Summary Care Record

Last updated

A Summary Care Record (SCR) is an electronic patient record, a summary of National Health Service patient data held on a central database covering England, part of the NHS National Programme for IT. The purpose of the database is to make patient data readily available anywhere that the patient seeks treatment, for example if they are staying away from their home town or if they are unable to give information for themselves. Despite opposition from some quarters, by September 2010, 424 GP practices across at least 36 primary care trusts had uploaded 2.7 million Summary Care Records. [1] On 10 October 2010, the Health Secretary announced that the coalition government would continue with the introduction, but that the records would 'hold only the essential medical information needed in an emergency – that is medication, allergen and [drug] reactions'. [2] By March 2013, more than 24 million SCRs had been created across England. [3]

Contents

In 2022 the Department of Health and Social Care set a new target for each integrated care system to set up a ‘shared care record’ accessible by health and adult social care providers by 2024. This replaces the summary care record programme. [4]

Content

Access to data is available to NHS personnel anywhere in England, but only if they have had the correct access rights on their smartcard approved by senior management [ citation needed ]. Pharmacists in five regions were given read-only access in an NHS England pilot in October 2014 so they could verify and compare a patient's medicines during medicine use reviews. [5] Patients were able to view their own records via the HealthSpace website, which closed down in December 2012. [3]

Initial content

The initial content of the database was to include the following:

In his announcement on 10 October 2010, the Health Secretary implied that its scope would in future be restricted to these three items, stating but that it would 'hold only the essential medical information needed in an emergency – that is medication, allergen and [drug] reactions'. [2] It also stated however that additional information can be added at the specific request of the patient.

Planned future content

It was originally intended that the database system would be upgraded in the future to add: [7]

However, following the Government announcement in October 2010 this is no longer envisaged. [2]

Implementation

Initial plans were that patients' records would be automatically be uploaded, without seeking patient consent. [8] In December 2006, Sir Liam Donaldson, the Chief Medical Officer, wrote to GPs telling them that letters from patients requesting that their records should not be uploaded should be sent to Patricia Hewitt, the health secretary, for 'full consideration', causing consternation among privacy campaigners. [9]

Opting-out introduced

As a result of pressure from privacy campaigners, the British Medical Association (BMA), the Ethics Committee of the Royal College of General Practitioners, and a report by the Department of Health's 'patients tsar' Harry Cayton (the Report of the Ministerial Taskforce on the Summary Care Record [10] ), the Government agreed that patients would be able to opt out of the Summary Care Record. [11]

After further pressure, it was decided that patients would be contacted before records were uploaded to provide them with the opportunity to opt out. Unless the patient does explicitly opt-out within the specified period after being notified (12 weeks as of April 2010), their details will be uploaded. Once entered and viewed, records cannot be fully deleted.

A number of pilot schemes followed, in the primary care trust areas of Bolton, Bury, South Birmingham, Dorset, South West Essex, and Bradford & Airedale. In response to a freedom of information request, the Department of Health revealed that, as at 24 April 2009, 258,488 patients' clinical records had been updated to form Summary Care Records. The Department was unable to provide information on how many of these related to children. [12]

Problems with the opting out scheme were reported by the independent evaluation, published 2010. [13] [14] [15] In September 2010 it was reported that the opt-out rate had risen from 0.6% to nearly 1% [1]

Roll-out begins

By the end of 2009 five strategic health authorities - NHS North West, NHS North East, NHS Yorkshire and the Humber, NHS London and NHS East of England – had announced that they would begin notifying patients and uploading records during 2010. The Department of Health agreed to make funding available to them within the 2009-2010 financial year for public information campaigns. [16] By 18 March 2010 letters had been sent to at least some patients notifying them that their details were to be entered unless they opted out within 12 weeks.

On 16 April 2010 the Department of Health suspended the implementation of Summary Care Records in the areas leading the roll-out, following calls to do so by the British Medical Association. [17] The BMA believed that implementation was moving forward too rapidly, that patients did not have enough information, and that it was too hard for them to opt out. [18] A week later it was reported that several primary care trusts and the NHS East of England Strategic Health Authority were seeking a dispensation to continue with their implementation. [19]

In August 2015 it was announced that retail pharmacies would be given access to NHS patients Summary Care Records after a pilot of 140 pharmacies in Somerset, Northampton, North Derbyshire, Sheffield and West Yorkshire, demonstrated “significant benefits.” Pharmacists have to ask for a patient’s permission to view their record, [20] and are required to complete the relevant Centre for Pharmacy Postgraduate Education e-learning package. [21]

In 2018 information on long-term health conditions, medical history and immunisations was available, and according to NHS Digital, this reduced the burden on the health service during winter. [22]

Patient awareness

A concern that has been raised is that surveys have shown that most patients know nothing of the SCR scheme even if they have received leaflets, so that when people receive a package on the SCR it goes straight in the bin as junk mail. [15] [23]

Criticism

In March 2010 the British Medical Association asked the British Government to suspend the roll-out of the database as it was an "imperfect system" being rushed into service prematurely, [24] amid accusations that the system is insecure and that data has been uploaded without giving patients the opportunity to opt out. [25]

The system has also been criticized for its inability to delete a patient record if a patient decides to withdraw from the system once their record has been created AND viewed. This has been stated to be due to the cost of completely deleting all information: "complete removal would require the hardware holding records to be completely sanitised. This is a process that destroys all data held, for example on a server or hard drive, and not just a particular record" [26] and that in any case the record needs to be retained for legal reasons [26] as "The issue of audit and the medico-legal evidential significance of the SCR will be extremely important and it would be inappropriate to provide tools that could completely remove a record, even if this were feasible." [27]

SystmOne and other GP systems provide much more detailed information than the Summary Care Record. The implementation of SystmOne Prison across the prison estate "should be taken as a sign that a more widespread system is easily achievable". [28]

Related Research Articles

General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

<span class="mw-page-title-main">NHS Digital</span>

NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly those involved with the National Health Service of England. The organisation is an executive non-departmental public body of the Department of Health and Social Care.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

The NHS Connecting for Health (CFH) agency was part of the UK Department of Health and was formed on 1 April 2005, having replaced the former NHS Information Authority. It was part of the Department of Health Informatics Directorate, with the role to maintain and develop the NHS national IT infrastructure. It adopted the responsibility of delivering the NHS National Programme for IT (NPfIT), an initiative by the Department of Health to move the National Health Service (NHS) in England towards a single, centrally-mandated electronic care record for patients and to connect 30,000 general practitioners to 300 hospitals, providing secure and audited access to these records by authorised health professionals.

<span class="mw-page-title-main">Healthcare in the United Kingdom</span> Overview of healthcare in the United Kingdom

Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences have developed between these systems since devolution.

<span class="mw-page-title-main">National Health Service (England)</span> Publicly-funded healthcare system in England

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).

SystmOne is a centrally hosted clinical computer system developed by Horsforth-based The Phoenix Partnership (TPP). It is used by healthcare professionals in the UK predominantly in primary care. The system is being deployed as one of the accredited systems in the government's programme of modernising IT in the NHS.

Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service as health is a devolved matter, there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.

<span class="mw-page-title-main">Liam Donaldson</span> British doctor (born 1949)

Sir Liam Joseph Donaldson is a British doctor. He was formerly the Chief Medical Officer for England, being the 15th occupant of the post since it was established in 1855. As such, he was principal advisor to the United Kingdom Government on health matters and one of the most senior officials in the National Health Service (NHS).

<span class="mw-page-title-main">Tim Kelsey</span>

Tim Kelsey is CEO of Beamtree,, an Australian healthcare company (ASX:BMT) based in Sydney, Australia. He started in the role in December 2020.

<span class="mw-page-title-main">The Phoenix Partnership</span> UK based IT company

The Phoenix Partnership (Leeds) Ltd (TPP) is a software company based in Horsforth, Leeds. It develops and supplies clinical software including SystmOne.

care.data was a programme announced by the then Health and Social Care Information Centre in spring 2013. It aimed to extract data from GP surgeries into a central database through the General Practice Extraction Service (GPES). Members of the English population who were registered with GP practices were informed that data on their health would be uploaded to HSCIC unless they exercised their rights to object by informing their GP.

Patient record access in the United Kingdom has developed most fully in respect of the GP record, because computerisation in that field is almost universal. British hospitals were slower to move into electronic records. From 1 April 2015 all GP practices in England have to provide online services to patients, including access to summary electronic medical records.

EMIS Health, formerly known as Egton Medical Information Systems, supplies electronic patient record systems and software used in primary care, acute care and community pharmacy in the United Kingdom. The company is based in Leeds. It claims that more than half of GP practices across the UK use EMIS Health software and holds number one or two market positions in its main markets. In June 2022 the company was acquired by Bordeaux UK Holdings II Limited, an affiliate of UnitedHealth’s Optum business for a 49% premium on EMIS’s closing share price.

Amir Simon Hannan MBE is an English doctor who works as a General Practitioner in Tameside and has pioneered patients having access and understanding to their Electronic health records in the English National Health Service.

Pharmacy in the United Kingdom has been an integral part of the National Health Service since it was established in 1948. Unlike the rest of the NHS, pharmacies are largely privately provided apart from those in hospitals, and even these are now often privately run.

In Practice Systems Limited (INPS) is a health informatics company, part of the Cegedim group and based in the United Kingdom.

In 2005 the National Health Service (NHS) in the United Kingdom began deployment of electronic health record systems in NHS Trusts. The goal was to have all patients with a centralized electronic health record by 2010. Lorenzo patient record systems were adopted in a number of NHS trusts. While many hospitals acquired electronic patient records systems in this process, there was no national healthcare information exchange. Ultimately, the program was dismantled after a cost to the UK taxpayer was over $24 billion, and is considered one of the most expensive healthcare IT failures.

The General Practice Data for Planning and Research system was set up by the British National Health Service as a replacement for the General Practice Extraction Service as a means of transmitting data intended for use beyond that of providing individual health care. This might include healthcare planning, or research.

References

  1. 1 2 Summary Care Record rollout pushes ahead as National Programme for IT axed published 2010-09-10, accessed 2011-01-13
  2. 1 2 3 Lansley confirms summary care record roll-out will proceed Health Service Journal, published 2010-10-11, accessed 2011-01-13
  3. 1 2 "HealthSpace — NHS Connecting for Health" . Retrieved 2 April 2014.
  4. ↑ "Community pharmacy access to shared patient records 'not prioritised'". Pharmaceutical Journal. 15 February 2022. Retrieved 21 April 2022.
  5. ↑ "Pharmacists given records access as pilot goes live". Chemist and Druggist. 13 October 2014. Retrieved 13 October 2014.
  6. ↑ "Summary Care Record". Leeds University Student Medical Service. Retrieved 17 March 2010.
  7. ↑ Richard Clay (27 October 2009). "The Summary Care Record Scope Document" (PDF). National Health Service. Retrieved 17 March 2010.
  8. ↑ From cradle to grave, your files available to a cast of thousands The Guardian, November 1, 2006
  9. ↑ GPs angered by call to reveal names of NHS database rebels The Guardian, December 2, 2006
  10. ↑ Report of the Ministerial Taskforce on the Summary Care Record, Department of Health, December 6, 2006
  11. ↑ Should we fear plans to put medical records on a national database? The Independent, December 19, 2006
  12. ↑ Number of Summary Care Records created WhatDoTheyKnow, April 30, 2009
  13. ↑ Health e-records 'struggling to fulfil potential'
  14. ↑ Greenhalgh T, Stramer K, Bratan T, Byrne E, Russell J, Potts HWW (2010). Adoption and non-adoption of a shared electronic summary care record in England: A mixed-method case study. BMJ, 340, c3111 Full text
  15. 1 2 Greenhalgh T, Stramer K, Bratan T, Byrne E, Russell J, Hinder S, Potts H (2010). The devil’s in the detail: Final report of the independent evaluation of the Summary Care Record and HealthSpace programmes. London: University College London. Full text
  16. ↑ Summary record roll-out builds momentum E-Health Insider, December 21, 2009
  17. ↑ SCR roll-out suspended E-Health Insider, April 16, 2010
  18. ↑ BMA says SCR roll-out ‘too hasty’ E-Health Insider, March 1, 2010
  19. ↑ PCTs push on with SCR despite DH stop E-Health Insider, April 22, 2010
  20. ↑ "Tesco, Superdrug and Boots to be given access to NHS medical records". Retail Week. 19 August 2015. Retrieved 22 August 2015.
  21. ↑ "How to use the summary care record in community pharmacy". Pharmaceutical Journal. 26 April 2016. Retrieved 16 January 2017.
  22. ↑ "More detailed SCR can help ease winter pressures". Pharmaceutical Journal. 3 January 2018. Retrieved 15 February 2018.
  23. ↑ Tony Collins (9 March 2010). "Is Summary Care Records rollout speeding up as GPs urge caution?". Computer Weekly.
  24. ↑ Tony Collins (10 March 2010). "BMA says: halt rushed roll-out of imperfect Summary Care Records". Computer Weekly. Retrieved 17 March 2010.
  25. ↑ Kate Devlin (9 March 2010). "Patients' medical records go online without consent". Daily Telegraph. Archived from the original on 11 March 2010. Retrieved 17 March 2010.
  26. 1 2 John Oates (9 April 2009). "Summary care records - you might die, but they never will". The Register. Retrieved 17 March 2010.
  27. ↑ "Health officials will reject requests to delete e-records once uploaded".
  28. ↑ "Prisons linked to single health record IT". The Guardian. 13 April 2011. Retrieved 16 October 2014.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.