Hants GP wants explicit consent for SCR
Fiona Barr writes in the online medical magazine EHI Primary Care:
A GP practice in Hampshire has recorded opt-out requests for the Summary Care Record from 20% of its patients.
The Oaklands Practice in Yateley, Hampshire, has run a five year information campaign for its patients on the SCR and pledged not to upload any records without explicit consent.
It has now received requests from other GP practices in different parts of the country asking for information and advice on running SCR information drives, following the launch of Public Information Programmes in five strategic health authorities.
Dr Neil Bhatia, a partner at the practice who has led the campaign, said the practice had yet to record a single request from a patient to have an SCR.
However, Dr Bhatia said his practice had not put 93C3 Read codes – “refused consent for upload to national shared electronic record” – on every patient’s record as some practices had done and it was not boycotting the project.
He told EHI Primary Care: “Nobody has given their consent at the moment, but we have said quite clearly that if they want one we will ask the PCT to create one if it decides to go-head with the project.
Meanwhile, Dr Gillian Braunold, the clinical director for the NHS Summary Care Record Programme, writes on Guardian Comment is Free:
Inquiries into cases such as those of Penny Campbell, Maria Caldwell, Victoria Climbié and Jonathan Zito all emanate from different parts of the health service. They have one recurring theme: if key information was available at a time when the risk is highest, the vulnerable, the sick and the old would be better protected.
The NHS has invested in a clinical record system called the summary care record to enable this information sharing to happen when patients receive unscheduled and emergency care. We know that patients have concerns about confidentiality and have gone through rigorous processes to ensure that the right levels of security and patient consent are in place. This means that you have an absolute right to opt out of having such an electronic record. It means you can change your mind at any time. And it means your permission will always be asked before a nurse or doctor accesses the record.
March 13th, 2010 at 18:45
Dr Gillian Braunold carefully writes:
However, if you try to withdraw from the SCR after a Record has been created for you, the data in “your” SCR will not be deleted, merely hidden from medical staff. Although doctors and nurses should ask you before accessing your record, nothing physically prevents them looking without asking, as did a Scottish Doctor curious about Gordon Brown’s health records. And while Doctors and nurses should ask, Sir Humphrey is allowed to rootle through the SCR without asking if he thinks it’s “in the public interest”.
References:
Records can be accessed without consent “in the public interest”:
http://www.connectingforhealth.nhs.uk/systemsandservices/scr/documents/scrcmodelptv.pdf
Security of Scottish records breached:
http://www.dailyrecord.co.uk/news/scottish-news/2010/01/10/doctor-who-hacked-into-prime-minister-s-health-records-escapes-prosecution-86908-21955907/
Once accessed, SCRs cannot be deleted (see item 28):
http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/faqs/mpsfaqs
March 13th, 2010 at 22:02
“the vulnerable, the sick and the old would be better protected”
If that were really the point, they should make SCRs available to “the vulnerable, the sick and the old” and leave everyone else out, at least to start with: that way they may be able to afford some meaningful SCR system which benefits patients rather than the bureaucrats.
In any event, no one (including the “the vulnerable, the sick and the old”) should have an SCR without explicit and informed consent. This should be a case of opting in not opting out.