The Pharmaceutical Journal
Vol 279 No 7470 p320
22 September 2007

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MPs criticise clarity of plans for NHS care records

The NHS Care Records Service, a central part of the National Programme for IT in England, has been criticised by MPs in the Health Committee's latest report, published last week.

The committee acknowledges that the summary care record (SCR) has the potential to improve the safety and efficiency of care but it is dismayed by the lack of clarity about what information will be included in the SCR and what it will be used for.

“Officials gave different answers to these questions on different occasions. The committee was told at various times that the SCR will be used for the delivery of unscheduled care, for the care of patients with long-term conditions, and to exchange information between primary and secondary care.”

The inclusion of prescription information on the SCR with “implied consent” remains problematic, the committee says. “On the one hand, prescription information can often make a patient’s diagnosis obvious. On the other hand, excluding some prescription information from the SCR would be clinically dangerous.”

Arrangements for the SCR will be strengthened when patients can access their record via the secure NHS web service HealthSpace and when “sealed envelopes” are made available to protect sensitive information, the committee believes.

It recommends that HealthSpace should also allow patients to view audit trails, showing who has accessed their SCR and under what circumstances, and offer mechanisms for investigating inappropriate access by people not directly involved in their care.

The committee describes maintaining the operational security of the new SCR system as a substantial challenge and recommends that a programme of security training for all staff with access to the SCR is undertaken, emphasising the importance of not divulging information to those who request it under false pretexts.

Regarding the detailed care record, to be held locally, the committee says that achieving widespread uptake of this is the single most important advance that the NHS can make towards the provision of faster, better integrated and more patient-centred care. However, it adds that it is not clear exactly what the NPfIT will now deliver in this area.

The report “The electronic patient record” is available on the Health Committee’s website.