Labour U Turn on medical data- NPfIT medical records a step closer

After another labour U turn the national electronic record of patients’ health (NPfIT) looks finally on the cards – five years late – after the NHS IT programme on Thursday changed the way patients will give their consent to the system.

Providing a brief, summary electronic patient record has been a key driver for the £12bn ($22bn) NHS IT programme, which will create a detailed, local electronic record as well as the shorter one available nationally, providing doctors with recent medical history, medications and allergies in an emergency or out of hours.

Tony Bliar, then prime minister, declared as long ago as 1997 that the electronic record would mean that “if you live in Birmingham and have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you”.

Development of electronic records, however, has been devilled by a long and bitter dispute, chiefly with general practitioners, over whether patients should explicitly give consent to having such a record – a more complex, lengthy and costly approach – or whether they should be presumed to give consent with the right to opt out – the approach that the IT programme originally backed.

On Thursday, however, Connecting for Health, which delivers computer systems and support to the NHS, announced a change of tack. Patients will now be written to and given the chance to opt out before a summary record is created.

They will in future be asked at each consultation if the clinician can look at their record and will have the right at that point to opt out entirely, to refuse for that episode of care, or to agree to the record being viewed. They will also be able to agree to the record being permanently available to accredited clinicians.

Dr Gillian Braunold, the lead GP for the programme, said the change “gives the patient control to say yes or no and it is much simpler”. The default position will be “Ask me first”, she said. The decision had been reached after consultation with GP leaders, the Information Commissioner and a wide range of others, she added.

The British Medical Association said it welcomed the changes “pending finer details”, believing patients should opt-in rather than opt-out.

The record has been piloted in five parts of the country, with fewer than 1 per cent of 160,000 patients refusing to have a summary record. Connecting for Health said it hoped to roll the record out nationally, starting in 2009 or early 2010. It is likely to take at least 2-3 years to cover the country.

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