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The year of the e-record

Fiona Barr checks on the summary care record as the DoH pushes its roll-out.

It is now six years since Tony Blair chaired a seminar that led to the launch of the world's biggest civil IT project, the NHS National Programme for IT.

Targets were set for a national booking system being fully functioning by late 2005 and last year we should have had electronic records and electronic transmission of prescriptions.

While these targets were clearly over-optimistic, the original vision remains - that there will be a shared patient record across all care settings.

Work continues on the NHS Care Records Service, the patient record, comprising two elements: the detailed care records and summary care records.

Bolton, Bury, Dorset, South Birmingham and Bradford and Airedale PCTs are early adopter sites for the summary records. By last month, 26 practices were taking part in the scheme and 163,000 summaries had been created.

Text-only summaries are extracted from GP records containing information on repeat and acute prescriptions and allergies, and placed on the NHS central Spine. Later a coded summary can be uploaded, giving information about patients' recent diagnoses.

Patient consent
Whether patients give 'implied consent' for the summary record until they request exclusion is the subject of controversy, with the BMA and others arguing that no summary should be uploaded without consent. Patients can opt out of the summary care record but cannot prevent the uploading of demographic details to the NHS Spine.

In Bolton, out-of-hours and accident and emergency departments can view summary records, and in Bury patients can already see their own summaries via HealthSpace, the DoH's secure online website.

The DoH has now set the target for PCTs to roll out summary care records, this year.

Patient access
Detailed care records, according to the DoH, will contain the full clinical notes for every patient, with records shared within a local health community using the same IT system. How that will work alongside GP and hospital record systems is unclear.

As the summary care record rolls out, more and more patients will be able to see their own summary record on HealthSpace but, so far, the DoH has no plans to deliver a national system that will provide patient access to full records.

Care records

Summary Care Record

  • Being piloted in five PCTs.
  • Expected to take several years to reach all practices.

Detailed Care Record

  • As yet undeveloped and unclear how it will interact with current hospital and practice record systems.

HealthSpace

  • Patients in pilot areas can view their records.

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