Chris Lancelot: So, where now for the summary care record?

One of the more contentious subjects at the LMCs conference was the summary care record (SCR).

The GP Record, by Fran Orford
The GP Record, by Fran Orford

Delegates voted to continue supporting the concept - but only by a small margin. Yet, later on, conference criticised the removal of the requirement for practices to achieve information management and technology accreditation prior to uploading to the SCR, because of the risk of downgrading SCR quality.

The message is clear: we want the SCR, but not like this. In its current incarnation the SCR is barely fit for purpose. The overall concept is superb - but only if records are complete, up to date, consented and confidential, with access allowed only to those with a legitimate medical need.

These concerns are not new: our IT-orientated colleagues have been warning about them for years. Initially their concerns were ignored by Connecting for Health: but the over-hasty roll-out of the SCR has brought all these problems to the surface, simultaneously. No wonder there is unease.

Wisely, as an interim measure the coalition government has stopped the premature roll-out of uploads to the SCR, while not rejecting it out of hand - a welcome approach, bearing in mind that scrapping large parts of NHS IT was in both parties' election manifestos. The government should now initiate a careful re-think, not just of the SCR but of the whole National Programme for IT, taking care not to throw the baby out with the bathwater. This review needs to take note of the observations of IT-savvy doctors and user groups.

Much work still needs to be done to develop mechanisms for keeping the SCR accurate, up to date and confidential: none of these requirements is as straightforward as it may seem. In particular, we need protocols for correcting errors and dealing with omissions, especially when made by distant third parties. That travesty of a project, Choose and Book, also needs reviewing - another good idea appallingly implemented.

This is no time for rushed action. There has been far too much unnecessary urgency in the past, and it has led medical IT up some spectacularly expensive blind alleys.

Instead, a measured approach, drawing on the combined knowledge and wisdom of all parties, is surely the best way forward.

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