The Department of Health says it cannot delete patient
records on the Summary Care Records (SCRs) service once uploaded,
because the cost would be prohibitive.
Its
reply to GP Neil Bhatia under the Freedom of Information Act
means that even if patients change their minds about their summary
health records being uploaded to a central database, their details
will not be permanently removed.
The department said to Bhatia in a letter:
"Whilst health ministers have determined that patients need not
have an
SCR if they do not want one, this should not be understood to
mean that once created an SCR can be completely removed.
"Records can be made inaccessible to staff in a number of ways,
but the cost of completely removing them would be prohibitive.
"As with all digital records systems, complete removal would
require the hardware holding records to be completely sanitised.
This is a process that destroys all data held, for example on a
server or hard drive, and not just a particular record.
"Furthermore, the SCR system has been designed in terms of the
functionality required when it is fully implemented and employed
across England.
"When this is the case, the issue of audit and the medico-legal
evidential significance of the SCR will be extremely important and
it would be inappropriate to provide tools that could completely
remove a record, even if this were feasible."
The Department says that a GP practice may authorise the masking
of an SCR and "can accomplish this by uploading a blank record that
has the effect of preventing the previous record from being
accessed".
A GP practice may also hide a record by flagging a record to
indicate that this is a patient's preference. "Once a record has
been masked, it should only be reinstated at the request of the
patient concerned. The process of reinstating a record is
multi-staged and cannot result from human error. A full audit trail
of changes to a patient's preferences is maintained," says the
department's letter.
Bhatia says the summary records will be on the central database
"for eternity" unless patients opt out of having their files
uploaded. They cannot change their minds later, he said.
The Department of Health and NHS Connecting for Health does not
want patients to opt out because too many gaps in the database
would make it all but useless to clinicians and doctors. The aim of
the summary care record is to make information such as adverse drug
reactions available to any clinician anywhere, provided they are
authorised to view the files.
The SCR scheme is in its infancy. It is part of the NHS's
National Programme for IT [NPfIT]. Thousands of SCR records have
been uploaded so far, but the aim is for the database to contain
records on 50 million people in England.
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