The Government should not introduce online access to medical records as part of a DES until ‘serious concerns’ have been addressed, including an ‘enormous’ increase in workload and data security issues, the GPC has warned.
Patients will be able to access their full medical records online under the Government’s proposal for a new DES, which will also reward practices who offer patients the ability to book appointments and order repeat prescriptions online.
However, in its response to the Government’s proposed contract changes, the GPC argued that patients should be given access to a more limited set of data, similar to a summary care record, rather than their full medical notes.
The GPC wrote: ‘We do not believe that online access to medical records should be included within the DES, either in the first or second year.
‘We believe that it would be more sensible to give patients access to a more limited set of data in the form of a summary care record, rather than all coded data and free text. This could mitigate some of the risks and concerns highlighted here.’
The evidence does not support the DH’s claim that the benefits ‘in future years’ to improve online access will include reduced administrative workload for GP practice and reduced administrative costs for the wider NHS, the response added. The increase in workload for practices would be ‘enormous’ as practices would have to support patients understanding their records and deal with questions from those who had viewed it.
The response cited research which showed that the introduction of an online record access system had led to a significant increase in encounters between GPs and patients.
The GPC also voiced concerns over confidentiality, security and verification with regards to online records. It argued patients could be put under undue pressure to reveal clinical information by third parties such as insurance companies, or other individuals, for example an abusive partner, bullying employer or controlling parent. This could have the unintended consequence of preventing patients from seeing the GP for sensitive matters.
Furthermore, the response said that allowing patients to access their records alters the purpose of a medical record as a tool for clinicians and will mean records may be ‘less useful’ in future. It said records often act as aide-mémoire for clinicians and contain relevant third party information so GPs would have to alter what they write in records to make it patient-friendly. Thy might also become less likely to record concerns that could inform another colleague reviewing the notes.
The GPC also said the other elements of the online DES will widen health inequalities. The proposal to allow patients to book appointments online more easily would reduce access for those less able to use online services, they added.