Volume 1

The Electronic patient record : sixth report of session 2006-07 / House of Commons, Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
2007
Catalogue details

Licence: Open Government Licence

Credit: The Electronic patient record : sixth report of session 2006-07 / House of Commons, Health Committee. Source: Wellcome Collection.

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    patient-centred. The SCR has the potential to improve the safety and efficiency of care especially in emergency situations when care is delivered by staff unfamiliar with the patient involved. The Committee supports the aim of introducing a nationally available summary record as soon as possible and deplores the delays and continuing indecision about its content. (Paragraph 113) The SCR has less comprehensive clinical value than shared Detailed Care Record (DCR) systems and is a comparatively straightforward application which extracts information from existing GP systems, whereas DCR systems must be built up from a range of complex and interdependent component applications. Given that there is expected to be clinical value from the SCR, its roll-out should not be held back by delays to DCR systems. (Paragraph 114) The Committee was dismayed, however, by the lack of clarity about what information will be included in the SCR and what the record will be used for. Officials gave different answers to these questions on different occasions. The Committee was told at various times that the SCR will be used for the delivery of unscheduled care, for the care of patients with long-term conditions, and to exchange information between primary and secondary care. It is little wonder that patient groups expressed confusion about the purpose and content of the SCR. (Paragraph 115) The Committee is aware of the Department’s most recent plans but is concerned that the complexity of the SCR appears to be increasing. This will make the SCR more difficult to use, particularly in emergency situations. The Department must be clear about the purpose of the SCR, and it must ensure that the record is easy to use. To this end, we recommend that the SCR include a single standardised front screen to display key health information which is vital for emergency care. (Paragraph 116) The Committee has also received inconsistent information about the patient consent arrangements for the SCR. Initially, we were told that information will be added to the SCR with “implied consent”, provided patients do not opt out. This approach was strongly criticised by clinical and patient groups. However, it subsequently became clear that while the creation of the SCR, and the addition of “life-saving” details such as prescription information, will require “implied consent”, the addition of detailed clinical information will only take place with “explicit consent” from the patient. This hybrid consent system represents a much more satisfactory model but one which has not been well communicated to patients or clinicians. (Paragraph 117) The inclusion of prescription information on the SCR with only “implied consent” remains problematic, however. On the one hand, prescription information can often make a patient’s diagnosis obvious. On the other hand, excluding some prescription information from the SCR would be clinically dangerous. If the Department of Health does use the “implicit consent” model for prescription information, it should make clear to patients the implications both for data privacy and clinical safety. (Paragraph 118) The Committee considers that much of the controversy over privacy and consent arrangements for the SCR would have been avoided if Connecting for Health had