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Care Record trial ignores call for explicit patient consent

Thousands of patients are being told they will have a Summary Care Record created for them unless they opt-out - just weeks after an official evaluation called for the controversial implied consent model to be scrapped.

The continued rollout of care records under the implied consent model comes despite comments from Connecting for Health's clinical director for the Summary Care Record that she now supported a model requiring explicit patient consent.

The independent evaluation into the Summary Care Record early adopter programme, published earlier this month, found the current consent model was ‘overly complex and unworkable', and warned two thirds of patients who had given implied consent were unaware of the project. It called for a switch to a ‘consent-to-view' model, requiring explicit consent every time a care record was viewed.

But one of the early adopter areas, Dorset PCT, last week pushed ahead with the care records rollout, sending letters last week informing patients that the programme would be proceeding on an implied consent basis.

A spokesperson said: ‘Patients registered with named practices will have 16 weeks to make a decision. Unless a patient dissents, these practices will automatically create Summary Care Records.'

The move comes despite strong indications from Connecting for Health that it might be ready to scrap implied consent. Dr Gillian Braunold, clinical director of the Summary Care Record, backed ‘consent-to-view', arguing it would be ‘much more acceptable both from the professional and patient perspective'.

The Summary Care Record Advisory Group met last week to discuss the evaluation's findings, but a final decision on the consent model and other recommendations is not expected until later this summer.

Dr Jon Orrell, a GP in Weymouth and clinical lead for the Summary Care Record project in Dorset, said: ‘These letters were planned some months ago, and the report came out in the middle of that mailing process, so these new letters don't take any account of the evaluation report's suggestion.'

It has also emerged that the Treasury has yet to approve the business case for the national rollout of the Summary Care Record.

Documents obtained by Pulse under the Freedom of Information act reveal that in January, Connecting for Health bosses expected the business case to be approved by the end of March.

Care Record Care record consent Care record consent

Implied consent
The current consent model. Patients are sent letters and given the option of uploading but not sharing a Summary Care Record, or opting-out altogether. If they do nothing, a Summary Care Record will be automatically created for them and uploaded.

The new consent model recommended by the evaluation report, supported by the BMA and already in place in Scotland and Wales. Records are uploaded as above - but patients are asked for explicit consent every time their Summary Care Record is accessed.

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