Consent to view to get first test

Tags: consent SCR SystmOne

01 Dec 2008

Five GP practices in South West Essex are to become the first GPs in the country to implement the new ‘consent to view’ model for the Summary Care Record from this week.

The practices will also implement consent to view for access to patients’ Detailed Care Records using TPP’s SystmOne.

Just under 15,000 patients from the five practices will receive information today (1 December) explaining how the SCR works and the implications for them as part of the 16 week consultation period.

After the consultation records will be uploaded by implied consent if patients have not chosen to opt-out, but the SCR will only be available to view if the patients give consent at the time of each clinical encounter. The new ‘consent to view’ model was agreed by Connecting for Health in September.

South West Essex has also opted to implement ‘consent to view’ for its detailed care records,as revealed by EHI Primary Care in September.

About 85% of practices in the area use TPP’s SystmOne and the company has been asked to modify its software in a future release to include ‘consent to view’ functionality. In the mean time consent to view for DCRs will be introduced as a business practice.

Barbara Stuttle, deputy chief executive for NHS South West Essex, who is also NHS Connecting for Health’s clinical lead for nurses, told EHI Primary Care that she felt very strongly that patients should be offered the same consent model for both detailed and summary records.

She said: “We will be the first early adopter site to implement the new consent model which I think is much more overt and straightforward. In terms of clinical best practice it’s my view that that should also apply for detailed care records.”

The use of consent to view for DCRs is also currently being considered nationally.

South West Essex is the last of the six original early adopter site to begin implementing the SCR, some 20 months after the first early adopters were announced.

Stuttle said the trust wanted to wait until the debate over the consent model had been resolved before launching the SCR in South West Essex.

The first wave of five practices will be followed by a much bigger second wave, beginning in February 2009, covering about a third of the patient population in South West Essex.

She added: “There is some nervousness which is understandable but we have got 17 practices queuing up to go in the second wave which is phenomenal. “

Dr Robin Bell, a GP at one of the first wave practices in Basildon, said the project was an important step in the development of electronic records which would help patients and health professionals alike.

“This project manages to strike the balance between the drive for improvement and the needs of patients. Using advanced and secure technology health professionals can have up-to-date information at their fingertips so that patients get the right treatment in the shortest time. I shall certainly be recommending it to my patients,” he said.

The SCR will only be available in A&E departments and out-of-hours when 60% of the population has an SCR. Stuttle said sharing of information via DCRs had been on a small scale so far but she expected that to grow with the introduction of the SCR and the consent to view model.

She added: “I am advocate of the shared care record and the DCR because I do genuinely believe this will make healthcare safer for patients.”

Stuttle said that as well as the letter containing information on the SCR and DCR South West Essex has opted to send all patients involving in the early adopter practices a copy of the Care Record Guarantee.

She said wider publicity would be kept relatively small scale to begin with because the SCR was only available to few patients but future plans included the possibility of advertising the SCR on buses in the area. A date has yet to be set for roll-out of the SCR to the rest of South West Essex because Stuttle said the trust was keen to learn from the experiences of the first two waves.

Related articles

SCR consent model changes

PCT seeks to align SCR and SystmOne consent

Fiona Barr

Reader's Comments

who will need to ask for consent

stressfreedave@hotmail.com

02 Dec 08 12:12

So will all the others (researchers, chemist, police, BT etc) who will have access to the patient data once it is uploaded need to ask? Will patients be fully aware of what they are allowing people to see? When I asked an NHS trust about medications used in abortions etc they made it clear that such information would be uploaded. There is a big difference in allowing someone view a record that contains information that shows what inhalers you are currently using and data that shows/implies you had an abortion 5 months ago. There is also the issue about who has access to it. Some patients might allow a doctor access to data that shows they had an abortion 5 months ago but are they also willing to allow the receptionist or a chemist access to such information?

consent to view first test?

02 Dec 08 17:12

I have seen the consent to view model in use elsewhere with other systems with relatively large volumes of patients.

Access is restricted to small numbers of specified clinicians that work for a specific services and is fully configured service by service.

Patients accessing these services have used the 'consent to view' model for approximately 12 months and it works well.

Isn't there a difference between summary and detailed records?

maryhawking@tigers.demon.co.uk

02 Dec 08 21:12

Stressfreedave is right: there is a very big difference between summary and detailed care records.

SCRs are just that: sumaries where, in the original model, after an initial upload of medication and allergies, patients and GPs would agree what other Coded data (no free text..) would be uploaded. This might be useful.

Detailed Care Records are the total record from all care providers - GP, Community, Hospital, GUM clinic and mental health services and foot care. They are also likely to contain free text. And with a cradle-to-grave record, I just don't know what is - or might have been - recorded in them.

I might agree to a Summary Care Record - but would be reluctant to give, say, chiropody access to my mental health and GUM records..

So I would not agree to an SCR.

As a GP, should I explain the issues to my patients - who do seek advice on this sort of thing?

RE: Why cause confusion?

03 Dec 08 12:12

Are we all reading the same article? I am slightly confused why stressfreedave emphasizes SCR access by the "researchers, chemists, police, BT, etc. I thought it was only to be accessed by clinicians within the out of hours care setting. Also, you have to be asked before you access the record - hence being called "consent to view". As the SCR only holds medications, allergies and reactions is this such a bad thing?

Cyber access

04 Dec 08 15:12

I think Stressfeedave was referring to the groups of people who (potentially) have access to your medical records under current legislation i.e. the Data Protection Act.

Obviously, if this is done electronically, it's far more scary...