A seven-day GP access pilot had to be temporarily pulled when GP commissioners realised that NHS England had failed to implement required controls for sharing patient records, potentially putting practices at risk of investigation.
One of four planned Challenge Fund ‘hubs’ in Leicester had already gone live when the CCG discovered that information-sharing agreements were not in place between the hubs and local GP practices, and decided to pause the rollout.
A GPC IT expert said that NHS England’s ‘complete incompetence’ could have led to practices facing a ‘potentially significant fine’.
NHS England was overseeing implementation of the seven-day access pilot, which is funded by the £100m ‘wave two’ of the national pilot scheme, when the hub at the Willows Medical Centre went live on 7 September. NHS Leicester City CCG discovered the oversight when it took over on 16 September.
The Leicester scheme has now restarted, with NHS Leicester City CCG saying hubs can only access full records where a patient’s practice has signed such an agreement. In other cases, they get access only to the summary care record.
The CCG said that, after being asked to take responsibility for the scheme by NHS England, ‘the CCG identified a delay in robust information sharing agreements being put in place between city practices and the healthcare hubs. This meant that not all patients would be able to receive the level of service that the hubs were envisaged to provide.
‘[The] CCG took the decision to temporarily pause implementation of the pilot project, including the hub at Willows Medical Centre, so that we could be assured about the service patients were receiving.’
The CCG’s statement added that GPs and nurses being able to make decisions ‘with all of the relevant information in front of them’ was an important element of the scheme, which is being run across three GP federations.
Dr Grant Ingrams, deputy chair of the GPC IT committee, told Pulse that the project should not have been given the go-ahead without the information-sharing agreement in place.
He said: ‘It has put the practices involved at risk of investigation by the ICO and potentially a significant fine.’
Dr Ingrams said there should be a ‘full audit’ of what has happened, and patients who had their records accessed should be advised what has happened.
He added: ‘I cannot understand the complete incompetence by NHS England that has led to this disaster. It will further undermine public and professional confidence in schemes like this.’
Dr Mohammed Saqib Anwar, medical secretary at Leicester, Leicestershire and Rutland LMC, said: ‘The LMC has been made aware of the situation in relation to an extended hours hub operating without a signed ISA in place.
‘It is of the view that NHS England and/or the CCG as the commissioners of the service should hold ultimate responsibility for ensuring its preferred providers for the Prime Minister’s Challenge Fund had the necessary and requisite governance arrangements in place prior to giving them the green light to proceed.’
NHS England told Pulse that ‘the Willows Medical Centre only accessed the records of patients who had explicitly consented to their doing so’.
It added that the ‘lawful basis’ of accessing the record is obtaining consent, while an information-sharing agreement is ‘best practice and a requirement set out in the Information Commissioners Office Data Sharing Code of Practice’.
It also wanted to highlight that these pilots are ‘local programmes which NHS England supports but does not manage’.
This is the latest problem with patient record sharing following the botched rollout of the GP record-sharing scheme care.data, which has been delayed since early 2013.
It comes as almost half of the ‘wave one’ seven-day access pilots are reducing their weekend hours, while another ‘wave two’ pilot was delayed after leaders underestimated the time needed to complete CQC registration.