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No boundaries plan needs shared records

Tags: booking   Boundaries   GPs   SCR   website  

09 Mar 2010

The abolition of GP practice boundaries will increase the importance of shared medical records, according to the Department of Health.

The DH has launched a consultation on its plans to scrap GP practice boundaries which it argues will meet demand from a “significant minority” of patients to move to a different practice.

The consultation looks at the implications of enabling patients to register with any practice of their choice including the impact on home visits, urgent care, co-ordination of care, access to secondary care, resource allocation and IT and access to patients’ medical records.

The consultation says “the need for a more accessible clinical record will increase” if patients are able to register with a GP practice some distance from their home and rely on a local service for urgent care and home visits.

However, it says “this is not in itself an argument against allowing people to register away from home.”

The DH argues that by allowing people to register with a more convenient GP practice, patients will be more likely to see a GP who has access to their medical records than if they rely on A&E and walk-in centres.

However, the document adds that “greater choice will nonetheless increase the importance of shared medical records” and highlights the roll-out of the Summary Care Record, which it says is due to be complete by the end of March 2011 where technically possible.

The consultation document says that “in due course” the SCR will contain key hospital discharge letters and out-of-hours contact information as well as information on allergies, significant medical history and treatment plans.

It says patients can also open a HealthSpace account to access their summary record and show it to any clinician they wish.

The DH document also sets out plans to publish more information about GP practices on the DH website NHS Choices and “through other sources” which the department argues would help patients make the right decision about their choice of GP practice and provide equal access for all.

The consultation document also discusses enabling patients to register with GP practices via internet or email. The DH says that, in light of electronic appointment booking and repeat prescriptions “we think electronic registration would be a natural development” and invites views on such a plan.

In January, the BMA rejected the DH’s proposals to scrap practice boundaries and argued that the introduction of videophones and webcams would be a better way of widening access.

The consultation document and response form is available online and the consultation is open until 28 May.

Fiona Barr

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Reader's Comments
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Reader's Comments

1

Does DH have any idea about either medical care or general practice delivery of medical care?

09 Mar 10 19:03

I've filled in the consultation - and some of the assumptions (including the assumption that the consultation is not about whether to abolish practice boundaries but about how to manage the abolition) are mind-boggling! My impression is that DH regards medical care as being a lifestyle choice for individuals who are fully mobile - and that general practice care of chronic disease, care plans and child/public health and community health services would not be affected - or if they were, this was irrelevant because of the only important vote-winner - "Patient Choice"! (I think that, as a GP with a 12-13 hour day, I should have an absolute right to have my bank manager, lawyer, MP and all the PCT and SHA staff available every Sunday (as a Choice issue!) - can I get support for this? ;->>)

Getting back to records - I am really worried if the DH believes that the SCR would solve all the problems of registering near place of work and needing care when too unwell to get to work.

Think about it: who does the work and takes the responsibility?

Readers of EHI are probably more capable of looking at the practicalities and issues than DH - if DH actually does have the beliefs in the article...


2

Crossboundary registration

10 Mar 10 08:03

How about we abolish MP's constituency boundaries and let people vote from anywhere in the country by e-mail or phone? This would be nice, because I don't really like my local MP and would like to vote for someone else. I don't feel that he reflects my needs and don't like his tone or his constituency surgery. I don't want to go out on a rainy Thursday here, when I could vote from here or Spain or anywhere sunny online. And yes, I am a GP in a heavily oversubscribed practice that limits its patients by area.


3

The saddest thing...

10 Mar 10 09:03

... is that Government ministers probably believe or have been told that the availability of the (Read Only) SCR will facilitate this.

The cat is finally out of the bag!


4

Absolutely Daft

wayne.walters@nhs.net

10 Mar 10 09:03

It beggars believe that this scheme ever left the few brain cells of the person who dreamt it up. Do they not realise the impact on the Exeter system? There again, they most probably have never heard of the Exeter system.


5

perhaps its another shared record?

cunpr@globalnet.co.uk

10 Mar 10 10:03

Yes obviously he's wrong, no one in their right mind would ever "care" for a patient using the SCR - in incomplete multicontributor record where there is no single person responsible for it - can accept any sort of rubbish sent to it by inexperienced inarticulate non UK trained employees of Mr Branson's Virgin GP chain and best of all its constructed in the main as an image store with no ability to search the imaged documents.

But of course there is another record that might fit the bill, GP2GP transfered GP records. From one GP practice to the next, same day, GP records for GPs managed by GPs. Now boundary abolition can be supported by GP2GP.

Its the unsung hero of NHS IT and proud to have existed before Blairs sofa breifing. Paul C


6

Associated services

elaine.morris2@nhs.net

15 Mar 10 10:03

Has there been any consideration for Community Services that are often associated to a GP surgery eg Midwifery or District Nursing? Unless there is a change to the way their work is managed, I can see a significant increase in mileage to cover visits for more widely distributed patients, and an increase in their information needs, eg to build relationships with additional pharmacies.

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