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Care Record rollout suspended amid revamp of consent

By Steve Nowottny

NHS IT bosses have launched a dramatic revamp of plans for electronic care records, with the rollout of the project suspended and an immediate change to the model of consent.

Connecting for Health announced the initial six early adopter areas for the Summary Care Record would now all convert to a ‘consent to view' model.

Patients' care records will still be uploaded under implied consent, but they will now be asked for explicit consent every time their record is accessed.

IT bosses, in their much-anticipated official response to May's damning evaluation of the Summary Care Record project, also slammed the brakes on plans to roll out care records beyond the initial six early adopter areas.

The wider rollout will now not start until next April and is likely to take a further two to three years to complete – putting back full implementation to 2011. Connecting for Health had told SHA heads last year that every patient in England would have a Summary Care Record by the end of 2008.

The delay comes after the independent evaluation of the early adopter sites – led by researchers at University College London – found the consent model had caused widespread confusion among GPs and patients.

Dr Gillian Braunold, clinical director for the Summary Care Record, said the new consent model had been considerably simplified.

‘We were asking people hypothetically about how they might feel in a situation in future,' she said. ‘Now we will be asking them Yes or No at the time they are seeing a clinician.'

‘The very fact that we had to have an aide memoire on doctors' and nurses' desks defined for me that there was a problem with the old system.'

Connecting for Health claimed its new model had received the backing of all the major stakeholder bodies, including the BMA.

But while the BMA welcomed the change, it warned security concerns remained.

Dr Vivienne Nathanson, the BMA's head of science and ethics, said: ‘We would also like reassurance that the security of the Summary Care Record is such that only people with a legitimate reason to view electronic health records are able to do so and that audit trails are in place.'

GPC chair Dr Laurence Buckman said: ‘The BMA is only fully onside when BMA council says it is – and BMA council isn't meeting until this week.'

Dr Paul Thornton, a GP in Kingsbury in Warwickshire, said: ‘Consent to view proposals do not sufficiently provide patient control because they can be overridden or bypassed.'

A loophole remains

Connecting for Health's U-turn over the Summary Care Record consent model has been generally welcomed. But privacy campaigners are warning a major loophole remains.

Patients will continue to have a Summary Care Record uploaded under implied consent, and clinicians will require patient consent each time they access a Summary Care Record.

But unscrupulous members of staff could simply override the request for consent by telling the computer they had spoken to the patient.

As a result, much hinges upon the audit trail. Connecting for Health said that privacy officers would be likely to check the audit trail. For instance, they could ensure that anyone accessing a celebrity patient's records had a valid reason for doing so.

NHS care record: national rollout suspended NHS care record: national rollout suspended

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