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Independents' Day

Q&A: The Summary Care Record rollout

What are Summary Care Records?

A Summary Care Record (SCR) is an electronic record held on a central database which contains details of allergies, current prescriptions and bad reactions to medicines. A patient and their doctor can add additional information to the patient’s SCR with their consent after this is created.

Connecting for Health says that SCRs will ‘assist in improving the safety and quality of patient care, by providing authorised healthcare staff with easier access to reliable information about the patient to help with treatment’.

Summary Care Records are being rolled out in England but not in the devolved nations.

Can patients opt out?

Patients are sent a Public Information Programme (PIP) mailing which contains information on the records and opt out forms. Patients have 12 weeks to opt out.

Who can access SCRs?

Healthcare staff ask patients if they can look at their SCR every time they need to. Healthcare staff only have access to an SCR if it is necessary for them to see the record to do their job.

What are the concerns over the SCR scheme?

There are concerns over the ethics of the ‘implied consent’ model. The GPC and LMC leaders warn that many patients do not open the PIP mailing or do not understand it, and therefore records are effectively being created without informed consent.

Problems with the use of smartcards mean some SCRs may not be up to date with the patient’s latest information and there are fears GPs or other healthcare professionals using the record subsequently would have no way of knowing that this was the case.

Last week it was revealed by Pulse that some SCRs had been mistakenly created for patients who had not been informed that they would be, raising fresh concerns over consent and information governance.

How many SCRs have been created so far?

As of the end of December, 3,031 GP practices have had SCRs created for 21,835,022 patients. Official figures released in April 2012 showed that SCRs were consulted in under 1% of OOH consultations, although this figure may have since changed.

How many patients have opted out?

As of the end of December, 41,560,182 had received a PIP mailing containing information about SCRs. Some 1.34% of patients opted out.

Readers' comments (3)

  • It is not only for OOH the benefit. Hospital pharmacists are using it for medication reconciliation and to my knowledge, here in Leeds, it is very popular.

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  • If the SCR is to be of use then it must be accurate, up to date and complete. As the only person who can be held responsible for this is the GP, then they must be obliged to ensure that every entry for all of their patients is correct. This means that all current medicines are included from what ever source they are obtained and to regularly check that the patient is taking them and had no adverse effects.
    All laboratory reports must be scrutinised to ensure that they are accurate and are from samples taken from their patient, therefore they should exclude, until verified, any results that are unexplained outliers, especially if they relate to examinations not raised directly by themselves.
    The problem as I see it is that if a GP sees their patient in their surgery, they will assess the patient and check any recent results or medication. If they have any doubts about information they see they can decide to check a result, ignore it or make a reasonable judgement of how it should influence their treatment.
    The OOH or A&E department has no such prior knowledge or ability to assess the value of the data.
    Another problem for reliance on the SCR is the positive identification of the patient, particularly in unusual locations such as A&E. With currently 21,000,000 records how do you identify them, given that we are not yet chipped or bar coded? Especially if the patient is confused or unconscious and the person who accompanies them could be poorly informed source of information, even if well meaning? The elderly patient who is always known as Doris could really be called Millicent or Dorothy. How many John Smith's are there and how many are known as Jack or use their middle name, of George or Dave?
    I have excluded my record from the SCR until I can be assured that every detail from every source is correct and until there is a positive patient ID system in place so that I am treated as me and not someone else with the same name. Mean while treat me as you see me and not according to the computer.

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  • The low usage of the SCR is because clinicians never bothered to engage with the planning, help to iron out flaws in the system, encourage software houses to link in the SCR, or, worst of all, offer any alternative approaches. The blame lies therefore squarely with the doctors and their leaders.

    I speak as a patient, whose safety continues to be compromised by the lack of an effective remote record.

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