NHS Summary Care Record – have we done this?

I’ll go with the legal definition under the Data Protection Act for this one Graham:

“Sensitive personal data is defined in the Data Protection Acts as any personal data as to –
(a) the racial or ethnic origin, the political opinions or the religious or philosophical beliefs of the data subject,
(b) whether the data subject is a member of a trade union
(c) the physical or mental health or condition or sexual life of the data subject,
(d) the commission or alleged commission of any offence by the data subject, or
(e) any proceedings for an offence committed or alleged to have been committed by the data subject, the disposal of such proceedings or the sentence of any court in such proceedings.”

I don’t know about you, but I have never discussed any of that when buying car insurance, but I guess it takes all sorts.

P.S I do this for a living btw

I use public computers wherever possible for the internet and similar. Insurance is kept to a minimum, I don’t drive, don’t have a credit card, and I use an unregistered PAYG SIM for my mobile.

Way to stick it to the man!

So are you in an internet cafe now then? Have you made sure they don’t have CCTV inside or out? Paid in cash? Remembered to burn off your fingerprints?

You’ve probably only got around half an hour before THE AGENCY trace your connection and get a team there.

Oh and make sure you don’t log into any websites by username or they’ll know it’s you… oh too late.. you’ve been compromised.. get out now!

😀

I can hear a helicopter, I’m off!

I’m happy for them to setup a summary care record for me, although having had three different NHS numbers in the last three years, the chances of it containing anything remotely useful is low…

Rachel

I don’t know about you, but I have never discussed any of that when buying car insurance, but I guess it takes all sorts.

Doesn’t most car insurance ask about d and e (e.g. “Do you have any points on your license or criminal convictions relating to driving?”) and would cover c too (e.g. “Do you have any medical conditions that impede you from driving”)

So what’s the chances of me being casevaced to A&E and treated according to slowoldgirl’s data, because she’s come up first with the name-matching stuff?

I just hope she too is om warfarin and some other stuff. That’s what bothers me, the first year or two while they sort out the bugs.

The SCR system has been crippled.

I used to work for an out of hours GP service, every day we fax/dts a ton of patient notes out.. to a clinical system in practices.

we don’t get information in hours from the GP’s unless they remoted into the ooh system… so patient gets a ton of codeine from their GP, then calls up the OOH GP, convinces them to get MORE. or even worse controlled drugs… if they could pull the records direct from the practice.. how much money could be saved in fraud?

but as i said, most of the good useful capability’s have been cancelled.. its a gloried allergies list now.. not that many of the GP’s have actually uploaded any data to it..

“
Initial content

The initial content of the database was to include the following:
Drugs which the patient has been prescribed[4]
Known adverse reactions to drugs
Known allergies

Planned future content

It was originally intended that the database system would be upgraded in the future to add:[5]
Accident and Emergency discharge summaries
Inpatient discharge summaries
Outpatient discharge summaries
Out of Hours GP service encounters
Health and Social Care Common Assessment Framework Plans
Contributions submitted by patients to their records via the HealthSpace website

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

The computer system in the NHS/ uk health system is a joke, tbh!

Getting away from the “tin foil hat brigade” for one moment, I would say that having a decent system(s) that ‘communicates’ effectively with itself would be a godsend to my every day work.
Typical example….
You see hospital specialist/ get admitted and discharged from hospital.
It would take at least a few days for me to realise this, and the communication is in the form of a letter containing minimal information. This letter gets posted to my practice, scanned, then uploaded to my computer system!!!,

TBH, I’m sure Facebook could come up with a smoother and more useful system! What I need is a “timeline” – a way of seeing WHAT happened, when, and why. Access to real time results, scans, and clinic letter. It’s embarrassing when a patient can “beat” their discharge summary to me, and ask for a continuation of a med they were prescribed, without them or I knowing the exact rationale behind it, or the dosing plan etc!

I can think of, to hand, at least 8 different systems I have used in the NHS, neither of which have communicated effectively with one another.
Anyone heard of the “spine”? It’s meant to be the “NHS computer backbone” that contains and communicates all our health data. The first thing I do when I log onto my of at work is click “no” when prompting me to connect to it! Fail at the first steps there DrP (we’re simply not set up to link to it yet. I say yet – I dread to think when the spine was actually set up….)

Anyway, the real benefit of a decent NHS computer system won’t be in deciding if injecting penicillin into your severed arm in A&E is a good bet or not (!), but in safely and promptly communicating between primary and secondary care services…..

DrP

You opt out, and then get run over – you end up in A&E unable to communicate and then they give you something that you are allergic too, which if they had access to your data, they would know…

Anyone that opts out is saying “I’m prepared to take that risk and and assume ALL responsibility of the consequences in order to protect my privacy”

I imagine it will come to a head when the family of a patient without an SCR try to sue a hospital trust for giving them penicillin.

Couldn’t have sumarised it better myself.

Hasn’t this already been tried, and was a huge expensive IT failure that is costing millions to fix ??

Depends whether you believe the Daily Mail or not. The SCR is still rolling out at minimal cost because, as someone above said, the information is already there anyway. There was/is a program called Lorenzo which was a hugely ambitious clinical records program intended to be introduced in some areas of the country, which has never worked and in all likelihood never will BUT the digitalising of xrays has gone pretty much without notice but allows rapid access to images from pretty much anywhere in the health service including the ability to compare with previous images and get specialist opinions form other hospitals. In short it has revolutionised care, saved lives and reduced the level of unecessary misery. The similar systems for biochemistry results etc have done the same. Computerised systems to record and monitor simple observations pick up early signs of deterioration and notify the clinical teams so they can get in early and avoid disasters. Finally, the fact that almost all GP records are being kept on one of 2 programs means that, with the patients agreement, a specialist can access the GP record and make informed decisions on the basis of all the information and then the GP can see what the advice is before the patient can find their car in the car park. My guess is that in 5-10 years both GPs and specialists will be accessing the same electronic health record, in our area the hospice and the diabetes service already do, and the need for an SCR as such will have become obsolete.

Feel free to opt out, it is your right and you will still be looked after to the best of the staff’s ability on the basis of the information they have available, but inside normal working hours your GP will in all likelihood print out a summary of your record which contains far more than the SCR shows, or A&E wish to access, and will fax it to the number they think is the A&E department thus avoiding the risk of A&E logging on in a secure and traceable manner and leaving an audit trail of the access to boot. Out of hours, well, they will do their best but it is not unusual for there to be a delay of 24-36 hours before old notes appear and lots of evidence to say that despite the best of intentions, decisions made in the absence of relevant information continue to harm people.

Of course there is a simple solution to this which is to allow those with a duty of care to access currently available information in a controlled, audited and secure manner which will undoubtably improve care and save lives. Ah……that’e where we came in isn’t it.

i don’t know where tj’s working but where i am we have a sort of summary care thing and i’m reasonably certain that if he provides me with his name and chi number i’ll be able to access his records.

should he turn up at mine not only will i be able to access the medications he uses for his ailing body, when and how they were prescribed, what drug reactions he may have had as well as what allergies he does have.

i use something like this on a daily basis and i find it invaluable, particularly for those folk who can’t or are unable to remember meds, for whatever reason can’t provode a medical history etc. we have a single sign on system so that any info i review is recorded as being reviewed by me and is therfore highly traceable.

all in all very jolly. that said our it mob are still a bit of a shower and there are many niggles with the system. security however is not paramount among them. most aften medical staff aren’t signed up properly (and more often even if they are the ‘helpful’ it folk sign them out) and so can’t actually access it.

that said, if i was wanting to worry about data security in hospital the stuff on computer would be the last thing i’d be worrying about

Blimey, this still going?

Sorry but am not changing my mind, it’s a resounding NO, and please don’t accuse me of having allergies. 🙂

Given the misuse of RIPA and other IT “mission creep” that our government falls prey to. HOw long before an American company gets the contract and moves all the records off-shore? It’s a no from me.

t inside normal working hours your GP will in all likelihood print out a summary of your record which contains far more than the SCR shows, or A&E wish to access, and will fax it to the number they think is the A&E department thus avoiding the risk of A&E logging on in a secure and traceable manner and leaving an audit trail of the access to boot.

This is what vexes me. People fret about their details appearing in an electronic system with encryption, auditing and secure access. But the current “system” is insecure, results/records are faxed or posted in plain text for anyone to read, it’s not properly audited and could easily be blagged by anyone with sufficient confidence.

HOw long before an American French company gets the contract

FTFY

swiss01 – Member

i don’t know where tj’s working but where i am we have a sort of summary care thing and i’m reasonably certain that if he provides me with his name and chi number i’ll be able to access his records.

Scotland – and if you could someone has broken the data protection act provisions.

It different up here.

er yes scotland, that would be right tj. but you’ll need to be explaining how you figure, given the circumstances above, how it is you presume i’m going to be contravening data protection act provisions. no, go on really…

and a big +1 for graham s, it being a personal bugbear that current record security is about as reliable as storing stuff in a skip in a carpark (i can’t speak for the inglese but judging by what i saw last time i was in that london it’s no better)

I’m wondering what would happen what the worst that could happen if someone outside the nhs found out I’d had intravenous immunoglobulin and about a million packets of movicol during a hospital stay.

I only think its a good thing

I work across A&E’s, acute hospitals and in the community; I think the chance these records will contain information that is accurate, up to date or even ‘yours’ is next to **** all. Strikes me spending a fiver on the system would be waste of public monies.