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Second GP decides to opt all patients out of records extraction as rebellion grows

Exclusive A second GP has taken a stand against the controversial programme and has unilaterally opted all of his patients out of the scheme, despite warnings that practices which do so are breaking the law.

The GP, who has asked to remain anonymous, but whose practice is in the North West, has given his patients the choice of opting in to the scheme but so far has only had one taker, a relative of a CCG chair.

He told Pulse he had taken the decision in order to protect patient data prior to NHS England’s U-turn on whether to hold a nationwide publicity campaign. NHS England will now send information leaflets to all 22 million households in England, in a move which has pushed back the extraction deadline to early 2014.

Last week Pulse revealed that another GP in Oxford had also decided to opt all of their patients out of the scheme, although the GP in the North West is the first known case where a GP has already applied opt out read codes to patient records.

The GP in the North West said it had been ‘very easy’ to apply a batch of opt-out read codes to patient records, and that it would be a ‘simple matter’ to remove the code for those within to opt in. He has notified patients via leaflets displayed around the practice, messages on repeat prescriptions and by consulting his practice’s patient forum, which he said was ‘happy’ with the action taken. He had also planned to send a mailshot to patients, but has held off since the announcement of the national publicty campaign, which will set out the benefits of extraction.

‘I did this before the change of timescale and the commitment to write to all households,’ he said. ‘I felt that the person or organisation that wants to use the data should have the responsibility for asking permission to use it. I also did this before there was any suggestion that the data could be used to look at practice performance. I don’t have a problem with practice performance being scrutinised however again I don’t see why you can’t use anonymised data.’

‘It’s clear that the data set extracted in the first wave could easily be further expanded in subsequent waves and I couldn’t see why you need personal data to make commissioning decisions. You just need to know how many people have strokes and which areas they live in, not their individual names and addresses.’

The GP said ‘there wasn’t much point’ in notifying his local area team, and added: ‘The LMC weren’t very helpful either. The chair just said that you had to comply by law, but he didn’t recognise that he would be held responsible if anybody objected after the event. I have asked the LMC why the BMA logo was on the original announcement when it was clearly in breach of the data protection act and so far they haven’t responded.’

NHS England has said it has provided ‘additional fair processing guidance and information to practices’, and will monitor objection rates from when the national extraction begins.

A spokesperson for NHS England said GP practices had a ‘statutory duty’ to take part in the extraction programme under the Health and Social Care Act, but declined to specify what action it would take against practices which have opted all patients out.

‘The NHS needs data to ensure that we are delivering high quality care for all,’ she said. ‘If a patient wishes to object to their data being used for these secondary purposes, they must do so autonomously, based on balanced information. It is not right for GP practices to make this decision on their patients’ behalf.’

GPC deputy chair,Dr Richard Vautrey also stressed the need for GPs to understand the legal position.

‘GPC guidance and the FAQs we have produced are clear on this matter,’ he said. ‘Practices are breaking the law if they opt all their patients out of The Health and Social Care Act gives the Health and Social Care Information Centre to require the information and GPs are legally obliged to comply with that requirement.’

‘It is only because of BMA pressure that the Government have agreed to allow practices to opt patients out at their request, and again because of our pressure there is now a delay in extraction of information to now allow for a national mail drop to every house in England, to inform patients about what is happening.’

‘However the law remains unchanged and practices acting in this way are at risk for doing so and should take legal advice and inform their medical defence organisation.’