The current NHS’ Summary Care Records system is “clunky” and "interfaces poorly with other ICT systems", according to a new report.
Staff who had attempted to use the electronic care records in a pilot programme found them complicated and difficult to use, the report by researchers at University College London warned.
System users struggled to keep pace with a raft of changes that had been made quickly, as the NHS faces pressure to deliver a programme that has already overrun by several years. Some GPs felt that trusts had put excessive pressure on them to use the system on a tightly-managed and non-negotiable timetable to, "despite the immaturity of technical solutions".
The report, called the ‘Summary Care Record early adopter programme’, monitored the use of the SCRs by four of the trusts that were first to use the system ahead of a national rollout. The UCL team interviewed 250 NHS staff from primary care trusts, GP practices, A&E, walk-in centres and out-of-hours services, as well as 170 patients.
The electronic record system is a key part of the government’s £12.4 billion National Programme for IT, and will contain basic information on patients’ details, prescriptions and allergies. More data will be added to them as patients are treated, and this is one area that has attracted controversy. The report questioned the way in which patient consent was being assumed unless the patient actively asked to be removed from the system.
GPs had raised “important questions” about the ethics and even legality of this assumption as many patients in the early adopter sites did not understand the programme, despite information they had been sent, the UCL team said. Two GP surgeries opted out of the early adoption scheme in objection to the consent model.
While eight in ten patients said they accepted the system, some of the rest were “strongly opposed” to it, the report warned. A number of GPs had chosen not to participate in the programme, choosing to wait until after data quality improvement work had been completed.
In two of the early adopter sites - Bolton and Bury - over 150,000 care records have been created. No timetable has been announced for the national rollout.
Adopting SCRs was not a case of switching on a system, but rather a "socio-technical change", the report warned. The NHS would now face challenges over careful staff selection and training, work routine realignment, and explaining clearly to patients what their options are, it said.
The report noted that comparable technology in Scotland, called the Emergency Care Summary, was found to be working well, two years after rollout.
Last month, the government admitted that security issues remained on the summary care record, but nevertheless proposed extending system access to local pharmacies. It has also previously been proposed that the care records could be shared with social services.
In 2007 the British Medical Association wrote to health minister Ben Bradshaw calling for a halt to the roll-out of patients’ summary care records until the results of pilot projects had been fully reviewed.
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