The Government is keeping the Summary Care Record programme despite concerns about its accuracy and usefulness to hospital doctors.
The decision to the keep the SCR is a testimony to the influence of civil servants at NHS Connecting for Health and the Department of Health who have strongly advocated the continuance of the programme, although they have never addressed points made in an independent UCL report on the programme earlier this year which questioned the accuracy of medications and allergies data held on the SCR.
The same civil servants have also persuaded the Coalition to keep the National Programme for IT NPfIT largely intact (although many articles in the media have, wrongly, described the NPfIT as dead).
The threat of inaccuracies in the SCR was raised by Trisha Greenhalgh and her team who published their research on the programme in May 2010.
She found cases where:
- The patient was taking medication which was not listed on the SCR (e.g. obtained from pharmacies, unscheduled care settings, the private sector, a relative’s medication, a stockpiled supply of past drugs, or abroad)
- The SCR listed ‘current’ medication which the patient was not taking
- The SCR indicated allergies or adverse reactions which the patient probably did not have
- The SCR failed to indicate allergies or adverse reactions which the patient probably did have
If doctors don't trust the SCR as a source of reliable information, will they use it? The Greenhalgh report found there was little use made of the SCR by hospital doctors.
In the latest SCR information which is published by the Department of Health no assurances are given that the medical information on the database will be accurate.
Indeed a letter published on NHS Connecting for Health's website, which was written by Professor Sir Bruce Keogh, Medical Director of the NHS in England, and Joan Saddler, National Director Patient and Public Affairs, Department of Health, says:
"We heard strong opinions that the use of smart cards was not universal within GP Practices and this has implications for accurate updating of the Summary Care Record."The Information Governance policy and controls that mandate smart cards are wider than the Summary Care Record Programme and as such, this issue is outside the remit of this review."However, we understand that this issue is important and we recommend that further potential options are investigated to mitigate this risk."
So why is the SCR continuing if the information on the database cannot be trusted? Perhaps it's down to the persuasiveness of the civil servants at NHS Connecting for Health, and the threat of paying compensation to the system's provider BT if the programme were cancelled.
Meanwhile Phil Booth, National Coordinator of NO2ID says:
"Andrew Lansley [Health Secretary] promised patients ‘no decision about me, without me’ yet barely a week later he’s throwing away the medical privacy of millions.
“It’s bad enough the Coalition has broken its promise on medical confidentiality, but capitulating to the bureaucrats on a system known to be unsafe shows who’s really in charge at the Health Department - and just how little they care.”
The Coalition is changing Labour's SCR policy in two ways:
- there will be an opt-out form in the material that goes to patients. Before, patients had to obtain an opt-out form. It was not sent out automatically before because the Department of Health was concerned that patients would fill it in without realising what they were doing.
- what will go in the SCR is now being specified and additional information can only be added with the patient's consent.
Other than that these two things, the Department of Health has won its case to keep the central SCR database scheme largely as it was under Labour.
NPfIT is not dead - the Tony Collins Blog
Opt-outs will be made easier - ComputerworldUK
Results of review into the SCR - NHS Connecting for Health website