Ex-BT executive ambivalent towards Summary Care Records

Sir Jonathan Michael has been a surgeon, Chief Executive of University Hospitals Birmingham NHS Trust, and later CE of Guy's and St Thomas' in London. In 2007 he became managing director of BT Health. His responsibilities included the NHS...

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Sir Jonathan Michael has been a surgeon, Chief Executive of University Hospitals Birmingham NHS Trust, and later CE of Guy's and St Thomas' in London. 

In 2007 he became managing director of BT Health. His responsibilities included the NHS 'data spine' - which includes the Summary Care Records database - and the London local service provider contracts under the National Programme for IT in the NHS. His job at BT included responsibility for implementations of the NPfIT “Cerner” systems.  

This year Michael moved back to the NHS, as chief executive of Oxford Radcliffe Hospitals NHS trust, which is one of BT Health's NPfIT Cerner customers.

Clearly he is a man who understands the IT needs of the NHS - and what tends to work and what doesn’t.  

In an interview with Smarthealthcare.com, Michael concedes he is ambivalent about the Summary Care Record. 

Smarthealthcare.com says that Michael sees the future of the NPfIT as focusing on sharing data, rather than massive deals. "The principles of the National Programme, whereby the advantages of having the ability to share information across the whole of the NHS, is still very valid." 

He supports the continuation of central systems such as the BT- run data spine but is ambivalent about the Summary Care Record and more interested in local IT systems that are interoperable.

His apparent lack of enthusiasm for the Summary Care Record is shared by many within the NHS - and Parliament.

The Summary Care Records is one of the main parts of the NPfIT. It is designed to give 50 million people in England an electronic health record. It contains limited medical information and which any clinician can access at any time, if they have good reason to. 

The SCR is controversial, in part because, as a team of expert researchers led by Trisha Greenhalgh discovered, the SCR data is sometimes inaccurate and so cannot be trusted. The evidence so far is that few hospital doctors will use it, in part because its use requires a change in ways of working. 

Some doctors say they don’t have the time to access it, and it is unclear whether the SCR will be reliably updated. It is even more unclear whether the benefits justify the money spent on the SCR. 

Meanwhile some MPs - including Coalition ministers - are unsure why Simon Burns, the NPfIT minister, is committed to keeping the SCR. The signs are that Burns would like to believe that the NPfIT is dead and is irritated that it is very much alive. If he had a choice, the NPfIT would probably not be in his brief.

The Coalition has proposed confining the information in the SCR, in the main, to name, date, place and time of birth, date of death, gender, alternative contact information, how to contact, whether patient has agreed to share their medical data, whether the patient is registered with a GP, whether the record is being reviewed to see if data is correct, allergies, medication and adverse reaction to drugs.  The Coalition has proposed that other medical information should be included in the SCR only if the patient gives explicit consent. 

Links:

Interview with Sir Jonathan Michael - Smarthealthcare.com


Devil's In the Detail - independent report led by Trisha Greenhalgh on the SCR