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One in six GP2GP records have ‘significant omissions’

By Laura Passi

Exclusive: One in six electronic patient records transferred between practices via the GP2GP system contain potentially dangerous omissions compared with a patient's full printed records, a practice audit has revealed.

Dr Mary Hawking, a GP in Dunstable, Bedfordshire, analysed 490 patient records transferred through GP2GP to her practice, and graded them on how complete they were compared to the patients' full records that arrived later. She found 16% of the records transferred electronically had 'significant omissions', including some which were missing key diagnoses that were present in the full printed patient record.

GP2GP is widely regarded as the success story of NHS IT, with more than 1.5 million records now having been transferred between almost 5,000 practices. But concerns around data quality have surfaced as the system's use has become more widespread.

Last year, a Pulse survey of more than 500 GPs found that almost half of those who had used it had found the quality of records was not good enough 'to ensure seamless delivery of high-quality care'.

Dr Hawking said that GP2GP, which allows practices almost instant access to the electronic records of new patients instead of leaving them waiting six weeks or more for paper transfers, was a 'marvellous system'. But she warned that in some cases errors or omissions in records could have grave results.

'Quite of lot of things may not be clinically significant but some of it will be,' she said.

'Putting in an unwarranted penicillin allergy, you know the patient may not get penicillin but they won't come to any harm. But if you have got an anaphylactic reaction to penicillin and that is not in the record, then if your independent nurse, prescribing in the community, gives them penicillin, it could kill them.'

Dr Hawking has now launched a wider study in collaboration with the University of Central Lancashire, surveying practices that use GP2GP to discover if the data quality problems, which she said could be due to variations in coding or incomplete summarisation, are widely replicated.

GPC negotiator Dr Chaand Nagpaul said: 'GP2GP is simply a technological process, it is not in itself a process that guarantees the comprehensiveness or accuracy of electronic records. You can never assume that the electronic record is the only source of information.'

'Having said that, the audit raises an issue about the standards of information that need to be recorded in electronic summaries. That may vary from practice to practice and we probably need greater clarity of standards.'

A Department of Health spokesperson said: 'GP2GP is a safe and reliable way of sending patient information between practices.'

'The GP2GP process retains the original content of a GP record, including all read-coded information, and will faithfully transfer what has been entered in the record by the sending practice. The quality of information and how this is held in patient records is the responsibility of practices and local health organisations.'

One in six GP2GP records 'not fit for purpose' GP2GP record quality survey

Fill out the online survey that asks how practices manage incoming records via GP2GP and for practices' views on the accuracy, completeness and usefulness of records received.

Survey open until 25th April.