Exclusive The Summary Care Record programme should be scrapped because only a small proportion of records are being accessed and the current utilisation rate means each viewing to date has effectively cost an estimated £1,200, the GPC’s IT lead has said.
Dr Paul Cundy, chair of the GPC’s information technology subcommittee and a GP in Wimbledon, south London, said that while almost 23 million Summary Care Records (SCRs) have been created, they are being accessed in just 98 of the several thousand institutions such as out-of-hours services and hospitals eventually intended to use them.
In an exclusive interview with Pulse as part of our Big Interview series, Dr Cundy said he believed the Government should ‘pull the plug’ on the entire SCR programme, although he later stressed he had been speaking in a personal capacity and that the BMA’s policy remained that the SCR should ‘stand on its merits’.
According to the latest NHS Connecting for Health bulletin, almost 23 million people in England – more than one in three – now have an SCR, and 50 PCTs have created SCRs for more than 60% of their patients. As of last week, there had been 242,341 clinical accesses of SCRs in urgent and emergency care.
But Dr Cundy said this represented a disappointing utilisation rate, and that his estimate was that even in the 98 institutions currently using SCRs, records are only viewed ‘on average eight times a day’. His own calculations suggested that the cost of each individual viewing was so much that the system should be discontinued, he said.
‘If you look at that in terms of utilisation rate, it means that each time an SCR has been accessed for a patient it has cost £1,200 per access,’ he said. ‘The system is an absolute disgrace and the plug should be pulled out on it as soon as possible.’
Most patients were not aware that records are being created because in many areas public information programmes were run several years ago, he added.
‘These records are now being created and patients are not aware of what’s going on,’ he said.
Dr Cundy’s comments were backed by Dr Chaand Nagpaul, the GPC’s lead negotiator on IT, who said the low utilisation rate was a matter of real concern.
‘The Government does need to take very seriously lack of access,’ he said. ‘It’s an expensive use of public resources at a time of cutbacks. They need to look very seriously about whether it represents value for money.’
But Dr Amir Hannan, primary care IT lead at NHS North West and a GP in Hyde, Greater Manchester, said SCRs were part of a broader trend of society become increasingly digitised.
He said: ‘It is useful to recognise that society is moving that way. We have a mixed economy of systems: from patients who are not interested to SCRs, EMIS Web and patient access to records on the other end of the spectrum. They all have pros and cons. The SCR isn’t a panacea, it’s just one solution.’
A Department of Health spokesperson said that SCRs are backed by patient groups such as Diabetes UK and the British Lung Foundation and help prevent medication errors, improve clinician’s confidence, and improve support for patients who may have problems communicating.
They added: ‘Summary Care Records are gaining increasing support from clinicians in urgent and emergency care because they offer quick access to key information about someone’s health – which means safer, quicker care for patients when they need it most.’
Telehealth ‘not evidence-based’
Dr Cundy was also highly critical of the telehealth DES proposed as part of the Government’s package of contract changes.
He said: ‘It’s a continuing disappointment that all governments are always pushing through non-evidence based policies.’
‘The problem with telehealth is that patients aren’t interested in it. There are a few niche areas where the use of telehealth can be very valuable, but for the average patient who lives half a mile from their practice, and who has conditions which are not terribly urgent and is mobile, for them telehealth is of no value whatsoever.’
He added: ‘It’s all very well being able to monitor someone’s blood pressure 12 times a day but someone somewhere has to assess those numbers. So you go from a situation where you take someone’s blood pressure once every six months to 24 every day. That overwhelms systems. We have to be careful not to do things because they can be done.’
Read more from Dr Cundy in the full Big Interview, published next week
Pulse Live: 30 April – 1 May, Birmingham
You can find out more about digital health at Pulse Live, Pulse’s new two-day annual conference for GPs, practice managers and primary care managers. Dr Kartik Modha, a GP in London and founder of Tiko’s GP Group, will be speaking on how technology and social media is changing GPs’ practice.
Pulse Live offers practical advice on key clinical and practice business topics, as well as an opportunity to debate the future of the profession, and a top range of speakers includes NICE chair designate Professor David Haslam, GPC deputy chair Dr Richard Vautrey and the Rt Hon Stephen Dorrell MP, chair of the House of Commons health committee.
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