British Medical Association sends open letter on NHS National Programme for IT

Below is an open letter sent by Dr Hamish Meldrum to Ben Bradshaw, Minister of State for Health Services, on the National Programme for IT.

Among other things it says there should be “no further roll out of the Summary Care Record (SCR), beyond the six early adopter Primary Care Trusts”, until an independent review has been completed.

The summary care record is part of a plan, under the NHS’s National Programme for IT [NPfIT], for a national database of electronic health records, called the NHS Care Records Service. The summary record would initially contain basic information such as the patient’s date of birth, address, details of allergies, current prescriptions and adverse reactions to medicines.

Hamish Meldrum is a GP Principal in General Practice and chairman of the General Practitioners Committee of the British Medical Association.

This is the letter, dated August 2007:

“The National Programme for IT (NPfIT) is an important but contentious aspect of health policy. I would like to take this opportunity to express the BMA’s hopes, to raise our concerns and to suggest recommendations as to what the programme should deliver to support patient care. I hope this will help inform debate at this crucial time for re-defining the future of the programme.

“The BMA wants to see the programme succeed. We recognise that there have been some successes. We believe that with a change in leadership it is an appropriate time to review progress and set out a clear strategy for the future of the programme.

“At the BMA’s recent Annual Representatives Meeting, doctors from both primary and secondary care expressed their frustration about the programme. Doctors called for a public inquiry to review the problems encountered by Connecting for Health (NHS CfH), the cost to the tax payer and whether this has been a cost effective use of public funds.

“The BMA believes there are some essential steps that must be taken to sustain successful delivery.

(i) Renewed engagement with system users

1. Provide greater clarity about the NPfIT Local Ownership Programme, how it will improve engagement and what it will mean for clinicians and patients.

2. Introduce an open, two-way reporting mechanism, which allows users to highlight problems with systems and suppliers to feed back what steps are being taken to address these issues and within what timeframe.

3. Renew engagement and confidence by delivering some quick wins, focusing on areas which are proving successful and holding a series of secondary care roadshows to listen to feedback and address misconceptions

4. Work with the BMA to address the continuing issues with Choose and Book.

(ii) Generate confidence in the Summary Care Record

5. No further roll out of the Summary Care Record (SCR), beyond the six early adopter PCTs, until the independent review has been completed and ways forward have been agreed by the Summary Care Record Advisory Group.

6. Work with the BMA to agree a code of practice/service level agreement for uploading information onto the SCR.

7. Seek a definitive legal opinion on the issues raised during the Health Select Committee hearings concerning the legality of the SCR and the Data Protection Act in relation to EU directives that can be agreed with the profession and patients alike.

8. Work with the BMA, Medical Defence Organisations and patient organisations to agree the final Public Information Campaign material so that together we can persuade PCTs to use an agreed standard package of information.

(iii) Tackle implementation issues in Secondary Care

9. Negotiate a choice of systems for secondary care within an agreed framework.

10. Establish a national implementation checklist, which must be completed before the implementation of any Patient Administration System.

11. Incorporate information governance and electronic records into the medical student curriculum and allow medical students access to the SCR.

(iv) Provide clarity about the Secondary Uses Service

12. Provide clarity about the Secondary Uses Service (SUS) including creating an area on the new NHS Choices website where patients can view details of how data is used for Secondary Uses.

I have provided further detail in the enclosed paper. I hope that these recommendations provide a helpful insight into our concerns, and that they inform your discussion. I would welcome your view on how we might work together on these recommendations.

I look forward to hearing from you.

Dr Hamish Meldrum

Chairman of Council


BMA letter and other material

Useful information on the National Programme for IT – wiki of 23 leading acdemics

Gordon Brown government rejects review of the National Programme for IT

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