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DH and BMA say as you were on SCR

Tags: BMA   CfH   Data   DH   NHS Employers   SCR  

05 May 2010

The summary care record roll out

Primary care trusts will be allowed to create and upload Summary Care Records so long as GP practices agree, the Department of Health and the BMA have agreed.

The latest statement on the SCR appears to reverse the decision taken just two weeks ago by the DH that all uploads to the SCR should be suspended in accelerated roll-out areas.

Now PCTs can go ahead if they have agreement from GP practices that patients have been adequately informed about the process and are able to opt-out if they wish.

The latest move appears to return to the previous policy on the SCR, which was that PCTs should only begin SCR creation with “full agreement” from GP practices.

However, it has the support of the BMA, which earlier in the year claimed that the accelerated roll-out was being "rushed."

Dr Laurence Buckman, chairman of the BMA’s General Practitioner Committee, said: “We are pleased that practices will not be under pressure to upload unless they are satisfied that their patients understand exactly what their consent means, and that all their records are set up properly.

"This will help ensure that the Summary Care Record maintains its potential to benefit patients.”

The DH and NHS Connecting for Health have found themselves under increasing pressure from SHAs and PCTs keen to go-ahead with the roll-out, having originally provided additional funding to help NHS organisations with it.

Delivery of the SCR by March 2011 was a requirement in the 2010-11 Operating Framework.

The joint statement from the BMA and NHS Employers on behalf of the DH and CfH states that practices must be “fully informed and supported” to upload data and that practices and PCTs must be satisfied that data is “of an appropriate quality for sharing."

It says the requirement for practice agreement before upload will apply in places that were working to implement the SCR before the accelerated roll-out, but which have yet to upload data, as well as in the five SHAs that accelerated the roll-out.

The statement adds: “This status should not preclude uploads where agreement about adequate information has been reached.”

When the row over the roll-out began in March, Dr Gillian Braunold, SCR clinical director, wrote to GPs about the SCR programme.

The letter, written on 10 March, states: “It is important to emphasise that no practice will begin Summary Care Record creation without full agreement and training on site.”

In this week’s statement, the BMA and NHS Employers say CfH has also agreed to continue to work with stakeholders, including the BMA, to improve nationally available templates and examples for PCTs and practices to support public awareness and practice and professional involvement.

The statement adds: “They have also agreed that the BMA and CfH will work jointly on what, within the constraints of current policy, constitutes an appropriate local campaign of public and professional awareness and practice support, in order to assist practices and PCTs in making decisions on whether local arrangements for public and professional information is sufficient.”

The statement says that SHAs are expected to ensure that their PCTs understand and implement appropriate communications arrangements.

Fiona Barr

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

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1

Process - and content

maryhawking@tigers.demon.co.uk

05 May 10 07:05

One of my many problems with the SCR and the implementation process is the lack of clarity, both in the process *and* in the content. I am not sure how much is due to the centre (DH and CfH) and how much to the implementing bodies (SHAs and PCTs).

As an example of the *process*: locally the upload of patient names and addresses was in mid-February, posting out March 19th and close of opt-out date June 11th. (yes, I do know that opt-out is possible after that). I have been informed that my practice received SCR awareness training on March 11th. There may have been a presentation at a practice manager's meeting - there certainly was nothing at the practice and no realisation that training had been delivered.

Where is the gap/failure of communication, and why in the CfH implementation plans are practice staff mentioned - but never GPs? *Who* is expected to agree to start the uploads? Practice staff or the GPs?

When it comes to content, I was given a new URL

http://www.nhscarerecords.nhs.uk/summary

which appears to be patient focused. On this website:-

"At first, your SCR will contain important information about your health, such as details of any allergies, your current prescriptions and whether you have had any bad reactions to medicines.

After that, each time you use any NHS health service, we may add details about any health problems, summaries of your care and the professionals treating you to your SCR.

As we add new information to your record, you can discuss what is being added and how sensitive information is handled."

This sounds as though the whole consultation will be added - including free text - and does "any NHS health service" include GUM clinics - where total anonymity is guaranteed by law?

Please, someone, could we have a final version of what is intended, what information will be uploaded and some details as whether or not failure to opt-out will be regarded as consent to enrichment after the initial upload?

At present, the SCR appears to have ambitions to become a DCR without information or clinical governance a.s.a.p.!


2

Baaa

Neil.Bhatia@nhs.net

05 May 10 10:11

What a useless statement. Any woollier and it would be a sheep.

Surgeries are now going to come under relentless pressure from PCTs and SHA's to "approve" the SCR. Press releases will abound about how "local GPs have declared the SCR safe, effective and secure".

Talk about passing the buck.

Shame on you BMA. You have truly let your GPs down.


3

is it impossible....

06 May 10 14:22

....that the communications hiccup might be between the practice manager and their GP(s)


4

Happened here too

07 May 10 08:33

I doubt it was a communication failure. In my practice's case the practice manager was phoned to arrange for someone to give us 'concept training'. 

When they arrived, it turned out that we had given permission to send out the PIP and then upload patient records simply by the practice manager accepting the training.

It became clear that the PCT viewed the move to upload as just an administrative process, not one which required the permission of the partners.

As a result, I suspect that the practice manager involved in the previous post may have simply thought that she was attending training for practice managers and that the partners would be consulted and trained later.

  


5

So, the patient, yet again, has no say

07 May 10 11:51

I urgently want my allergies etc to go up on my SCR, so that doctors can treat me with more knowledge of my back-history, and with less likelihood of killing me with "inappropriate treatment".

I now understand that my GP, not me, is the person who decides whether my data is posted.

If I wanted to opt out, that's easy. I can send the form. But, if I want my data to be posted - which I do - I have no rights to demand it, until my GP or PCT gives the nod.

I thought the NHS was supposed to be patient-centric nowadays. What a naive idea!


6

patient control

Neil.Bhatia@nhs.net

07 May 10 16:42

"I now understand that my GP, not me, is the person who decides whether my data is posted. "

No, it is up to the PCT to decide when it wishes to rollout the Summary Care Record in its area.

Some PCTs (Hampshire, Bucks, IOW) have made it clear that they have no intention of rolling out the SCR until at least 2011/12.

Until such time, why don't you talk to your GP about all the different ways that you can make your medical information - such as your allergies - widely available to those who might need to treat you, if that's what you want right now.

Here are just some ideas: www.summarycarerecord.info/optout-main3.htm#other

Neil


7

Medicalert ID seems sensible for the last poster

07 May 10 16:50

http://www.medicalert.org.uk/pages/how-it-works.html

All doctors I know would suggest that if an individual (or carer) has concerns about any allergies or conditions that might impact on the type of emergency care they (or the person they care for) should receive, then good sense would suggest wearing a medicalert id

Medicalert is a not for profit charity and membership costs £25 per year (offers telephone service) and a further £20 for one of the emblems. According to the medicalert website, their foundation can also provide free membership to those on lower incomes.


8

to posters 5 and 7

maryhawking@tigers.demon.co.uk

07 May 10 20:02

to poster 5.

Please keep posting: you are absolutely right: if you have looked at the details and implications and want to have an upload to the SCR, there are no problems (but if you are one of my patients, could you tell me so that I can Code your record 93C2 - consent to upload?)

Informed consent is always valid: the concerns are over assumed consent - and on the consent side, the extensions of the SCR which, legally, as they are unknown, cannot be consented to in advance.

to poster 7 and poster 5.

Again I agree.

I always advise my patients that, regardless of any decision to opt-in or opt-out (and patients with complex histories and multiple medications will benefit) , if they have *any* major medical problems, it is much safer to carry details at all times and invest in a Medic Alert.

Poster 5 - even if you stay strictly in England (SCR is only available in England), there is no guarantee that either your local or any other emergency services will have access to your SCR in the near future: and don't forget that in all cases you are likely to be resuscitated *before* anyone abandons you to check your SCR. Please. £25 is very cheap insurance and personal risk mitigation.


9

medicalert & SCR

07 May 10 21:53

http://www.medicalert.org.uk/pages/response-to-summary-care-record.html

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