GP representatives to call for public enquiry on CRS

Tags: booking Choose and Book Confidentiality consent Government GP Liverpool LMCs

05 Jun 2007

GPs representatives are to hear calls for a public inquiry into the cost of the NHS Care Records Service (CRS) at the national local medical committees’ (LMCs) conference next week. Doctors will also consider a call for Choose and Book to be suspended.

A priority motion at the LMCs conference demands that a public inquiry should examine the costs of the CRS to date and whether it is a cost effective use of public funds. The same motion also deplores the potential restriction of access to services for those who opt-out of uploading their records to the spine and demands that additional funding should be provided to GP practices for the work involved in uploading records to the spine.

Devon LMC is one of 13 LMCs that has submitted critical motions to the LMCs conference on the NCRS. Chief officer Dr Peter Joliffe said that while there was support in principle in Devon for the concept of the CRS doctors felt that the current proposals endangered patient confidentiality and cost too much money for the potential benefit that would accrue.

He told EHI Primary Care: “They are wasting taxpayers’ money and NHS money. We are particularly upset that the national view appears to be that patients will not have to give full informed consent before their details go on to the spine.”

Dr Joliffe said he believed most patients had no idea about what the government was planning and that the CRS was designed more for statistical purposes than for the benefit of the individual patients. He added: “I believe this is one thing we might actually be able to do something about.”

Other motions on the LMCs’ agenda on the CRS include one from Worcestershire LMC asking the General Practitioner Committee to advise patients to opt-out of the NCRS and stating that the conference has no confidence in the reassurances on confidentiality given by the Department of Health and Connecting for Health.

On Choose and Book the conference will hear a call that the e-booking scheme is “currently unfit for purpose” and that it should be suspended until such time as the system is efficient and effective.

Redbridge LMC is one of the 13 LMCs that have submitted critical motions on Choose and Book demanding its suspension and criticising the manipulation of Choose and Book by hospital trusts. Other LMCs criticised hospitals and primary care organisations which refused to allow booking to named consultants.

However Liverpool LMC has submitted a motion which will be debated at the conference applauding the introduction of Choose and Book as “one of the best things to happen for primary care” both for patient autonomy and choice.

The LMCs conference takes place on June 14 and 15 in London.

Links

LMCs agenda

Reader's Comments

Political Statements

05 Jun 07 15:06

There's also a motion condemning the government. Go have a read. It's very informative (if slightly raving).

Money money money

07 Jun 07 09:06

The NHS CRS may not be good value for money so we want to be paid more to upload the records. How does that work?

Re: the article

07 Jun 07 13:06

The arguments around patient confidentiality will never be settled - there are advantages (audit trail) and disadvantages (more people having access) of electronic record but there are also disadvantages to isolated electronic and paper records held at multiple locations and who of us in the NHS has not overheard receptionists discuss patient details in a GP waiting room or seen on screen something we should not or even been able to pick up unattended records in an acute setting? Any system whether paper or electronic depends on trust in those with access to that system and dealing with violations of that trust severely enough to discouracge others. At least with electronic systems there is an audit trail not available to paper records.

"They are wasting taxpayers' money and NHS money" is a strong comment to make particularly at a time when patients are trying to work out how the new GP contracts equate to so much extra money whilst the majority can no longer see their GP out of hours - the tragic case in the press only last week has highlighted problems with out of hours care - problems a CRS may well have avoided!

The experience of Choose and Book for most patients (sadly not all but the system has improved since its inception) has been a positive one - shorter waiting times and less worry before seeing a consultant (and also fewer calls to the practice to ask if the letter had come from the hospital yet!) and I expect fewer DNAs.

Ask your SHA for the Choose and Book figures for the period when payments (since reactivated) ceased and you will find that many GPs stopped using the system not becuase of their perceived or genuine shortcomings but because they were no longer being paid for it! This does not reflect well especially as "demands that additional funding should be provided to GP practices for the work involved in uploading records to the spine" were also part of the costs of the CRS motion. I have heard GPs make comments which confirm this.

The motion from Liverpool regarding Choose and Book illustrates that the system cannot be entirely bad yet it continually gets assessed in very black and white terms. It may sometimes be an inconvenience at a practice or during a consultation but really, as with all new systems and ways of working, be assessed in terms of patient benefits first and foremost.

Choose and book dips - not just money

13 Jun 07 11:06

Stuffing mouths with gold is as old as the NHS when it comes to Doctors, and unpallatable to those of use who work for the NHS to salaries, with strict rules on probity and not accepting inducements.

But even where Choose and Book is well used, GPs and their practice staff complain bitterly about performance of the system, and the extra staffing and administration costs to make it work. For some, the withdrawral of funding meant stopping those arrangements.

I look forward to the day when CfH sort out the complicated web of systems and connections that they have constructed so that it works efficiently. GPs do not demand money to use their clinical systems because they work well. That is not true for C&B and the spine.

But then am I too optimistic ?