Both the Liberal Democrats and Conservatives, forming the current coalition government, had promised before the election to scrap centralised SCRs because of privacy concerns – but since forming a government they have made no such steps. Last week, health minister Simon Burns worsened confusion around government plans by promising a review of the model, but suggesting that much discussion was still needed on the subject.
The UCL report confirmed widely-documented problems over the progress of the SCR rollout. The government faced a number of “insoluble” problems, including the “numerous technical and operational challenges associated with uploading data onto the SCR database from local GP records”. Fewer than 30 care records are being accessed each week.
The systems used were also questioned. Local health authority managers were “surprised at the immaturity of the technologies and business processes at the outset of the national roll-out”, the report stated.
The quality of data on the record, and whether it is organised in a useful and standard format, are two serious concerns long-expressed by doctors. The UCL report confirmed that the government, now over seven years into the programme, was still facing difficulties defining a “minimal dataset” of key medical data.
A number of records evaluated for the report contained errors, including missing allergies and incomplete medication lists, so doctors were required to stick with their own judgement and verify the information with patients. SCRs failed to cut consultation times.
The UCL report concluded that it is time to “revisit the logic” of a centralised online records service. “Scaling things up” to a national database level “doesn’t necessarily” make healthcare systems more efficient or useful, Professor Greenhalgh said.
A spokesperson at the Department of Health lent his support to summary care records, but added that "the current processes that are in place need reviewing to ensure that both the information that patients receive, and the process by which they opt out, are as clear and simple as possible". There was also, he said, a need to review the content of the record.