NHS England removes web page hinting at plans for ‘central database’ of GP patient records

Exclusive NHS England took down a web page which hinted at plans to use GP Connect to create a ‘central database’ of GP-held patient records.

A publicly-available open source page, where NHS Digital stores codes, had previously said it was being used ‘to demonstrate that GP Connect can be used for maintaining a central database of GP data’.

GPs told Pulse they were ‘deeply concerned’ about this, with the chair of the BMA’s GP Committee for England saying it would be a ‘misuse’ of GP Connect, which is intended only for direct patient care. 

The codes found on this page would be able to pull confidential data about patients from their GP record, including addresses, medications, and contacts. 

The page was taken down earlier this week but has now been reinstated, and references to a ‘central database’ have been removed.

NHS England told Pulse that the plan for these codes is to develop a simpler way of transferring data from one supplier to another using GP Connect.

However, the information provided on the page indicated the national commissioner has been exploring other uses for this. 

It said: ‘This is a proof of concept for using GP Connect as a means of migrating data between suppliers. 

‘It is also being used to demonstrate that GP Connect can be used for maintaining a central database for GP data and contains a first draft database schema for storing GP Connect data for research purposes.’

The page went on to say: ‘There are currently no unit tests as the aim is to grab the data and prove it is sufficient for our needs but these will come later.’

Open source pages such as this, which display NHS Digital’s coding work, are intended to increase transparency with the public. 

NHS England has said the page was updated as the references to a ‘central database’ and ‘research purposes’ were inaccurate.

GP Connect is a system which allows authorised staff members from across the health and care system to access their patients’ GP records. 

All GP practices in England are mandated to provide access to patient records via GP Connect, and GPs signed an updated data sharing agreement as recently as last year. 

This agreement explicitly said: ‘The use of GP Connect for indirect care or purposes beyond individual care purposes is prohibited.’

GPCE chair Dr Katie Bramall-Stainer said the use of GP Connect is ‘reliant on there being an appropriate need for direct care’. 

She said she is ‘extremely concerned by these findings’ and that ‘every GP’ will feel the same, in their role as data controllers for the medical record. 

In response to NHS England’s claim that this web page was inaccurate, Dr Bramall-Stainer said: ‘My understanding is that this is a public-facing page, so presumably one might assume an internal sign-off process?

‘To be clear, GP Connect is for essential direct care only, requiring clinical permission on an individual basis. It is certainly not for maintaining an NHSE centralised database for the GP medical record.’

Dr Neil Bhatia, a GP and records access lead at his practice in Hampshire, said the ‘whole point’ of GP Connect is that ‘there is no central database’.

He said: ‘It’s very difficult to know whether this is just somebody’s theory, a proof of concept. But I think it’s deeply worrying.

‘This is exactly what’s called mission creep – where you set up one thing, and it works really well and everybody accepts it, and the GPs say “yes this is great, our colleagues can see relevant information, we can see relevant information”. 

‘You then can’t hijack it and say “well now we’re going to use that for what we’ve always wanted, which is to get a database of GP data”.’ 

NHS England told Pulse that no patient data had been accessed or transferred as part of the exploratory test work. 

A spokesperson said: ‘The NHS is continually looking for new ways to improve patient care, and we would always engage with the profession as plans develop. 

‘We are exploring how to improve the way patient data is handled when GP practices move to new IT suppliers, and the NHS will only use GP Connect for direct patient care and not for research purposes.’

An update to the website on Tuesday said that a ‘first draft of the database scheme’ is being shared ‘with a team looking at using GP Connect for direct care’.

In September, NHS England announced £2m of funding for an engagement campaign to gather views from patients on how data in their GP record is used. 

This will include public views on NHS data projects such as the Federated Data Platform (FDP), which has been the subject of controversy among GPs and the wider NHS. 

The health secretary recently suggested that GP data could be included in the FDP, despite repeated assurances from NHS England that the platform will not include GP data at a national level. 

In 2013, the Government announced plans for its care.data programme whereby patient identifiable data would be extracted from GP records and sent to the Health and Social Care Information Centre, which later became NHS Digital – this data could then be anonymised and sent to customers such as NHS England.

Initially, GPs were expected to be solely responsible for informing patients about the programme, however NHS bosses later backtracked on this and announced a major £2m publicity campaign.

The flagship scheme was shelved at the last minute in 2014 and later scrapped altogether in 2016 following a series of concerns raised by GPs and patient groups.

Last year, NHS England indicated it could become a co-data controller of patient records to help relieve individual GP liability.