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Rule for care record opt-out

Patients who do not want to have a Summary Care Record will have to apply for exemption under a clause in the Data Protection Act on the grounds it would cause them 'substantial damage or distress.'

Connecting For Health guidance sent to every GP in England last week outlined how the care record system will work when it is rolled out.

It advises that 'if patients are concerned about who can see their care record, the most appropriate option is to choose the "dissent to sharing" position'.However, patients who request not to have a care record at all will be required to sign a form indicating this.

They will be exempted under section 10 of the Data Protection Act, which means that they believe having a Summary Care Record would cause them substantial damage or distress.

The GP will be able to veto this. Dr Paul Cundy, chair of the GPC IT subcommittee, said: 'This is at odds with Lord Warner's confirmation that people who did not want a Summary Care Record would not have to have one. It's completely inappropriate for GPs to decide whether or not patients are going to be distressed by this.'

But Dr Gillian Braunold, GP clinical lead for Connecting for Health, said that in practice patients who declined to have a care record would not be challenged. 'You don't have to prove that you've suffered distress – the form doesn't say that,' she said.

'The tool that we're using is section 10 because that was the legal advice Connecting for Health was given.'She added that some GPs had been confused by the guidance, which had been sent in case early adopter pilots in Bolton triggered patient enquiries elsewhere.

The guidance was sent as a precaution, she said, and GPs not involved in the early adopter scheme would not need to take any action for now.Meanwhile the Medical Defence Union has advised its members that the implied consent model may contradict existing GMC guidance.But a GMC spokesperson said: 'GPs following the reasonable processes laid out by Connecting for Health will not be liable to disciplinary action by the GMC.'

Options for patients

Participate: Have a Summary Care Record uploaded to the spine that can be accessed by other health professionals

Not share: Have a care record uploaded but opt out of allowing access by other health professionals with a legitimate relationship

Opt out completely: Refuse to have a care record by signing a form under section 10 of the Data Protection Act

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