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Health: Personal Medical Records

Volume 687: debated on Tuesday 21 November 2006

asked Her Majesty's Government:

What safeguards are in place to ensure the confidentiality of personal medical records on the National Health Service spine database; and [HL61]

What is the justification for including personal medical records on the National Health Service spine database without patients' consent; and [HL62]

What information is being provided to patients about how their personal medical records are retained and used by the National Health Service. [HL63]

We believe that the summary care record will deliver very significant benefits for safety and the efficient management of National Health Service services. Information for safe and efficient care is not always available under current systems. Medication errors, poor record documentation and communication failures are among the top five causes of injury to patients. The best research-based estimates suggest that in National Health Service hospitals alone, adverse events in which harm is caused to patients occur in 10 per cent of admissions. Electronic records and clinical communications provide hugely powerful tools significantly to reduce the causes, and the human and financial cost, of medical errors. Electronic prescribing, with the NHS care records service at its core, linked to appropriate decision support, can massively reduce the percentage of drug prescriptions in which misreading or mistranscription leads to the wrong drug being prescribed or the recommended safe maximum dose being exceeded.

Following extensive consultation with the public about these benefits and the practical difficulties of populating 50 million summary care records, we have decided that a small amount of key information relating to prescribed medicines and known adverse reactions to drugs should initially be placed on the NHS database by automated means from general practitioners' records. The benefits, both in terms of improved patient care and safety and cost efficiencies, justify this action.

We recognise, however, that some may have concerns and so we are giving people the choice of asking for their record to be “flagged” so that no one can see it without their consent and this choice can be registered in advance of a record being created for them. This means that the information will be there for the great majority who want safer more joined-up care, while giving those who remain unsure a choice.

When the new NHS care records service systems are fully deployed, there will be a range of new controls in place. The staff of NHS organisations will be able to access systems and records only if they have a current secure smartcard and valid pass code. No one will be able to access clinical data unless they are working in a team that is providing care to the patient concerned or checking the quality of care provided. Additional controls will give patients control over whether specific entries in their records should be seen without their express consent. There will be exceptional arrangements for overriding restrictions in the event that a patient is unconscious or if a court requires disclosure of the records, but in these exceptional circumstances the system will generate an alert to ensure that an appropriately senior member of staff is informed and can properly investigate the occurrence.

The introduction of the summary care record will be preceded by an extensive communication campaign within each community prior to its being introduced locally. This will cover what information the NHS keeps about them, how it is used, the safeguards in place and people's options for putting restrictions on who can access information about them, so that everyone has the opportunity to make this choice. This builds on local efforts to inform the public about how information is used that have been a local responsibility since the introduction of the Data Protection Act 1998. The department has also produced what we believe is the most comprehensive privacy statement of any public service in the form of the NHS care record guarantee for England, setting out 12 commitments the NHS makes to patients in order to protect their confidentiality. A copy of the guarantee is available in the Library.