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GPs go forth

NHS bans practices from sending notes on CDs contrary to DH guidance

Exclusive NHS England has banned practices from sending patient information on CDs or memory sticks, despite Department of Health good practice guidelines allowing it.

A primary care support service bulletin sent this month prohibits practices from using CDs or USBs ‘for information governance reasons’ where the NHS electronic record transfer system - GP2GP - is unsuccessful.

Instead, it states, every practice must ‘print out a full and legible copy’ of the patient record.

GPs and practice managers have said that this represents a 'massive waste of resources', with one LMC calling for its retraction.

GP leaders criticised NHS England's stance, warning that GP2GP was unreliable, and that using USBs and CDs should be acceptable until the problems with the record transfer system were fixed.

Practices are continuing to report problems with the movement of patient records since Capita made changes to the system in 2016, a move that saw huge backlogs of records and one case where they ended up in a car park. LMCs recently said that these issues were ongoing, and is ‘potentially risking patient safety’.

But although CDs are moved in the same way as paper records, the latest Primary Care Support England bulletin sent to practices says: ‘For information governance reasons, patient records should not be copied and sent on CDs or mobile storage devices.’

NHS England told Pulse as ‘background’ that it had concerns about the long-term viability of CDs and USB sticks, as well as issues with the security of an encrypted CD compared to printed notes.

But Richard Miller, a practice manager in Great Bentley Surgery, Essex, says that all practices within his region have digitised their patient notes and send new patient information on a CD rather than by printout.

He added: ‘In my CCG, practices have had their entire paper note archive digitised so other than printing out reams of paper, this is the only way to move the data.

‘Obviously unnecessarily printing out entire records is a massive waste of resource in practices not to mention the significant increase in fuel used to physically transport them between practices.’

'I’m very concerned about the confusion this will cause with thousands of CD ROMS being in the transfer process already as a normal and acceptable method of transfer'.

GPC IT lead Dr Paul Cundy told Pulse transferring notes by CD ‘wasn’t ideal’ but practices were making the best of it while IT systems provided by the NHS fail to work as expected.

Dr Cundy said: ‘Ideal would be GP2GP working, but until it does then this is acceptable as an alternative to printing reams of paper.’

He said NHS England’s advice to print records ‘in full’ was wrong and practices only needed to print or send the bits of the record record that couldn’t be sent electronically.

He told Pulse: ‘Only certain transfers between certain versions of the accredited GP2GP versions can guarantee 100% success in transferring all the records. This generic statement is dangerously naïve.’

Humberside LMC's latest newsletter states: 'It is the LMC’s view that it is perfectly acceptable for records to be provided on CD providing that the information is encrypted. We have raised the issue nationally with GPC and a formal request has been made for PCSE to issue a correction'.

An NHS England spokesperson said: ‘GPs should ensure all patients’ data is treated with privacy and security, in line with NHS England policy and best practice guidance.

‘GP2GP is the quickest and most secure way of transferring patients’ electronic clinical record between practices.’

Please note: This article was changed at 14:25 on 27 October 2017. It originally said that this was contrary to the GMC's Good Practice Guidance. This should have said contrary to DH's Good Practice Guidelines for GP electronic patient records

The problems with Capita's movement of patient records

Practices have complained about the extra work and waste entailed by the new system for records movement commissioned by NHS England from Capita.

Patient records must be individually bagged and barcoded before being sent to the next practice.

When the scheme first launched in 2016, practices were left with piles of notes as a result of NHS England underestimating the demand on the contract, and Capita being slow to increase the capacity of its couriers.

It also included one case where they ended up in a car park.

LMCs recently said that these issues were ongoing, and is ‘potentially risking patient safety’.

Readers' comments (8)

  • Vinci Ho

    Remember those days we had black vinyl record players and tape recorders?
    Then it came CDs , DVDs , blue ray discs etc.
    What do our youngsters do now? Downloading and streaming.
    While our health secretary is so obsessed about digitalised technology, smartphone apps and Skype , it is difficult to fathom why NHSE wanted to revert to all papers as CD is clearly a good compromise if the full technology is not working . The other obstacle could be Capita , somehow, refusing to comply ?? (I take the point there might be difficulties with encryption in CDs)
    Well , perhaps NHSE is really a bunch of nostalgic geeks who prefer black vinyl to anything else ?

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  • I have just stopped my secretary from sending paper notes, as this was using and wasting a huge amount of her time. We now send CDs and will not be reverting to paper. NHSE should think about the effect on frontline services before issuing these edicts. If my secretary is wasting time printing off vast reams of paper, then not only is this increasing our staff costs at a time when our MPIG is being cut, but will result in delays in referrals and other important secretarial work, with delays and patient harm.

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  • I'm struggling with the logic of this. How exactly is an encrypted CD riskier than a pile of printed paper? This seems to be an example of 'information governance' being used as a barrier rather than an enabler.

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  • Can any contributor please identify the cumulative NHS total wasted "investment" in failed/abandoned - "state of the art" - "definitive" Computerisation / I-T projects which should have resolved this costly and outdated administrative process?

    To the nearest £billion would suffice, over the last 20 years.

    Surely sufficient to address the vast and increasingly recognised underfunding and excessive workload, demands and demoralisation of the highly valued and vital primary care backbone of the NHS?

    Thank you.

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  • @Troughtastic
    Are you suggesting that NHS England are being delibarately obstructive?
    With their past perfect record of helpfulness toward General Practice.
    How very dare you sir!

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  • National Hopeless Service

    We have a lot of new housing development in our practice area. We are receiving bags full of expansive paper notes which are taking up huge amounts of office space for no purpose.

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  • Why are Practices bothering to encrypt the data on CDs?
    Paper notes are not only not encrypted, but can be read immediately without even needing a computer!
    I once passed a flat-bed van in town centre with LLoyd-George folders in open boxes in the back - I could have reached in and grabbed a few, as could any passing person! Had they been CDs, the information would have been unreadable.

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  • You cannot underestimate the work load, and cost, of transferring written records to electronic records, and also whether the coding is done with accuracy. Provided there is governance around the sharing of CD records, what is the difference in security between paper and CD records? I would say CD records/electronic records offer more security and accuracy.

    Once electronic records are downloaded there should not be an issue of permanence as this record forms part of the general record data base. The CD can then be destroyed after the download.

    Once again we are managed by people that do not understand the cost and time restraints of general practice, and have an outdated notion as to the security and permanency ( please don't have a fire or flood!) of paper records.

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