Scottish ECS proving a success

Tags: Cancer Community consent ECS feedback GP NHS 24 Out-of-hours Scotland

02 Nov 2006

Launched last summer the Scottish Emergency Care Summary is already proving a success making out-of-hours communications more efficient and effective.

Libby Morris, chair of SCIMP told E-Health Insider Primary Care: “Following a public information campaign about the ECS, through leaflets delivered to all 2.5 million households in the country and a further 400,000 copies of the leaflet distributed to GP practices, primary and secondary care services, we were able to successfully go-live across all 14 NHS boards.”

The half million pound campaign gave full details of how patients could opt-out of ECS. Some five million records are now on the system and to date just 174 patients have opted out.

NHS staff will have to ask the patient's permission before they can look at the ECS, except in the event the patient is unconscious or unable to give consent.

The system makes it possible to check who has looked at the patient's ECS. Patients can ask their GP to show them the information in their own summary.

The ECS contains important basic information such as name, date of birth, Community Health Index (patient ID number used in Scotland), medication prescribed by a GP and any adverse reactions to prescribed medicines.

Dr Ian Kerr, an Edinburgh GP, who sits on the SCIMP board and chairs iSoft's Scottish Users Group told EHI Primary Care: “Since rolling out, the scheme has been a success. Out of Hours teams and A&E departments in particular are finding the system very useful.”

He added that he would like to see IT reduce the need for re-entering data, and in the future see the ECS systems further integrated with out-of-hours services, the ambulance service and NHS 24

Plans are now in place to begin the switch over to electronic records and NHS Scotland is aiming to store and link full health records electronically by 2010 – beginning implementation in spring 2007.

A Gold Standards Framework Scotland (GSFS) IT development project has been established which aims to provide electronic patient records in one place helping those with cancer and palliative care needs in particular.

Dr Kerr explained: “GSFS will support clinicians to do the right thing at the right time, making it easy to have the best possible information available for forward planning, team review, consistent communication and sharing critical information.”

Staff will be able to fill in the patient record forms using the system, which can be saved electronically and then accessed by authorised staff. These will replace current paper-based tools and be integrated into existing practice IT systems.

Morris told EHI Primary Care: “Patient-clinician interaction is important. Patients should know what is going on and who knows what about them. They must give explicit consent for information to be released, and trust the clinician not to abuse details which can be sensitive.”

The ECS has been piloted by various trusts, accident and emergency units and focus groups since its initial launch in October 2005. Dr Kerr believes that the success of its national launch is thanks to the large amount of feedback received from patients, clinicians and administration staff.

Reader's Comments

Lack of awareness of system

03 Nov 06 09:11

I have a comment to make about your mention of the system in Scotland.

Part of the reason is that not everyone is aware of who will have access to the information or that the data is reportedly copied to another 3rd party database (this is not mentioned in the information given out) and it is not just the dovtor/nurse that will have access. It is because of the amount of people that will have access I have opted out.

It is also not that easy to opt out. I tried to restict my data sharing at a practice in Aberdeen and was told that this was not an option, that included me not being allowed not to have a emergency care summary and that an ECS would be created whether I liked it or not. When I insisted that I restict access to my data in ways the NHS, GMC, BMA and PIAG say I can, I had treatment withdrawan and told I was being removed from the practice list.

When patient do try opt out they are often frightend into allowing it to be created. The information NHS-Scotkand gives out warns people that it could effect their level of care even though the receptionist not knowing would not effect your level of care and a doctor/nurse not knowing that 3 years ago you had been issued by a antibiotic would not effect your health care unless you had a serious reaction to it.

Of you are going to make comments about the way things are being done north of the border, please look at how it is being done before making such comments.

ECS Reply

10 Nov 06 16:11

As Clinical Director for e-Health in NHS Grampian, and a member of the ECS Programme Board I am somewhat surprised by the above comments. Firstly it is simple for a practice to allow individual opt out of information going to the ECS store, the feature is part of the GP Clinical System, secondly I cannot believe that a practice would remove a patient because of their descision to opt out of ECS. If this was the case I would be very grateful if they would consider forwarding the copy of the letter of explanation for removal from the practice list to the following address; Director of Primary Care, NHS Grampian, Summerfield House 2 Eday Road, Aberdeen, AB15 6RE, so this can be further investigated. The other point that I should make is that no clinician can access the ECS record without the explicit consent of the patient, unless of course the patients condition precludes them from giving consent, for example if they are unconscious.

The Problem

13 Nov 06 08:11

The problem this correspondent is trying to raise I think is even if the patient opts out of ECS and no other clinican can access his/her details, they are still sat on some central NHS database. Who knows what secondary uses this person's information will be used for in the future. I believe this a case of Big Brother is watching us.

This is absolutely no opt out from these central governemnt NHS databases as I have personally found it is the case in England.