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CAMHS won't see you now

Summary Care Records for all by end of 2008

Every patient in England will be able to have a Summary Care Record by the end of 2008,

according to Connecting for Health.

The prediction came as

guidance explaining the

early adopter implementation process, which will begin in April, was issued to strategic health authorities and trusts.

Initially a small number of practices in a single PCT will be chosen to use the Summary Care Record. It will then be rolled out to more practices in that PCT, and then into a second PCT.

This will be followed by a

second wave of practices going live in the latter half of 2007.

The two early adopter waves will involve 2.5 million patients and be evaluated before 'full rollout across England by the end of 2008'. The evaluators have yet to be appointed by Connecting for Health.

A pilot of the HealthSpace service, which will allow patients to access their clinical

information online, will be run alongside the early adopter

programme from May or June 2007.

Professor Mike Pringle, GP clinical lead for Connecting for Health, said most, if not all, patients should have a Summary Care Record by the end of 2008.

'We expect and hope for a very significant proportion,' he said. 'Everything depends on how well the early adopters' experience goes.'

However Dr Paul Cundy, chair of the GPC's IT subcommittee and a GP in Wimbledon, south London, warned that such a tight deadline would leave little time for thorough evaluation of the early adopter implementation.

'I think it's premature to prejudge the evidence of the pilots,' he said. 'The evaluation needs to be about whether it

improved patient care, had no effect on patient care at all or if it may have harmed patient care. That's not something you can quickly evaluate.'

The guidance also details how the implied consent model will work (see left), and how patients can opt out.

Connecting for Health plans to send guidance to all GPs 'very soon', explaining in detail how the Summary Care Record and implied consent will work.

Dr Cundy said the GPC would continue its campaign for an opt-in rather than opt-out system.

'Implied consent is a very easy argument to make prior to uploading 56 million patient records, but once 56 million patient records have been uploaded into the ether, patients may have a very different view of implied consent,' he said.

How implied consent works

• If patients do not choose to

opt out, an initial text-based summary of medications, allergies and adverse reactions will be uploaded to the spine.

• If they opt out, they can choose to dissent from sharing but still have this basic information uploaded. Alternatively they can opt for no summary to be stored, meaning this information will not be available later if they change their mind.

• After the initial upload, patients will be able to limit the data by asking their clinician to remove specific items from

the summary ('tailoring'). Alternatively a blank summary update that overwrites the text summary can be sent to ensure no clinical data is stored but that demographic data remains.

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