The NHS’s Connecting for Health CfH, NPfIT continues to push forward its plan to nationalise and centralise all medical records in England.

This despite a misleading announcement from the Department of Health that uploads to the Summary Care Record (SCR) aka Snoopers Charter are ‘on hold’.

In just the last few days, the medical press has reported that:

• NHS East Riding of Yorkshire began sending out notification letters to patients the day before election day;

• GP practices in Hastings, East Sussex have uploaded records over the past 2-3 weeks, despite patients complaining they hadn’t received a notification letter;

• At least 9 other Primary Care Trusts are working towards upload, and practice managers – not GPs – may already have given the go-ahead for upload at some practices in South West Essex.

Clearly, whatever deal was agreed between the British Medical Association and the NHS, there is no effective barrier to upload. And CfH is desperate to create a ‘critical mass’ of records, which it thinks will make the system impossible to scrap.

Health Direct warns that you need to act quickly.

30 million ‘Patient Information Packs’ were sent out in the run-up to the general election. No-one knows how many failed to reach their intended target. Both parties that now form the new government pledged to scrap the Care Records system but, every day that uploads continue, people’s medical confidentiality is being put at risk.

Please take a few minutes now or today to write to your new MP, urging him or her to call for an immediate halt to Summary Care Record uploads. POWER2010 has very kindly built an online letter-writing tool to help
you do this: http://www.power2010.org.uk/Halt

On the subject of the Nanny State’s Snoopers Charters- Home Information Packs (HIPs) were announced in the Queen’s Speech in November 2003, so were plans for a national ID scheme. The introduction of HIPs was subject to delays and plans were scaled back – just like the ID scheme.

In 2009 HIPS were finally issued and so were ID cards. The scrapping of HIPs was a manifesto pledge by the Conservatives and the Liberal Democrats, so was scrapping ID cards.

Yesterday Eric Pickles MP, the new Communities Secretary announced that “HIPs are history” and “laid an Order suspending HIPs with immediate effect” (pending primary legislation for a permanent abolition).

Meanwhile ID cards are still being issued and the UK Identity and Passport website states: “Until Parliament agrees otherwise, identity cards remain valid and as such can still be used as an identity document and for travel within Europe.” Alas we still await a Pickles style announcement from the Home Office.  See http://www.communities.gov.uk/news/corporate/1591777

The NHS has been accused of scaring patients into agreeing to have their personal information included on the controversial NPfIT electronic records database.

The agency charged with rolling out the new system is warning of “adverse consequences” if people choose to opt out of the computerised network, which has been criticised as chaotic by doctors.

It is also claiming that the NHS currently has “significant problems” with lost records.

A document posted on the website of NHS Connecting for Health lists several dangers to patients if they continue to have their medical information stored on paper files.

It states: “Health-care staff treating you may not be aware of your current medications in order to treat you safely and effectively.

“Health-care staff treating you may not be made aware of current conditions and/or diagnoses leading to a delay or missed opportunity for correct treatment.

“Health-care staff may not be aware of any allergies/adverse reactions to medications and may prescribe or administer a drug/treatment with adverse consequences.”

While acknowledging confidentiality risks over the digital database, the document continues: “It is … misleading to suggest that not having such a record is risk free.”

The computerised record system, also known as the care summary record, is intended to make it easier for doctors and nurses to get access patients’ medical histories.

But the programme has been beset by technical problems and criticisms. Last month the labour Government halted the national roll-out after it emerged that data could have been logged on the system without patients’ knowledge.

Information about more than 1.25 million patients have already gone on to the database, which eventually could hold up to 50 million records.

The Big Brother Watch lobby group accused Connecting for Health of overstating the risk to patients if they opt out of the system, after a Department of Health spokesman said the problem of lost paper records was not “significant” as the agency claimed.

Dylan Sharpe, the Big Brother Watch campaign director, told the Daily Mail: “If you value your privacy ignore these false and misleading warnings and opt out.”

From: http://www.telegraph.co.uk/NHS-scaring-patients-into-accepting-electronic-records-database

Health Direct urges you to opt out of labour’s snoopers charter NOW- WHILST YOU STILL CAN!

The NHS is sending millions of patient records and confidential medical notes to India for processing — despite a pledge by Labour that personal information would not be sent overseas.
It is the first time that databases of names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments.

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

The National Health Service’s £12.7bn scheme to create an electronic patient record will “no longer provide the comprehensive solution” originally promised, says a top NHS executive.

Until now, health ministers and officials have acknowledged that the world’s biggest civilian information technology project is running four to five years late, and have said they want to make £600m savings on the £4bn-plus worth of contracts held by CSC and BT to deliver it.

Up to now, however, no one has conceded that the programme will fail to deliver everything that was promised back in 2003 when the contracts were signed.

Following a revamped deal with BT – the London supplier, which has cut £112m or about 12 per cent off its contract – Ruth Carnall, the chief executive of the London strategic health authority, has said the spending reduction means “it will no longer be possible to provide the comprehensive solution that was anticipated in 2003″.

Not all NHS organisations in London will now receive the software needed to deliver the records, Ms Carnall makes clear in a letter to London chief executives.

Meanwhile, Christine Connelly, the health department’s chief information officer, has said that only about half of London’s 32 big acute trusts will now get the full solution. Others will be able to add clinical systems to existing patient administration systems.

In place of a dedicated means of sharing records across hospitals, and between hospitals and primary care – a key goal of the programme – London will have to rely on the national summary care record, Ms Carnall says. However, this contains little other than allergies and current medication, and does not yet carry referral or discharge information.

On top of this, the Tories have said they will scrap the national record if they win the election.

BT will no longer have to deliver new systems to London’s ambulance service or GP practices. And London can afford to pay for Map of Medicine, a decision support tool for treating patients, for only one more year, says Ms Carnall.

In much of the country, installations in acute hospitals are stalled after CSC missed a deadline to get its solution running at Morecambe Bay NHS Trust. The supplier risks being fired, but is likely to sign a similar, more restricted, deal if it does hit a new deadline for a successful installation.

Glyn Hayes, president of the UK Council for Health Informatics Professions, said it had been clear for some time that the programme was to be reduced. “But this is the first official admission that there are things it will not do that it was intended to do.”

It was unclear, he said, whether the Conservatives would in fact scrap the national record if they won. “But if they do, it knocks a hole in London’s plans,” because without it the capital had no easy means of transferring patient information between settings.

From: http://www.ft.com/cms/s/0/fba8e660-436d-11df-833f-00144feab49a.html

The biggest single supplier to the £12bn NHS NPfIT white elephant programme is on the brink of being fired from a key part of its contract after failing to meet a deadline to install systems at hospitals in the north west.

CSC, which holds the contract for two-thirds of England, missed the deadline to get the Lorenzo electronic medical record product up and running at the Morecambe Bay NHS Trust’s hospitals.

CSC originally said the system would go live almost two years ago, in June 2008.

The failure is the latest crisis for the much-troubled programme which is running at least four or five years late.

CSC and BT, which covers London, had each been given a deadline to get new systems running smoothly in a big, acute, hospital, with the Department of Health warning last year that it would “look at alternative approaches” if that failed to happen.

BT has since installed a system at Kingston Hospital to the health department’s satisfaction. Christine Connelly, the department’s chief information officer, said it now needs to go through a due process under its contract with CSC which could yet see a new deadline set and met.

But if progress is not made, she told the Financial Times, the department has the option of cancelling CSC’s contract to install the systems in acute hospitals and letting hospitals choose from other suppliers.

Morecambe Bay, she said, remained keen to continue and under the contract CSC has to be given time to propose a fresh deadline for deployment, with the programme then assessing the credibility of that and whether to agree it.

“We have to walk through this step by step,” Ms Connelly said. “In a contract as large and complex as this we cannot just set a deadline and say that’s it. We have to act responsibly and not expose the department and the taxpayer to risk.”

But, she warned bluntly, “we cannot wait for ever”.

CSC has contracts worth about £3.3bn to install hospital, community, mental health and GP systems, with the latter elements progressing much better.

But Ms Connelly said if CSC’s plan was not credible the NHS had the option of cancelling the acute hospital part of the deal, thought to be worth around £1bn. CSC did not respond to attempts to contact it last night.

BT, having hit its deadline, has agreed a contract variation, signed yesterday, which the department said would save the NHS £112m, or about 12 per cent of the contract value, as part of the £600m savings the health service is seeking on the programme as a whole.

As part of the deal, BT is now signed up to install much fewer full systems in London, with about half the hospitals likely to add clinical systems to their existing IT arrangements, rather than replacing everything, Ms Connelly said.

Allowing hospitals to choose other suppliers is already starting to happen in the south of England, although the first contracts for that have yet to be signed. That should start to take place from May this year, she said.

From: http://www.ft.com/cms/s/0/6a9f7ee2-3d26-11df-b81b-00144feabdc0.html

Some patients will not be warned before their private records are put on a controversial NHS database because confidential letters offering them the chance to opt out have gone astray, health officials admitted.

Around nine million patients are due to receive letters this month asking whether they wish to stop their medical records being transferred onto the £11 million system, but officials said the sheer scale of the project has made errors inevitable.

Patients should be notified 12 weeks before their records go live, but the NHS admitted that people scattered across three counties in the North East have not been informed because their confidential letters were sent to the wrong addresses.

The Summary Care Records system, which will eventually hold the medical details of more than 50 million patients, has been dogged by fears that the private information it stores will never be safe from hackers and data losses.

Deepa Shah of NHS Connecting for Health, which manages the database, said: “It’s very difficult not to make mistakes when you are mailing nine million people. It’s a shame that a handful of letters have gone missing, but it would be very difficult for us to monitor ever single one.”

Patients in Hertfordshire, Cambridgeshire and Norfolk have received letters addressed to the wrong person in the same envelope as their own letter.

NHS Connecting for Health claimed the error was confined to the North East, but inside sources said letters had also gone missing across Trafford in the North West.

The extent of the error, which occurred when staff began stuffing envelopes manually after machinery broke down, is unknown, but 25 cases of duplicate letters have already been reported.

Officials at the Central Office for Information, which manages Government mail-outs, said they would inform patients whose letters had been sent to the wrong address of the mistake.

But they admitted that none of at least 25 cases discovered by The Daily Telegraph had been reported directly to them, raising fears that many more letters may have gone astray without officials realising.

Lateral Group, the private company contracted by the Central Office for Information to carry out the mail-out, did not respond to questions about the number of letters that had been lost. A spokeswoman for the NHS said the company had taken the error “very seriously”.

At present 1.29 million people have had their details placed on the system and a further 8.9 million records are due to be added by June. By the end of next year, the NHS hopes to have more than 50 million uploaded.

The system is designed to link about 30,000 GPs to 300 hospitals, providing access to an online appointments system and electronic prescriptions.

The labour Government says patients would be able to access their own records online and will be asked before health care staff view their information.

But The Daily Telegraph disclosed on Wednesday that the British Medical Association had written to ministers to give warning that records are being placed on the database without patients’ knowledge or consent.

The chairman of the Association called for the project to be suspended amid claims that the Government is rushing it through before the Conservatives have a chance to cancel it if they win the General Election.

Hamish Meldrum wrote: “The breakneck speed with which this programme is being implemented is of huge concern.

“Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it.”

He warned that people were not receiving their letters because they were being sent to the wrong addresses and many patients who have received them are unsure of what they mean.

Some patients have also complained of being made to answer a series of personal questions before being allowed to opt out of having their confidential records placed on the database.

Staff on the Summary Care Records helpline are told to ask a person’s name, address, date of birth, ethnic group and whether they work for the NHS before agreeing to send them an opt-out form.

Chris Mannering, a 57-year-old housewife from Sussex, said: “It’s intimidating when you’re told that all you have to do is ring the number and ask for a form, and in fact you are interrogated. It made me very cross.”

Dr Katherine Murphy, director of the Patients’ Association, said: “There is a real danger that an initiative that will benefit patients is going to turn into the usual complete mess. Many patients are rightly concerned about their confidentiality and consent and if there is even the slightest impression that this is being pushed through it will generate a feeling of mistrust.

“People who might otherwise have consented could end up opting out which would be the last thing everybody wants.”

A spokeswoman for the Central Office for Information said: “As soon as we became aware [of the mistake] the contractor acted promptly to put in place additional quality checks to safeguard against a repeat of the issue. We remain committed to patient confidentiality and the local NHS will write to those affected to apologise and provide reassurance.”

She added that the letters do not themselves contain any confidential medical information, although they do contain names, addresses and details of the GP surgeries attended by the individuals concerned.

From:
http://www.telegraph.co.uk/health/healthnews/Patients-will-not-be-warned-before-medical-records-go-online-after-vital-letters-lost