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Letter of the week

Our Summary Care Record fears

From Dr Tim Isaac, Dr John Tabor, Dr Barry Silvert and Dr Chris Woods, Bolton, Lancashire

We are writing to express our concerns about the Summary Care Record and how it is to be implemented in Bolton.

Bolton PCT has written to all patients informing them of the situation, whereby their present confidential medical details will be uploaded on the national spine. In the first stage this will only apply to medication, drug sensitivities and allergies. This is already happening at 11 practices in Bolton. At this point consent is 'implicit' – that is, patients imply their consent by not opting out.This is the first problem. Much can be gleaned from knowing what drugs a patients is taking, so why does the first stage not require explicit consent? Nationally, 67% of GPs oppose implied consent.Explicit consent will be needed for the second stage, but it is not clear yet how this will operate in practice. Each patient must agree the details at each consultation. This will be a complicated process that will lengthen consultations and reduce access to clinicians.Second, there is the problem of confidentiality. The recent exposure of the personal details of young doctors demonstrates the vulnerability of large Government IT systems. No matter how confidential the system is supposed to be, once material is entered, mistakes can happen.Third, there is the matter of cost. The National Programme for IT was initially costed nationwide at £2.3bn. This then rose to £6.2bn and now stands at £12.4bn, according to the National Audit Office. This seems an enormous sum when the NHS is in deficit.There may be advantages to the care record and it would be useful to see it in operation in a handful of practices in Bolton so we could all learn from them. But we need to know the software works. We need time for a full debate and patients need to understand the implications of sharing their details.We believe any attempt to implement the programme at this stage may not be in the best interest of patients.

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