This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

Care homes to update GP records 'daily', says Hunt

Health secretary Jeremy Hunt has said care homes will be given the ability to make daily updates to GP records as part of his plans for ‘named GPs’, in what the BMA has described as a potential ‘minefield’ for patient confidentiality issues.

Mr Hunt said integrated care can only be achieved by medical record sharing between GP surgeries, hospitals and social care services and that the ‘named GP’ plans, agreed as part of the 2014/15 GP contract deal, will hold a ‘big opportunity’ for care homes.

But GP leaders criticised the health secretary, calling for the Government to concentrate on implementing the agreements made as part of the contract negotiations, and warning that this will be a ‘minefield’ for patient confidentiality.

This follows the contract agreement, which stated that GPs will only be obliged to offer patients basic information from their records by 2015, in a significant row-back on earlier Government promises of a ‘revolution’ in the way patients access their healthcare information online.

In a recent parliamentary questions session, Mr Hunt told MPs: ‘If we are to give integrated, joined-up care, in which people deal with NHS professionals who know about them, their medical history, their allergies and all the other important things, it is vital that, if they give their consent, their medical record can be accessed. That needs to be from GP surgery to hospital to social care system.’

He added: ‘Under the named-GP policy that we have announced, there is a big opportunity for care homes to access GP records and keep them updated daily, so that GPs are kept in daily contact with how some of the most vulnerable people are doing.’

However, yesterday the GPC hit back at the claims made in Parliament on 26 November, with chair Dr Chaand Nagpaul pointing out that no such plans have been negotiated with the profession.

Dr Nagpaul told Pulse: ‘Certainly that does not form part of contract negotiations. I think it is important to actually establish the current contract changes first, before we move on to other things – the most important thing is to establish current changes and let them take effect. To allow GPs to work with current changes is the greatest priority, because there is a lot of change next year, to be sure that GPs can deliver that change effectively.’

GPC negotiator Dr Beth McCarron-Nash added: ‘I don’t think that the answer to everything is that every man and a dog has to have access to GP records. I think that there can be other ways of making sure that nursing homes flag up patients who they feel are unwell and raise concerns to practices, which are not about access to records.

‘[Mr Hunt] may think that that is something that we can just allow to happen but as we all know, patient confidentiality, and the robustness of that record, is absolutely paramount. So I cannot see this as something that will happen widespread across the country because it is an absolute minefield.’

She added: ‘As we know, NHS England has pushed very hard for full and open access to patient records. I think that it is very important that patients are involved in their healthcare decisions and they have a right to know what is in their records – currently they can ask to see their full record – but there are certain caveats about that. There needs to be safeguards in place. GPs are wary of issues around IT security, and these issues need to be addressed. Then there is the whole issue of vulnerable children and adults, people who are abused and so on. The whole issue needs careful planning, and obviously there are huge implications on workload for practices.’

An NHS England spokesperson said: ‘NHS England and the GPC have agreed to undertake joint work during 2014/15 to explore how to deliver consistent access to the detailed patient record for other care providers.

‘This work is in development and is ongoing and we are not in a position at this stage to confirm or rule out care home access and the governance arrangements for that.’

The Government has set out plans for the NHS to be ‘paperless’ by 2018, including handing patients online access to their own GP record, saving £4.4bn in the process.

Readers' comments (19)

  • Dear Mr Hunt
    I can tell you right now that no care home is going to write one word in any of the records that I hold on patients. If you are interested i hte reason why, it is because such entries will be inaccurate, misspelt, ridiculous, critical of the GP, and most probably written in the wrong patient's notes.
    Perhaps you should consult the profession before opening your mouth - just a thought.

    Unsuitable or offensive? Report this comment

  • His first name should be Whatack

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    we just 'love' you,agent Hunt....

    Unsuitable or offensive? Report this comment

  • It is very interesting that this record sharing is only in one direction. There is no suggestion that we will have access to hospital records, or those from social services, district nursing etc. in a recent multidisciplinary meeting we asked the social worker for a list of patients receiving care. She refused to give it to us citing " confidentiality".
    The legal 24 hour responsibility will be with us, but with no suggestion of us being able to access information from other agencies to help.
    This is a recipe for meltdown.

    Unsuitable or offensive? Report this comment

  • You know, I'm beginning to think I'm giving Hunt more credit then he deserves. I thought he is trying to destroy primary care for his own gain but he might actually be doing it from pure stupidity.

    We've been having a long battle with or local hospice who have access to our record. They use it as nursing record and there are so much daily dribble I can't actually separate useful information from daily input of 'bowel opened, patient washed, goal achieved, breakfast eaten etc etc'. Even if the nursing home agrees to make daily update, they will not be able to input record in useful manner.

    And that's even before we discuss the time lost in writing over actual care on patients. Francis report Mr. Hunt?

    Unsuitable or offensive? Report this comment

  • Daft Hunt

    Unsuitable or offensive? Report this comment

  • Life is funny...in how one fails to identify correctly, what one is dealing with. Just when you think you are actually seeing an Ignorant minister at work, an absolute imbecile turns up. You think you have just about got used to his squealing and he starts braying loudly. I think its time to get a saddle!!!!

    Unsuitable or offensive? Report this comment

  • This just serves to show how little mr hunt actually understands about GPs, their work and what good medical notes mean.....very worrying.

    Unsuitable or offensive? Report this comment

  • Dear Mr Hunt, I don't know who is feeding you these wild suggestions but please, speak to some real doctors before coming out with guff like this. GP notes are packed with confidential medical data, compiled for the purpose of providing medical care. Care home staff do not need and should not have access to patients' detailed medical history and as a GP, I certainly do not need daily updates about all my care home patients.

    Unsuitable or offensive? Report this comment

  • medicine tastes awful

    This Mr Hunt(the buck stops not with me man) wants to pass liabilities and responsibility to the GP - carer would file in daily update reports??--your patient refused her medication today, your patient missed her meal, your patient has a headache, your patient went to toilet 4 times today, etc etc etc. all this 24/7 365 days daily updates. The GP needs to UPDATE himself daily for all his patients??? Is this man kidding me!!!!

    Unsuitable or offensive? Report this comment

  • RE Above

    Maybe consider a Doctor who is a GP with GPwsi in elderly care who exclusively works with care homes in particular CCG area- or paid on hourly/pro rota basis and could be 24/7. Mr Hunt this doctor who is fully liable and accountable and buck stop here, would come at a massive cost to you.

    Unsuitable or offensive? Report this comment

  • The only way out of this mess is to become a salaried service.Micro management is only going to get worse.Why is it that the profession will not accept this.Salaried would mean that you do your shift and that would be it.No worries about all this rubbish being spouted by Hunt and co.

    Unsuitable or offensive? Report this comment

  • Anon@8.14 - perhaps because some of us can see where this would lead and would prefer to be allowed to go back to doing the job we used to love for the benefit of patients. I think it is naive to imagine that micromanagement would cease were we to become salaried drones.

    Unsuitable or offensive? Report this comment

  • I am not sure my care home patients really want their carers knowing that they had a miscarriage or abortion when they were much younger.

    In many cases their children do not even know.

    Unsuitable or offensive? Report this comment

  • It is fair to say that care home staff are not medics. Their note writing is not appropriate for medical needs. I don't really need a daily update on what she had for lunch.

    Unsuitable or offensive? Report this comment

  • Obviously, it should not just stop with nursing home patients - I think it is vital that all our patients provide us with an hourly update of their health. Hunt has to be joking, right?

    Unsuitable or offensive? Report this comment

  • I am retired now but I can remember when physios etc could write in the medical notes rather than in their own file.
    It was a nightmare trying to track down important information within reams of [no doubt important] PAM notes.
    Another important fact completely missed in this rush for opening notes to all and sundry is that GPs need to document every last thought that goes through their minds when assessing a patient including negative findings.
    How will patients and relatives feel when they read about all of the very worrying things going through a GPs mind when trying to make a diagnosis.
    You may think that it is part of the partnership between doctor and patient that the patient understands what the doctor is eliminating but start doing this with children and we will end up with extremely upset parents who may never settle back into the entirely reasonable blissful ignorance about their childs' health.

    Unsuitable or offensive? Report this comment

  • Mr Hunt knows exactly what he is doing here - this is all a trojan horse for the real agenda, which is privatisation. Care home workers having access to medical records and clogging up the screen with daily updates on bowel motions is a red herring. It is the care home PROVIDERS that we should be concerned about. By loosening GPs' grip on the patient record it allows private providers the all-important access to patient data so they can carve off bits of NHS GP activity for profit. Only last month we heard he wants pharmacies to have access to patient's records. I'd like to think Mr Hunt is genuinely acting out of good motives - but his faith in the market, competition, and the profit motive in delivering better healthcare is simply mis-placed.

    Unsuitable or offensive? Report this comment

  • As the big bad wolf here, please be fully informed that I have no intention of writing in little Red Riding Hoods diary.
    Seriously as a responsible mental health care provider we talk to and inform our GP's and CPN's, notifying important changes, which we write up in our records.
    Why on earth do we need primary care notes to copy file!

    PS. Fed up of Social Care Providers referred and treated as a bolt on to Primary Care, as very obvious from some anonymous comments, yearh Go "Team Health".

    Unsuitable or offensive? Report this comment

Have your say