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.”

Patients don’t have enough information about electronic patient records and their roll out should be slowed down, the BMA has warned.

Following some local piloting, patients’ summary care records are set to be uploaded to a central database across England.

The summary care record (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.

Dr Grant Ingrams, chair of the GP IT Committee, said: “The care record roll-out is now happening too hastily. While we believe it has the potential to improve both the quality and safety of patient care, we are concerned at the speed because it means patients are very unlikely to be aware of what they are automatically being enrolled into.

“We don’t believe the national roll-out needs to be or should be done in a hurry. We would like to see it rolled out carefully area by area in a properly supported and evaluated fashion.”

The NHS in England has adopted a ‘consent to view’ model which means that a patient will automatically have a SCR created unless they choose to opt out. However, they should be asked explicitly, on each occasion, before their summary record is viewed, for example during out of hours care or when they go to A&E.

Five strategic health authorities recently announced they were speeding up their plans.

John May, from the BMA’s patient liaison group, said: “An independent evaluation of the regional pilots found that seven in ten patients in those areas weren’t aware of the SCR, which meant they also weren’t aware that their details would go on to a national database. There needs to be a higher profile national information campaign to ensure everyone can make an informed choice about whether or not they want to be included.

“We also think it is important that opting-out is made easier.”