NHS summary care records are so far delivering “only modest benefits” after billions of pounds have been spent creating them, according to the damning conclusions of a government-commissioned report.
The report, penned by Professor Trisha Greenhalgh and a range of academic health experts at University College London, painted the picture of a stormy culture clash and heated meetings between clinicians, politicians, local civil servants and IT integrators that is constantly tripping up progress on the £12.7 billion NHS National Programme for IT. Care records are one of the main parts of the programme.
Rather than improving patient safety, a goal long-trumpeted by the government for the programme, patient records served so far only to reduce stress for clinicians, said the three-year evaluation.
As of a year ago, some £789 million had been spent on contractor costs to develop the spine, or database, according to a parliamentary written answer in 2009. This does not include the £1.4 billion also spent so far on supplier costs to develop hospital patient administration systems or GP costs to extract and clean the data.
Widely-voiced concerns, that doctors had been somewhat ignored when the programme was created, were also addressed by the new report. The report quoted staff at BT, the supplier delivering the SCR database, who said they felt the original specification “had been set in board-level meetings where insufficient attention had been paid to the perspective of front-line users”.
A previous version of the report criticised the automatic opt-in of patients to the scheme, which it said was questionable on legal grounds as many people did not understand what they were being signed up to. The NHS for the most part did not address the concerns, sticking with the opt-in model and making only the concession of insisting doctors ask patients’ consent to view the SCR.
Doctors have also expressed concerns about “mission creep”, whereby data is added to the records over time but patients had not understood that the sensitive information would be added. The newly-released UCL report noted that staff in a range of settings had different attitudes to the need for consent to upload this information.