All patients to view and comment on their full GP record by 2018
The NHS has set out a landmark plan to create a ’21st Century’ IT system, including giving patients the opportunity to access all their medical records through NHS Choices, adding comments to their GP medical records and expanding care.data by 2018.
The Personalised Health and Care 2020 report explains how the NHS will go about giving patients digital access to all their records by 2018, and how the CQC will regulate the quality of record-keeping from April 2016.
Under the 2015/16 GMS contract, GPs are required to provide online access to all coded information in the patient record by 2016 for patients who request it and access to summary care information from April next year.
But the latest report goes further, setting out how patients will have access to all their health records through NHS Choices.
GP leaders warned that the ‘information overload’ could lead to ‘noise problems’ for GPs, making it harder to spot important information.
The landmark report, developed by NHS England, the Department of Health, CQC, Monitor and research organisations among others, sets out how they hope to achieve health secretary Jeremy Hunt’s pledge for a ‘paperless NHS’ by 2018, and explains how all NHS providers will have to develop up-to-date electronic record of patients’ care by 2018.
Among the key lines in the report are:
- All care records will be digital by 2020, and GPs will not be using paper records by 2018;
- Patients will be able to access their digital NHS records through NHS Choices by 2018;
- The CQC will regulate on providers’ record keeping from April 2016;
- A consultation on how to provide carers with access to patient’s medical records, due to start in April 2016;
- NHS England will pilot ‘digital care accounts’ where patients hold their care records and personal health budgets, as part of a programme commencing in April 2015;
- Pilots of a ‘personalised, mobile care record’ which will be held by and editable by patients, but which will be viewable by clinicians;
- An expansion of NHS England’s delayed flagship GP record sharing scheme, care.data, to join up information from other providers such as care homes for commissioning purposes.
- This is follow by a pledge that the NHS will move to a ‘whole-system, consent-based’ approach, which respects citizens preferences and objections about how their personal and confidential data is used.
- Introduction of statutory powers for a new ‘National Data Guardian’ role, which will ‘provide public and transparent scrutiny and challenge about the safe use of personal health and care information.’
The report states: ‘From March 2018 all individuals will be enabled to view their care records and to record their own comments and preferences on their record, with access through multiple routes including NHS Choices.
‘Initially, this will focus on data held by NHS providers (primary care, acute, community and mental health), but it will be progressively extended to cover other care settings,’.
It adds: ‘All patient and care records will be digital, real-time and interoperable by 2020. By 2018 clinicians in primary, urgent and emergency care and other key transitions of care contexts will be operating without needing to use paper records’
Dr Peter Swinyard, chair of the Family Doctor Association told Pulse there was a risk of ‘information overload’ for GPs with the NHS striving to add more and more the record.
He said: ‘You get so much information; about such trivia that you get a signal-to-noise problem, and you don’t always hear the things you ought to hear.
‘I’m absolutely in favour of patients telling me what they feel, and what they think is wrong with them. But that’s what I do, I spend most of my life actually trying to interpret what people are telling me,’.
He added there could be legal ramifications too, saying: ‘There is a risk, of course, that if something is slipped into the patient record and we don’t have time to read the entire record during each consultation … I can see the lawyers making a lot of money out of that.’
Dr Grant Ingrams, deputy chair of the GPC’s IT subcommittee said benefits would depend on the scheme’s implementation.
He told Pulse: ‘You have to treat patients as adults, if they are adults, and to use or abuse their data in the way that they see fit.
‘As long as it’s not doing anything which is going to undermine the effectiveness of the record to provide healthcare, and as long as it’s done with foreknowledge of what they’re doing and why, then that’s up to them.’
He said of the new CQC regulatory powers: ‘Something else for the CQC to bash us with it’s not going to be helpful. And made accessible to carers and patients, what the hell does that mean? And what’s timeliness?’
Mr Hunt said: ‘I want the NHS to be a world class showcase of what innovation can achieve. Today’s plan sets out how we can give patients 21st century, personalised healthcare.’
David Behan, chief executive of the CQC, said: ‘Using information from the public and from other organisations is a crucial part of how we check the care that people receive – it helps us to make decisions about where and when we inspect.’