Nurses surveyed by the Royal College of Nursing have questioned whether electronic records are more secure than paper ones. Will their concerns undermine the national roll-out of a national Summary Care Record database?
The views of nurses on electronic records are included in the Royal College of Nursing’s formal response to a government consultation paper “Liberating the NHS: an information revolution”. The consultation started in October last year and closed this month.
The coalition’s push for a national database of patient records, the Summary Care Record, is founded on the principle that personal health data is secure. But the Department of Health and NHS Connecting for Health no longer promise that patient records are actually secure, though that is their aim.
On its websites the Department describes the security of electronic records as an “aim” and “one of our top priorities”. About 4.4 million patients have had summary data from their GP-held health record uploaded to the national SCR database, which is run by BT under its NPfIT contracts.
The Department tells patients on the security of their electronic health records:
“We aim to use the strongest national and international security measures for handling your information ”
“ one of our top priorities is to make the process of accessing your electronic information secure. ”
“ No matter how careful we are, there are always risks when information is held on computers, as there are with paper records.”
Nurses surveyed by the Royal College of Nursing say that increased sharing of information across multiple care providers brings a “risk of increased problems with information security”.
The RCN says in its paper that “fewer than half (49%) of the nursing staff surveyed in the RCN e-Health survey thought that electronic patient records are more secure than paper-based ones”. The Royal College says that “this concern should be addressed by Government”.
The Royal College of Psychiatrists, in its response to the consultation, is also concerned about the security of electronic records. It says the public is justifiably concerned that insurance and finance companies could access e-records.
“Having total access to their care record will enable service users to see what is recorded about them and 'challenge' anything they feel is incorrect or has been misunderstood“However, service users and carers have strong concerns about the lack of security and possibilities of abuse from electronic care records systems.
“In light of well-publicised, recent data confidentiality breaches by Government departments, the public remain justifiably concerned about who else might access information (e.g. insurance companies, finance providers etc.).”
The Royal College of Psychiatrists points out that NHS users - and those outside - could view information they shouldn’t see.
“There are real concerns about information in records that it might not be appropriate for the carer to see - such as personal information relating to a relative or carer.
“ within the area of mental health it is a genuine and general concern for family members and we would want to see specific safeguards spelt out in order to address this issue.
“There are also occasions when health and social care professionals want to share thoughts (hunches about potential risks of abuse for example) that would be to the detriment of patient well-being were they to be transparently available.”
It’s unlikely that the concerns of the two Royal Colleges will influence ministers or the Department of Health. Whitehall officials have consistently briefed ministers that the national database of summary care records is secure.
When there are inappropriate accesses of the SCR database, the reactions of the Department of Health and NHS Connecting for Health are in effect: it isn't our fault. This means they will continue the SCR roll-out unimpeded by security concerns.
Indeed nothing, it appears, will stop the roll-out, even if SCRs prove of little use and, as a result, are little used. The records may go largely unused because the SCR data isn't always perceived by doctors and nurses as trustworthy. The DH and CfH argue that it's up to clinicians to ensure the data in SCRs is accurate. And if it's not? Not our problem, say DH and CfH.
And the roll-out continues.
Thank you to GP Neil Bhatia for drawing my attention to the papers of the RCN and the RCP.