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BMA wants consent on all uploads

Patients should give explicit consent after every consultation for new information to be uploaded to the national spine, the BMA has told an inquiry

by MPs.

The BMA stands alone among the organisations that have submitted written evidence to the Health Select Committee inquiry on the care record system in wanting to see explicit rather than implied consent for uploads.

Other organisations, including the Medical Protection

Society and the GMC, believe a system where patients were

required to actively opt in would be time-consuming and unworkable.

Privacy worries top the list of concerns in the BMA's submission, which argued that patients 'must have the right to prevent the sharing of their

detailed care records beyond

organisation boundaries'.

Patients should be able to share their summary care information nationally without sharing detailed care information on a regional basis, the BMA said. It wants patients to be offered a range of options.

The BMA also called for more training and resources for the Caldicott Guardians whose job it will be to protect a patient's confidentiality, and warned there were 'unanswered questions' regarding the extra workload GPs would face.

But the MPS said an opt-in model would 'place an unrealistic administrative burden on highly pressed clinicians'.

It said: 'The level of work involved in gaining each patient's express consent would be completely disproportionate to the potential benefit.'

It also questioned whether information of a highly sensitive nature should have been included in the pilot phase of

the system, which is currently under way in Bolton.

The GMC said patients should have the right to opt out of the care record system and the sharing of their information. It said GMC guidance on

confidentiality, which requires GPs to seek patients' consent before sharing or using their personal information, was 'drafted in an age of simpler local or area networks'.

It said: 'We are not in a position to assess the security arrangements of care records and it would not be reasonable to expect doctors to do so.'

Last month the GMC confirmed that GPs who follow Connecting for Health procedure would not be liable to disciplinary action in the event of a patient complaint.

The Health Select Committee is expected to publish all written submissions before it

begins taking oral evidence on 26 April.

Contrasting views on care record

BMA – 'Patients should play a central role in deciding what information, if any, is shared and checking for accuracy. It is the BMA's view that explicit consent should be obtained.'

MPS – Proposals for explicit consent 'are wholly unworkable and would place an unrealistic administrative burden on highly pressed clinicians, particularly in the primary care sector.'

GMC – 'We are not in a position to assess the security arrangements of the care record system and it would not be reasonable to expect doctors individually to do so. Of course, if doctors have concerns about data security, we would still expect them to raise concerns where they believe that patient safety is compromised.'

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