Revised NCRS proposals allow for multiple summaries

The concept of a single summary record on the spine is to be replaced by a system that will allow several separate summaries to co-exist, according to revamped proposals on the content of the NHS Care Records Service (NCRS).

Patients will also be able to opt out of having a summary care record of any kind.

Connecting for Health clinical leads have reworked their suggestions for how the content of the NCRS will work [Word, 136K] following a short consultation period with patients and professionals that yielded around 100 responses.

The new document was discussed by Connecting for Health’s Care Record Development Board last week and has now been released again for further consultation.

Dr Gillian Braunold, joint GP clinical lead for Connecting for Health, said the new document takes account of all the responses that have been submitted as well as the views of the Care Record Development Board.

She told EHI Primary Care: “I would like to think that the profession will be happy with the direction of travel although there are still a lot of details to be worked out and I look forward to seeing the responses to the latest document.”

Changes to the original consultation document include alterations to how a summary record will work together with more information on access controls and confidentiality.

The document says that the Summary Care Record will initially be created from GP records and include information on major diagnoses, problems and surgical procedures, allergies and interactions, recent and current prescriptions and recent results of investigations.

The clinical leads have retained their suggestion from the first draft of the document that information on sensitive mental health diagnoses, sexual health episodes and infections should be excluded.

However the report addresses concerns about who will own the information on the summary record by saying that the Summary Care Record will now consist of different ‘components’ with each organisation responsible for its own component.

It adds: “There may be components from several hospitals that the person attends, a mental health trust, a dental practice and so on. For example the hospital may place discharge summaries into its component of the Summary Care Record. These component will in total be the Summary Care Record with each organisation responsible for maintaining its part.”

Patients will be able to choose not to have a summary record at all, or to elect that access to the summary should only be allowed in an emergency or that some information is withheld from the summary record with a flag to indicate that some data is missing.

The new document also renames the electronic records held by individual organisations as the Detailed Care Record. It says that care professionals and their teams will normally have access only to their own Detailed Care Record.

However it says that ‘with explicit consent’ the Detailed Care Record can be more widely available so that one organisation can see important information entered by another.

The document says there must be an evolutionary pathway towards the NHS Care Records Service and that there will be pilots involving early demonstrator sites.

It adds: “Each facet of the NHS care records service must be tested and refined until it is shown to be fit for purpose.”

The document is now out for further consultation, with no deadline set yet for responses, and three work streams have been established to work on the detail of the NCRS. These work streams will begin work in September and look at the content of the Summary Care Record and the Detailed Care Record, access controls and confidentiality and risk assessment.