evaluation of pilots has taken place. It calls for the Department of Health in England to urgently consider halting implementation in areas which have not yet launched public information programmes (PIP). In addition, the BMA wants future information packs sent to the public to contain an opt-out form.
The letter says: ‘The UCL independent evaluation found that the PIP had failed to inform patients of their choices, with seven out of ten patients in early adopter areas unaware of the SCR. The BMA’s acceptance of the consent-to-view model was subject to a review of the PIP.
‘We recognise that the PIP is now conducted on a regional, rather than PCT, basis but there has been no evaluation or evidence presented to the BMA that this has significantly improved awareness and that consent is therefore valid. We are also concerned that an opt-out form is not included with the patient information material and patients have to log onto a website to download a form, request a form from a call centre or inform their GP practice.’
The BMA has also issued guidance to doctors advising them that they have a crucial role to play in advising patients about their rights, and recommending that opt-out forms be made available in GP practices.
Dr Hamish Meldrum, chairman of council at the BMA, said: “The break-neck speed with which this programme is being implemented is of huge concern. Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it. If the process continues to be rushed, not only will the rights of patients be damaged, but the limited confidence of the public and the medical profession in NHS IT will be further eroded.”
A Department of Health spokesperson re-iterated that no-one has an SCR created without receiving an individual letter sent to them at the address held by their GP, at least 12 weeks beforehand.
She said: “The SCR is an important patient safety initiative widely supported by clinicians, in particular those working in out of hours and emergency settings, and by the patients they treat.
“We are surprised to have a five year timeframe criticised as a ‘break-neck pace’ when the programme had been previously criticised for its slow uptake. We absolutely support the right of any patient to opt out of having a summary care record and have provided various options to make this process straightforward.”
Is this yet another Govt. IT disaster waiting to happen? Of course, surgeons could save a lot of time and trouble by adopting a similar stance - we could ASSUME consent to an operation unless the patient ‘opted out’! I wonder what the lawyers might make of that as ‘informed consent’?
Of course there are instances when it would be clinically advatageous to be able to get access to a patient’s records in an emergemcy; but the number of such caeses is small in relation to all doctor/patient encounters - it is only when someone arrives in A&E in a coma with no obvious cause. But we must not allow such rare events to change the whole ethical baisis on which the doctor-patient relationship is built. Without POSITIVE (actively sought) consent of the patient, this becomes another erosion of our freedoms; and another step down the road towards a totalitarian State. Beware the argument that the needs of The State outweigh the needs of the individual!
Malcom Morrison has clearly never had to deal with the patient who may be allergic to an antibiotic “but I can’t remember which” or a confused patient with abdominal pain and a scar on their tummy, or the patient on holiday who has run out of their tablets and doesn’t know the name. Anyone who has moved house will be aware it can take anything up to six months for your notes to arrive from your previous GP. And what about those emergency doctors, who troll up to your home in the middle of the night having just got off the plane after a 98 hour shift in Dusseldorf? Wouldn’t you prefer them to be able to have at least a little background information on you as they give you betablockers for your tachycardia, not realising you are also on zillions of inhalers for your asthma? Roll on full electronic records!
I accept APGB’s comments - BUT all these people can give their consent to the A&E doctor accessing their notes