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A faulty production line

All patients to view and comment on their full GP record by 2018

The NHS has set out a landmark plan to create a ’21st Century’ IT system, including giving patients the opportunity to access all their medical records through NHS Choices, adding comments to their GP medical records and expanding by 2018.

The Personalised Health and Care 2020 report explains how the NHS will go about giving patients digital access to all their records by 2018, and how the CQC will regulate the quality of record-keeping from April 2016.

Under the 2015/16 GMS contract, GPs are required to provide online access to all coded information in the patient record by 2016 for patients who request it and access to summary care information from April next year.

But the latest report goes further, setting out how patients will have access to all their health records through NHS Choices.

GP leaders warned that the ‘information overload’ could lead to ‘noise problems’ for GPs, making it harder to spot important information.

The landmark report, developed by NHS England, the Department of Health, CQC, Monitor and research organisations among others, sets out how they hope to achieve health secretary Jeremy Hunt’s pledge for a ‘paperless NHS’ by 2018, and explains how all NHS providers will have to develop up-to-date electronic record of patients’ care by 2018.

Among the key lines in the report are:

  • All care records will be digital by 2020, and GPs will not be using paper records by 2018;
  • Patients will be able to access their digital NHS records through NHS Choices by 2018;
  • The CQC will regulate on providers’ record keeping from April 2016;
  • A consultation on how to provide carers with access to patient’s medical records, due to start in April 2016;
  • NHS England will pilot ‘digital care accounts’ where patients hold their care records and personal health budgets, as part of a programme commencing in April 2015;
  • Pilots of a ‘personalised, mobile care record’ which will be held by and editable by patients, but which will be viewable by clinicians;
  • An expansion of NHS England’s delayed flagship GP record sharing scheme,, to join up information from other providers such as care homes for commissioning purposes.
  • This is follow by a pledge that the NHS will move to a ‘whole-system, consent-based’ approach, which respects citizens preferences and objections about how their personal and confidential data is used.
  • Introduction of statutory powers for a new ‘National Data Guardian’ role, which will ‘provide public and transparent scrutiny and challenge about the safe use of personal health and care information.’

The report states: ‘From March 2018 all individuals will be enabled to view their care records and to record their own comments and preferences on their record, with access through multiple routes including NHS Choices.

‘Initially, this will focus on data held by NHS providers (primary care, acute, community and mental health), but it will be progressively extended to cover other care settings,’.

It adds: ‘All patient and care records will be digital, real-time and interoperable by 2020. By 2018 clinicians in primary, urgent and emergency care and other key transitions of care contexts will be operating without needing to use paper records’

Dr Peter Swinyard, chair of the Family Doctor Association told Pulse there was a risk of ‘information overload’ for GPs with the NHS striving to add more and more the record.

He said: ‘You get so much information; about such trivia that you get a signal-to-noise problem, and you don’t always hear the things you ought to hear.

‘I’m absolutely in favour of patients telling me what they feel, and what they think is wrong with them. But that’s what I do, I spend most of my life actually trying to interpret what people are telling me,’.

He added there could be legal ramifications too, saying: ‘There is a risk, of course, that if something is slipped into the patient record and we don’t have time to read the entire record during each consultation … I can see the lawyers making a lot of money out of that.’

Dr Grant Ingrams, deputy chair of the GPC’s IT subcommittee said benefits would depend on the scheme’s implementation.

He told Pulse: ‘You have to treat patients as adults, if they are adults, and to use or abuse their data in the way that they see fit.

‘As long as it’s not doing anything which is going to undermine the effectiveness of the record to provide healthcare, and as long as it’s done with foreknowledge of what they’re doing and why, then that’s up to them.’

He said of the new CQC regulatory powers: ‘Something else for the CQC to bash us with it’s not going to be helpful. And made accessible to carers and patients, what the hell does that mean? And what’s timeliness?’

Mr Hunt said: ‘I want the NHS to be a world class showcase of what innovation can achieve. Today’s plan sets out how we can give patients 21st century, personalised healthcare.’

David Behan, chief executive of the CQC, said: ‘Using information from the public and from other organisations is a crucial part of how we check the care that people receive – it helps us to make decisions about where and when we inspect.’


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Readers' comments (29)

  • Great way to divert GP time away from the ill, answering endless questions on whether what they had for breakfast last Tuesday was correctly documented. I look foward to spiralling litigation where every 'missed' diagnosis can become an opportunity to sue the tax payer claiming apparent clinical negligence. With the state of our economy and the NHS, is this really appropriate use of public money ? (answers on a postcard please - not)

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  • Hmm.

    Another "radical" nationwide IT-based NHS project.

    Good job there's no recurrent history of such projects being expensive disasters, isn't it?

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  • What is this obsession with IT and access? Can they not just concentrate on the basics that need fixing rather than spending more billions distorting medical records for other purposes? Is there actually public demand for this? I am not aware that the question has ever been asked or featured in any political manifestos. I, for one, don't have a burning desire to see my GP's notes

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  • If you do not wish to read your notes nobody will be forcing you.fact is though that many people do and are still afraid to even ask for access to their own medical information

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  • Anon@9.55
    Where is the evidence that "many people" both want to read their notes and are afraid to ask? It so wasn't my point but why "afraid" to ask?

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  • Why?? Seriously, Why?, what for? This is going to cost billions, and why, oh why?
    Someone help me, "other healthcare professional"??
    What do you think is so interesting or valuable??
    Someone explain

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  • I actually think that this is a great idea - but can we go further? We need to challenge the old fashioned notion that records should be an accurate dispassionate account of facts, recorded by professionals with no agenda. That approach does nothing to consider my feelings and agenda.
    I would love to be able to access and alter the records that show I was caught doing 37 in a 30 zone and the opportunity to make "corrections" to my Bank accounts would be wonderful.
    If UKIP don't adopt this as policy then I will be forced to vote for the Monster Raving Loony Party who surely will, along with the proposal that Nursing Homes also have the power to access and alter our records.

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  • I'm a different OHP to the other who commented, but I know many patients with LTCs who wish to access their own notes regularly as they are the ones doing the majority of the management of their diseases.

    It can be very helpful for patients to check their own results online and to check clinic and referral letters and would save patients from phoning or making an appointment.

    As mentioned by Grant Ingrams, patients are adults and I'm really not sure why this has to be an issue. There may be plenty of patients (healthy people, elderly people who aren't online) who don't care to see their records but there are a substantial number of self-managing patients who would benefit from access.

    If records are online, links could be made to an online glossary that explains medical terminology.

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  • I cannot see a true benefit here for doctor or patient worth the expense. Think about it - it will generate a great deal of additional work for the GP. Meanwhile, in the room down the corridor in the DoH , another civil servant is trying to attract young doctors into general practice. Where's the joined up thinking?
    Thankfully 2018 is my pencilled- in last year

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  • There is a big risk that the notes will become swamped with utterly useless chaff.

    Of equal concern is the possibility of having conversations in the medical record - gp records consult, patient challenges it, gp replies etc, and you end up with pages of entries like this one or the BBC have your say type, and nobody knows where they are in the end.

    This will make the records potentially clinically unsafe and I have no doubt that in the end some harm will be done.

    I'm in favour of patients being able to see their record but I am firmly against them being able to edit or record in them. These notes are where GPs record their clinical findings, and should not be a generic smorgasbord of opinions from anyone who wants to chuck in their own ha'pennyworth.

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