The two main suppliers of GP IT systems – EMIS and TPP – have confirmed they will not switch on automatic patient access to their records via the NHS app tomorrow.
Patients were set to be given automatic access to their prospective patient records through the NHS app from 1 November – starting with EMIS and TPP, and with other smaller suppliers to follow at a later date.
However, the RCGP has advised GP practices to consider opting patients out of the programme on the grounds of patient safety.
And the BMA last week suggested that system suppliers who turn on automatic patient access to their records without the explicit consent of practices may be acting illegally.
In order to roll out access through the NHS app, IT suppliers will have to allow this through practices’ systems.
But EMIS said on Saturday that it ‘will not be making any practice-level system changes’ on the planned go-live date.
It said this comes as ‘many’ GP practices have asked it not to switch on automatic patient access to their records ‘due to GDPR and/or patient safety concerns’.
In a post on an EMIS Facebook group seen by Pulse, country director for England at EMIS Group plc Karen Bonnett said: ‘We have received requests from many GP practices asking us not to make the system change due to GDPR and/or patient safety concerns.
‘This is a complex issue and we have been in constructive dialogue with NHSE, over the past few days, on an appropriate way forward.’
She added: ‘We continue to be in dialogue on these matters and we can confirm that we will NOT be making any practice-level system changes to EMIS Web until we have a clear path forward.
‘We will continue to update you as we know more.’
TPP (SystmOne) said it will take the same stance, in a statement posted today on an internal daily noticeboard for TPP practices, seen by Pulse.
It said that it too ‘will not be making any practice-level system changes to SystmOne’ until it has ‘a clear path forward’.
It added: ‘For all stakeholders in this process, patient safety and compliance with GDPR are important priorities.’
TPP has also received ‘many’ practice requests not to go ahead, with lots saying that ‘they require more time to be ready for the proposed change’, it added.
The BMA’s GP Committee for England said it was ‘pleased’ with the news.
Deputy chair Dr David Wrigley said: ‘Patient safety is at the heart of what we do, which is why any changes to the system – particularly default ones – should be carefully thought through.
‘We hope that following EMIS and TPP’s decision, NHS England will now also rethink how this roll-out is going to work, and ensure that every practice is given the time and resources it needs to properly prepare in the interests of both patients and practices, especially at a time of intense pressure on general practice. We remain keen to engage with NHS England on this project going forward.
‘In the meantime, the BMA is compiling new guidance for practices on what to do going forward and in support of patients.’
Meanwhile, one local commissioner has recommended that practices apply an ‘opt-in’ approach to automatic records access following a ‘clinical safety review’.
In an email sent to practices on Friday, North Central London integrated care board (NCL ICB) said that its ‘clinical safety report’ concluded that ‘the safest option is to enact an opt-in solution’.
It added: ‘When patients then request access, you will then have the opportunity to review records for any content that may cause harm to the patient or disclose third-party information.’
The ICB said local practices should take ‘immediate action’ to allow an opt-in process and ‘prevent global access being automatically activated’ by applying a SNOMED code to the full practice list before 1 November.
NCL ICB is ‘confident’ that this decision is ‘in keeping’ with practices’ contractual obligations, it added.
However, practices will not currently need to take this action if all suppliers delay the scheme’s launch.
NCL ICB said the principle of records access is ‘a good thing’ and that it will issue ‘further guidance’ to practices ‘in the next few weeks’ about how it can be rolled out ‘in a safe way that is manageable in primary care and protects our most vulnerable patients’.
The BMA had previously suggested that an opt-in system might be the ‘safest and most effective’ way to roll out patient access to their records.
The road to prospective records access so far
NHS Digital had first intended for patients whose practices use TPP to be first to have access to new entries in their GP notes through the NHS app from December 2021 – with EMIS practices to follow this year.
But the launch date was delayed until April 2022 for both systems, after the BMA wrote to NHSX expressing its concerns about the timing of the rollout.
It was then delayed again, with NHS England recognising concerns around ‘safeguarding’.
Meanwhile, Pulse revealed earlier this month that NHS England plans to enable patients to request their historic GP records through the NHS App from next year, as well as prospective records access.
READERS' COMMENTS [13]
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You couldn’t make this stuff up. Outrageous high-handed behaviour, who are EMIS (or even worse TPP) to decide if patients can have access to their own medical records. RCGP twaddle about working in partnership with your patients – all just more college hot air. BMA as a trade’s union should know better. And GPs who believe they know best for their patients – come on. The mindset of the Rees Mogg’s nanny et al is over? The last squirms of some in our GP family in leadership roles to try and prevent patients having full access to their medical notes is just futile, they should be ashamed of themselves, it’s just change, it’s going to happen if not tomorrow then next week or next month, just get over yourselves and embrace the change and get ahead of it.
Nigel, I advocate patients records being available but it seems clear you can’t understand the data protection risks in releasing records and the accidental inclusion of 3rd party information, especially if this progresses to retrospective access. The data laws in combination with NHS IT provision and lack of skilled staff leave huge risks. And then there is the risk of misuse of record access in abusive relationships. its all very hard and impossible to get truly right..
You must have a lot of free time on your hands to ’embrace the change’ Nigel Dickson. We unfortunately are not so fortunate. I am very happy to embrace free access, not so happy to be held responsible for any potential harms as imposed Data Controller, certainly not happy to redact and re-redact, certainly no capacity to explain what a mildly elevated ESR means and why I marked it as normal. Then there is the can of worms that is correspondence, unactioned results from sources like secondary care to deal with. Remove me as responsible for these issues with unfettered access accepting there may be some harms and we are good to go. But if the access is as suggested, then unlike you, I need time to ensure that the data I am being held responsible for releasing causes no harm despite your Rees Mogg assertions
Nigel. The minute our clinical systems automatically redact sensitive problem list and consultation information (such as multiagency conferences identifying victims / perpetrators of domestic violence) – great! Any system change that potentially exposes vulnerable people to additional risk without first quantifying that risk is (IMHO) unacceptable.
If access to records was simply a case of reminding someone when they had their laparoscopic cholecystectomy, what their last lithium level was or allowing them access to their most recent hospital clinic letter, turning on access for all as planned would be far less contentious.
Kind regards
Niel
Good points all – I humbly stand corrected.
One was looking forward to them reading about panic attacks, cocaine, argumentative behaviour and DNAs ; perhaps they’re not ready.
The benefits will far outweigh the harms and delays will never address all the risks.
I think time to get on with it.
Sam Tapsell, are you a partner who will be the one dealing with the law suits and complaints when it does so? If so, how are you preparing for this? If not, then speak to somebody who is and who will be rightly worried about where one incident goes wrong and it costs a fortune in time and legal fees…
Emis web is bought by Optum, a subsidiary of the US corporation United Health.
You’re just a gimmick trial run for the world. But with lawyers, and no NHS backing.
Nigel Dickson – a quick Google search tells me you may have retired in 2015. Please do share if this is incorrect.
It’s so easy to be a keyboard warrior and criticise everyone in a leadership role. I am one of those people in a leadership role and I have been campaigning for more safeguards to be put in place.
This will explain all the reasons why:
https://www.pulsetoday.co.uk/views/opinion/whose-notes-are-they-anyway/
Better to do your research before insulting people’s leadership next time
Dear Shaba, thank you for the personal insults I may no longer be a single handed GP but as a GP locum on the performers list I am used to personalised attacks. Any chance of an apology? Best wishes Nigel
If this goes through I’m probably going to set up shop as a professional adviser to patients. Show me your full set of notes and I’ll supply you with a critical commentary for your solicitor to make merry with. Well, someone’s going to do it!
I suspect the vast majority of GPs are ignoring all this in the vain hope it might just go away.
Given that we haven’t the time, skill nor inclination to police the redaction of thousands of medical records, most of us will squat in the corner with our fingers in our ears humming “tra-la-la”, then deal with the fallout (that we are in reality powerless to prevent) when it happens with a weary shrug and a wistful glance at the calendar to see when we can afford to retire from this unholy mess.
This could be the NHS’s worst self-inflicted wound yet, and that’s up against some pretty stiff competition.