GPs voice patient confidentiality concerns

Doctors have voiced concerns about how patient confidentiality can be preserved while maintaining the health service's Integrated...

Doctors have voiced concerns about how patient confidentiality can be preserved while maintaining the health service's Integrated Care Records Service.

Dunstable GP Mary Hawking underlined the difficulty of ensuring patient confidentiality. "If you have a central spine that contains all the patient information, which is updated every time there is an encounter with a patient, and needs to provide high-quality information throughout the NHS, how is it going to be kept confidential?" she said.

The ICRS is a core component of the government's £2.3bn national programme to overhaul NHS IT. One of its key functions will be to store millions of electronic patient records.

However, there is growing unease among GPs about the impact of the project. Hawking said, "How do you balance the objective of having information available for clinical care with the patient's desire for confidentiality? It will put me in an extremely difficult position."

Grant Kelly, chairman of the British Medical Association's IT committee, highlighted the importance of ensuring that only the right people can access the data.

He said, "The idea of having the data centrally available is the right one, but access control is extremely important. We need to be aware of levels of access so that people get access to the data that is appropriate for the job that they have to do and not more than that."

In a letter to the Times earlier this year, Paul Steventon, chairman of the Doctors' Independent Network, which helps doctors resolve data problems, said GPs routinely keep detailed patient records of a social, psychological and sexual nature on their practice computers, which are reasonably secure.

"The prospect of a faceless and non-accountable NHS bureaucracy 'controlling' access to vast numbers of intimate and detailed medical records at central locations is deeply worrying," he said.

Getting buy-in from doctors is critical to the success of the national programme, which promises to be the largest technology project ever seen in the UK. Former health minister Lord Hunt and Frank Burns, chief executive of Wirral Hospitals NHS Trust, are just two of the figures who have highlighted the importance of getting doctors on board.

The government is currently working to get greater involvement from clinicians on projects such as the ICRS, and a core team of clinicians at the National Design Authority have been working on the outline specification for the service.

A spokesman for the national programme said the NHS Information Authority and the Department of Health had collected nearly 2,500 responses during a three-month consultation into patient privacy that ended earlier this year. The NHS sought information on a range of issues, including the handling of computerised records and a code of practice for healthcare staff.

In addition to healthcare professionals, suppliers, patients and members of the public also took part in the process. The information from the consultation is currently being analysed, and officials said the results will be used by the Department of Health to finalise a new confidentiality system for the health service. A final report based on the findings of the consultation will be available next month.

Earlier this year, Computer Weekly commissioned a survey by medical specialist Medix UK which highlighted doctors' concerns about the national programme. The research found that only 27% of doctors believe the NHS IT overhaul will deliver significant improvements in patient care.

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