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Letter errors fuel SCR roll-out row

Tags: BMA   CfH   GPC   GPs   Lancashire   SCR  

09 Mar 2010

The summary care record roll out

The British Medical Association is to write to health minister Mike O’Brien as the row over the roll-out of the Summary Care Record escalates.

Local medical committees have reported that their attempts to include opt-out forms in information sent to patients has been blocked.

Meanwhile, a glitch at a mailing house used by NHS Connecting for Health has led to patients receiving information packs addressed to other patients.

The BMA’s General Practitioner Committee has also issued guidance to GPs on the roll-out, which says it is “deeply concerned by this sudden acceleration in the roll-out and feel that it being rushed.”

The guidance outlines the BMA’s call for opt-out forms to be included in information packs sent to patients and states that the BMA would have preferred to see a national publicity campaign for the SCR.

The GPC and BMA have stopped short of advising GPs to boycott the SCR roll-out, since it says this is a decision that should be made by patients.

However, the guidance says GPs should ensure that opt-out forms are available in their practices and that any information provided to patients is “ balanced and empowers them to make an informed decision."

It says practices can also decided whether they want to be involved but those that decline must still ensure that any patient requests to opt-out are recorded.

Dr David Wrigley, a GP in Lancashire and GPC member for Lancashire and Cumbria, said he and colleagues were not opposed to the sharing of information but were concerned by the pace of roll-out and the potential implications for patients and practices.

He told EHI primary Care: “By last Friday, one of our local practices had had 96 requests from patients to see either the practice manager or GP about the letter.”

He said his LMC’s request to include a tear off slip for patients to opt-out at the bottom of the letter sent by their PCT was refused by CfH.

He added: “It just makes it more difficult for patients and we know from the early adopter areas that seven out of ten patients had not assimilated the information they had been sent.”

Dr Wrigley said he would like to see more time allowed for consultation and discussion before further roll-outs went ahead. He added: “It seems to be like a steam-roller and once it’s started it’s very difficult to stop.”

Earlier this week, the BBC reported that some of the SCR information packs sent to patients in Cambridgeshire also contained a letter for a second patient, including the name and address of the patient’s practice and their NHS Number. A patient in Hertfordshire reported a similar error.

CfH said that “in a small number of cases” more than one patient letter had been included in an envelope.

In a statement, it added: “The NHS would like to reassure people that the letters contain no medical information. The letters have been sent to inform patients about changes to their health records.

"Furthermore, it should be emphasised that no-one will be able to access medical records as a result of this issue.

"The mail house supplier responsible for sending out the letters has undertaken a rigorous review of their processes and have immediately implemented additional safeguards to ensure that these issues are kept to a minimum.

"We remain committed to patient safety and will write to those affected to apologise and provide reassurance."

Fiona Barr

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© 2010 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

Readers Comments
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Readers Comments

1

Will patients be informed that they are about to have an SCR?

maryhawking@tigers.demon.co.uk

09 Mar 10 20:06

The mailing house has managed to send letters directed to patients to different addresses - and this is listed as a "glitch". If you are selling socks, or peddling insurance, no harm is done: but surely the opportunity to allow yourself to be passively opted in to an unknown and undefined SCR, when the final scope is completely unknown, should not be negated by the incompetence of the CfH's mailing contractor - especially when there has been no attempt to mount any publicity campaign, either local or national?

I am Data Controller and Caldicott Guardian: where will the buck stop on this one, if I do not prevent upload when I now know that there is a strong possibility that some/many patients will not have received *any* information due to this"glitch" and absence of any other patient information?


2

to quote CfH

10 Mar 10 10:32

"Many patients will be missed by the patient-pack mail out"

http://tinyurl.com/yhllhxm


3

As a patient

10 Mar 10 12:38

Well I did get my letter through and promptly looked for how to opt out. The main advice was to call a phone number where i got a very friendly and completely clueless person who had clearly not had any training. The only advice he could give was to visit the website - glad to see money isn't being wasted on pointless call centres!

Eventually have managed to print off the form, fill it out and drop it off at my local surgery. No idea if anything has happened to it and no acknowledgement that they will take any action to prevent my details going on a SCR!


4

As a patient...

11 Mar 10 09:08

I have opted out and I haven't even received my letter yet. I have concern over the many different systems where information will be held and who can gain access to it, not just the SCR. One would assume that the systems contracted under Connecting for Health will be tightly controlled around access etc. But what about those outside the programme such as the out of hours service system which seems to be tapping into information everywhere?

What will prevent the information being mis-used? I have been a victim of this already. Someone with no 'legitimate relationship' contacted me about a medical problem from many years ago because they were doing research for a course! They got me details from a friend in the PCT!!!!! Needless to say the Data Protection Agency was prompt to act on my complaint. But what is to stop this?

The letters need to be very clear and detailed about who really will be able to see information and the monitoring of the 'emergency override'. 

I'm afraid that government 'Big Brother' has gone a step too far. 


5

As a patient...

11 Mar 10 12:33

I have opted in because I want my allergies and adverse reactions to be known everywhere I'm treated.

As a patient I already know about the summary care record because it's been on the front page of newspapers for years now. I genuinely thought the NHS could see the right information at the right point and the right time. I wanted this fixed sharpish.


6

as advisor to a patient ...

11 Mar 10 14:13

99.93% of medical consultations are with conscious adults who are able to tell a medic of relevant allergy / adverse reactions.

Only 0.2% of the remaining 0.07% will have a known reaction to a therapeutic substance that is likely to be used in the immediate management of the condition which caused their unconsciousness.

Of these reactions, 97% will be successfully managed and will come to no harm.

Therefore, in England and Wales under NPfIT, only once in 210,720 years will a single patient have their life even potentially saved by allergy information on the SCR.

So the safe and sensible course is to opt out (and get yourself a medicalert bracelet if you really need one). The personal data already misappropriated in the mailing "glitch" is certainly the first of many such compromises.

(All statistics are approximations).


7

Rebuttal to Patient Advisor

11 Mar 10 16:08

The SCR won't only contain allergies and adverse reactions. One of the most important parts of the core data set is the medications section. It is this section that will have the most impact on care given in unscheduled care settings and without having to ring the GP practice as the patient can only tell you that they're taking "the little blue ones once a day, the big white ones twice a day and the little pink ones every other day"! Currently the GP Practice doesn't ask for the patient's permission before they divulge this information, they just get on and do it. So what's the fuss? It's the ability to see a reliable current medications list that will help bring benefits to patient care as there will be fewer incidents of contraindicated drugs being prescribed in unscheduled care settings.

Not to mention the fact that it can be enriched with diagnoses and care plans for patients with complex conditions, with their consent of course.


8

Consent NOT required

11 Mar 10 16:43

"There is no legal requirement to gain a patient's explicit consent before they add significant medical history to the SCR. The decision to do so is at the discretion of the GP but they may wish to discuss this with the patient. Practices which enrich records without consent should ensure that the material patients have received through the public information programme incorporates the significant medical history elements that could be included."

I have yet to see any information regarding the "significant medical history elements that could be included".

http://www.connectingforhealth.nhs.uk/systemsandservices/scr/staff/faqs/mpsfaqs


9

@7

11 Mar 10 22:27

@7

Yeah, I know - and obviously an accurate and up-to-date medications list is potentially useful. And the medications will be selected from drop down lists. Penicillamine / penicillin ... um ...

Just weary of those who try to justify the whole thing on an allergy ticket as if it was the most blindingly obvious benefit. It is not.


10

Here we go again!!

12 Mar 10 10:10

Clinicians have been crying out for connected systems for years. The National Programme is now trying to deliver these and all that follows is critisism. The Summary Care Record hold limited information, but when Lorenzo and other clinical systems are delivered they will provide a much fuller record, and guess who will benefit, GPs of course, the same group who are complaining about records being sent to the National Spine. I guarentee you this, they will not object to having access to this information, but do object for some strange reason to sharing theirs. This has to work all ways.

What a crazy world we live in where we complain about sharing critical patient data that saves lives.

Our banks hold substantial data about us, how often to we complain?, without this information they could not perform their role, the NHS is no exception.

 


11

What a joke...

12 Mar 10 14:08

"the opportunity to allow yourself to be passively opted in to an unknown and undefined SCR, when the final scope is completely unknown"

What scaremongering by a regular commenter. The Summary Care Record will provide details of the medical record. What is so unknown about that? It hasn't been completely defined but that does not mean that is completely unknown. Of all the medical record data that is recorded, the SCR will be a subset of this. And who is it going to be shared with? Other clinicians. Similar to the fact that other clinicians can already see your medical record on any clinical system that is out there, so too the SCR will allow other clinicians to access this information.

Are you going to continue using broad sweeping antagonistic statements when the SCR dataset might have to change in future because people view different pieces of information as being important to share?

I think you will find that a fair part of the population is more in line with this sort of comment:

"I genuinely thought the NHS could see the right information at the right point and the right time. I wanted this fixed sharpish."

While I completely respect your responsibilities as Data Controller and Caldicott Guardian - what I want to know is where will the buck stop with all these individuals doing their best to question and slow the sharing of clinical information that will improve the quality of care that I receive.

The SCR isn't perfect but the sort of personal information that it is going to contain is far less than could be researched online by someone with some technical skill, or far less even than is probably gossiped about at the local village hairdressers.

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