Pioneering NHS trust reports "excellent progress" with summary care record

Bolton Primary Care Trust – the first in England to test the summary care record as part of the NHS’s National Programme for IT [NPfIT] – has reported “excellent progress”, though the scheme has met some strong local resistance.


The summary care record is a database of basic medical information run on the national data “spine”, which is supplied by BT. It will include information – initially allergies and medications – which could be useful to doctors who are treating patients unexpectedly or out of hours.

Some GPs want a reliable and well-stocked database of patient information to be running as soon as possible. Others refuse to allow summary data on their patients to be uploaded to the spine, fearing that it will not remain confidential.

The Bolton trust board was told this month that “despite some delays outside of our control, excellent progress is being made as the Primary Care Trust has already uploaded summary patient records for 48,000 patients in Bolton and is soon to go live with access to the summary care record in the out-of-hours service and the Primary Care Trust’s walk-in centre”.

The board was also told that “over 50% of practices have indicated their willingness to be involved in the summary care record project and during 2008 we will continue to work and engage with practices in order to maximise the number of patients in Bolton who have a summary care record.”

But staff at the trust also concede that the project has “attracted a degree of controversy across GPs in Bolton, with some wishing to be involved and others not at this stage”.

The Local Medical Committee has balloted 169 GPs in the Bolton area on whether they want to proceed with the summary care record. Only 20 were in favour of the scheme, though about 70 did not respond to the question. Of the 98 who responded, 67 did not want to proceed. I’ve covered this in more detail in a separate blog entry which includes a comment.

Links:

Trailblazing GPs want Care Record scrapped – Pulse magazine – 22 October 2007

Letter sent by Bolton Primary Care Trust to patients about the summary care record trial

Will national database of patient records have a 50% shortfall?

Comments of Health Committee MPs on the Summary Care Record

Policy of the British Medical Association on the summary care record and the NPfIT Care Records Service – August 2007

Bolton GPs first to take part in trial of summary care record

More GPs to introduce summary care record

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The instructions sent by Bolton to GPs include the advice that parents may opt out on behalf of their children, but in the case of an older child, if the parents choose to opt out the GP should make an appointment to see the child and decide if the child is 'Frazer competent' and the parents can be overruled.

This is a complete misunderstanding of the legal position, which is in any case about 'Gillick competence' - Lord Fraser being the lead judge in the House of Lords case.

He delivered a judgment that a child could consent to certain medical procedures *so long as certain criteria were met* - not least that the child herself refused any parental involvement and the clinician couldn't persuade her otherwise.

He warned that the judgment should not be seen as a licence to disregard parents' wishes whenever it was expedient to do so, and that he would expect a clinician to be disciplined if that were the case.

It is alarming how often Gillick competence is now being misused in order to justify data-sharing. More, while a GP is qualified to assess a child's competence to consent to a medical procedure, s/he is no more qualified to assess competence to consent to data storage and sharing than the man on the Clapham Omnibus.

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