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Care record system is under way

The Government's long-awaited plan to create a national system of summary care records finally got under way at two practices in Bolton last week .

The 14,500 patients affected received letters explaining how the system will work. They have eight weeks to decide whether they wish to opt out.

Otherwise details such as their name, address, allergies, prescriptions and any previous adverse reactions to medicines, will be uploaded to the spine in a summary record.

Bolton PCT hopes to involve more practices in the area over the coming months, and Con-necting for Health plans to roll out the system in seven PCTs by the end of the year.

Dr Paul Cundy, chair of the GPC IT subcommittee, predicted that although the initial opt-out might be low, patients would be increasingly likely to opt out as the rollout gathered pace and their awareness grew of what shared records meant

.'I think more and more people will opt out when they understand this is not a summary care record, this is an ongoing accumulation of everything they tell their GP.'

He added that some GPs would also be 'reluctant' to participate. The GPC has been campaigning for an explicit consent model where patients have to opt in to record sharing rather than implied consent where information is uploaded unless patients object.

Dr George Ogden, a GP at Kearsley Medical Centre, one of the two Bradford practices trialling the shared-care records, said: 'We did have concerns initially but the information going out to patients is quite clear about the ability to opt out.

'I understand the BMA's point of view but we think there are benefits, given the safeguards in place.'Dr Julie McMillen, from the second practice involved, Bradshaw Brow, said she thought other GPs in the area would come on board as they found out more about the system.

'I think there are a lot of concerns,' she said. 'But the more I found out about it, the happier I was with the system.'

Chris Russ, associate director of IT at Bolton PCT, said that while the implied consent model would be used for summary care records, full informed consent would be sought from patients before further detailed information was uploaded to the spine.

'It can happen at any potential point in time following a discussion between the patient and GP,' he said. 'That's where the explicit consent comes in.'

Professor Mike Pringle, joint GP clinical lead at Connecting for Health, admitted guidance issued to strategic health authorities last month stating that summary care records should be in place across England by the end of 2008 was over-optimistic.

'We won't necessarily have every health community and every practice involved by the end of 2008, but we will have got a significant proportion of the country,' he said. 'Obviously a lot will depend on the political climate and the support we can get from the profession and the public.'

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