Back in 2007 when NHS Connecting for Health unveiled its ambitious scheme for online summary care records, fears regarding privacy and patient safety back-lashed a rather good idea. In an age where we demand better healthcare, we need better resources to achieve it. Technology has progressed lightening over a very short space of time, and it’s because of this that civilization has made huge improvements and advancements throughout history. Whether it’s flying into space, making telephone calls or surfing the internet – technology has empowered the world, and there is no doubt that IT in the NHS has had a vital role to play in improving our health. So why now the fuss over summary care records all over again?
The summary care record scheme is there to aid healthcare professionals and patents alike, enabling patient records to be accessed wherever we are treated in the country. It means staff has faster and easier access to information, which makes treatment more effective. Now to me this sounds like a pretty good idea – a summary of basic medical information that lists any previous illnesses, vaccinations, allergies, medications and all the information my doctor would find useful in treating me. Well maybe this time people do have a point to make. The problem is, what happens when things go wrong, when your information is incorrect, missing or accessed by someone who shouldn’t even be looking at it?
The British Medical Association has called for a standstill on a large NHS IT upgrade that will see the summary care record system link more than 30,000 GPs to nearly 300 hospitals, hold records of more than 50 million patients and present an overall faster and more complex IT network. Currently there are 1.25 million summary care records held on the central system; bringing that figure up to 50 million in a space of a mere 4 years is phenomenally fast. That’s quite a blink of the eye. It’s concerns like these where fears become more than a mere fly in the ointment. The Doctor’s union has accused the scheme of accelerating at ‘break- neck’ pace before any sufficient independent evaluation of pilots has been allowed to take place. Patients do have the option to opt out of the system and are supposed to be notified by letter at least 12 weeks before their details go live on the system, however the BMA believe the information given is inadequate and confusing, and that letters have been sent out to the wrong addresses. There has been no national advertising strategy explaining the developments and how they will affect patient information. It’s no wonder then that Doctors believe their patients are receiving insufficient time to make informed choices because of the rushed implementation of the strategy. But the biggest arrow has to be allegations against records being created, and going live without the consent of patients.
Dr Hamish Meldrum, BMA chairman, said: “If the process continues to be rushed, not only will the rights of patients be damaged, but the limited confidence of the public and medical profession in NHS IT will be further eroded”. Patients have the right to be concerned over their confidential private details, and accusations of breaching that trust will have major implementation implications for the NHS.
Putting the element of trust aside for a moment, we have to ask ourselves are we just too risk averse in the NHS? Not long ago, Connecting for Health had the finger pointed at for being too slow in rolling out summary care records, and now they’re being told that they’re steam rolling ahead out of control! History is repeating itself once more; yes we have to be careful with patient confidentiality but how do we expect to improve healthcare without letting technology move forward? Without risk you cannot advance, and it’s not even like the risks are uncalculated. The concepts of risk and danger have overshadowed decisions, judgments and more importantly implementation of strategies within the NHS, yet we remain happy to risk our most personal details in far more risky circumstances and environments, such as online banking! Forgive me if I sound confused, it’s because I am. At the end of the day I want my private details safe and sound just like everyone else, but we can’t always control this, especially if we want change. Our healthcare system will remain in the dark ages due to widespread uncertainty and fear, when the truth is that without taking those leaps of calculated faith a better healthcare system will never be achieved.
Pawandeep K Kahlon