NPfIT has developed software that automatically anonymises GP electronic patient records for audit by primary care organisations under the Quality and Outcomes Framework (QOF), in response to concerns over confidentiality from the BMA – but it will not work with all practices.


The program, QOF Assessor Toolkit, will connect with the majority of GP software, including EMIS and Torex/iSoft systems, and automatically generate reports with identifiable details removed when inserted into a compatible system.


However, in the case of systems that do not connect, GPs will have to carry out a “manual assessment" that could involve printing out the records and erasing them by hand. A spokesperson for the DH told E-Health Insider that they wouldn’t presume to instruct GPs exactly how to do this, and that they should follow best practice guidelines.


In the case of records held on paper only, the BMA have said that taking action such as photocopying them and Tippex-ing out the sensitive data may not be a sufficient method of anonymisation, and may also be unnecessarily labour-intensive.  


Dr Hamish Meldrum, chair of the BMA’s GPC, welcomed the release of QOF Assessor Toolkit: “This new software should ensure that there is no risk to GP practices of a breach of patient confidentiality. That is good news for patients and for practices."


However, the BMA continue to be concerned that electronically-held patient data that haven’t been censored could breach confidentiality when primary care organisations visit GP practices to audit information under QOF, and that GPs could be prosecuted under the Data Protection Act. They are currently seeking legal counsel over the issue.


A spokesperson for the BMA told E-Health Insider: “GPs must not put themselves at risk to give non-anonymous data,” the BMA told EHI. “We don’t want the GPs we represent to be in breach of the Act."


A spokesperson for the National Programme argued that care record anonymity was not an issue with regards to simple data processing and auditing: "Patients do have a right to object to the processing of data that identifies them where this is causing or may cause substantial damage or distress. We are currently considering how this might best be determined and whether or not patients should be able to opt out of having a record without having to demonstrate distress or damage.


“As the NHS CRS will only support care, anonymisation of the record is neither necessary nor appropriate."


According to the DH, ongoing work is taking place to make QOF Assessment Toolkit compatible with as many GP record systems as possible. Figures of around 80-90% coverage have been quoted to EHI. A new version compatible with Microtest’s GP record software is due in December.


The new software was developed for the NPfIT through BT by Apollo Medical Systems, and two copies of each CD are currently being sent out to QOF leads at primary care organisations.


The DH have listed the following systems as compatible with QOF Assessor Toolkit:



  • EMIS GV

  • EMIS GV1

  • EMIS GV2

  • EMIS LV

  • EMIS PCS

  • In Practice Systems Vision

  • Torex Premiere 2.4

  • Torex Premiere 2.5

  • Torex Synergy 1.2

  • Torex Synergy 1.3

  • Torex Synergy 1.4

  • Torex Synergy 1.5

  • Torex System 6000 3.3

  • Torex System 6000 3.4

  • Torex System 6000 3.5

  • Torex System 6000 3.6

Links


BMA guidance for GPs on QOF and confidentiality (November 2004)

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