GP bodies clash on SCR

The Royal College of General Practitioners has publicly backed the Summary Care Record following criticism of its consent model by GP representatives from the British Medical Association.

Professor Steve Field and Dr Clare Gerada, chair and vice chair of the RCGP, have written to the BMJ. arguing that the need for a shared record is compelling.

They add: “The Royal College of General Practitioners supports the use of the Summary Care Record (SCR). We had concerns over this scheme initially, but now believe there are enough checks and balances to make it a significant move forward in patient safety and clinical care.”

The letter was prompted by a motion at the National Local Medical Committees’ conference earlier this month. This said that patients’ data should not be shared on an implied consent basis. The motion was overwhelmingly backed by the GP representatives.

Widespread concern about the implied consent model for the SCR led NHS Connecting for Health to introduce changes to the system last year.

These mean that while information is still uploaded with implied consent, patients must give clinicians ‘consent to view’ their SCR at each medical encounter.

Drs Gerada and Field say patients can still refuse to have a summary record, can change their minds at any stage and can limit what is being shared.

They add: “We believe this is a reasonable model offering the best protection of confidentiality balanced against the best access to information when appropriate.”

The two leading doctors from the RCGP also argue against LMC representatives’ concerns about data security and the impact on GPs’ professionalism.

They say: “Some general practitioners see this as a threat to their position as guardians of the continuous health record, arguing that if other providers of primary care can access the patients health record one of the key tenants of general practice will be lost.

“We recognise this fear, but have more confidence in the intrinsic value of general practice – a value that far exceeds access to clinical records.”

The RCGP’s letter was backed up by letters of support for the SCR by some GPs but criticised by others.

Hampshire GP Dr Neil Bhatia, a campaigner against the SCR, said GPs and patients had severe misgiving about the programme.

He added: “The assertion that ‘the College’ supports the use of the SCR highlights once again how hopelessly out of touch the RCGP is with frontline general practice.

No one has asked me – as a member of the college – whether I support the SCR either in principle or in the way in which it is being rolled out in those few PCTs so far.”

His view was supported by Dr Peter van Kaehne, a GP in Scotland, who said the RCGP had never asked its members what position to take on the SCR.

He added: “A centrally kept care record is at its core a mean to break the continuity of care by GPs, disempower patients and allow government and commercial monitoring and data mining of the most intimate and confidential data one can have. It should never happen.”

Link: BMJ letters on the SCR