Summary Care Records to go ahead, says Department of Health review

A review of the controversial NHS Summary Care Records programme has concluded that centralised electronic patient records are a valuable tool, but...

A review of the controversial NHS Summary Care Records (SCR) programme has concluded that centralised electronic patient records are a valuable tool, but the amount of information they include will be restricted, says the Department of Health.

SCR has been one of the most widely disputed aspects of the £12bn NHS National Programme for IT (NPfIT) with critics highlighting the privacy and security issues of allowing widespread access to patients' medical history.

But a review by NHS medical director Bruce Keogh says a record containing only critical information will be good for emergency or unplanned care, when clinicians would not otherwise be able to find out about medical conditions.

Previous plans could have seen more of a patient's medical history stored in the SCR, but now it will only contain a patient's demographic details, medications, allergies and adverse reactions, to ensure safe treatment. Any additional information will need explicit consent from the patient, who will also have the right to view the record at the point of care.

"In an advanced national health care system it is reasonable for citizens to expect that when they arrive in Accident and Emergency or require treatment out of hours that clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions," said Keogh.

A separate review by NHS director of patient and public affairs Joan Saddler said patient communication about the SCR needed to be improved.

Controversially, SCR has been made an opt-in service, which assumes all patients want an SCR record created unless they tell their GP otherwise. More than 30 million people have been written to already, and opt-out rates have so far been negligible, but critics have said the letters did not adequately explain the process.

Sadler recommended awareness-raising campaigns at local, regional and national levels to ensure people realise that a Summary Care Record is being created for them, unless they choose to opt out. In future, all patients contacted by letter informing them that a record will be created, will have an opt-out form and pre-paid envelope included.

"If we really want patients at the heart of care, the availability of core, personal and medical information when patients need care is essential," said Sadler.

"They must also be given clear and simple information about the Summary Care Record and the choices available to them. Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use."

So far, three million SCRs have been created, according to the Department of Health. The SCR is one of the few central NHS IT programmes retained by the coalition government, after a decision to scrap the NPfIT and decentralise IT purchasing to individual NHS trusts.

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