FoI reveals plans for SCR Release 2

The summary care
record roll out

Summary Care Records may be created outside general practice under NHS Connecting for Health plans for the development of the SCR programme.

Documents released under the Freedom of Information Act reveal that ‘release 2’ of the SCR would enable non-GP care settings – such as A&E and outpatient departments – to create a record and not just to add to one created in general practice.

The documents obtained by Hampshire GP Dr Neil Bhatia also indicate that ‘release 2’ would hold far more information, including hospital letters.

Public information programmes would not run for release 2 information. However, CfH said systems sending release 2 content to the SCR would first check the patient’s SCR consent preference on the Spine.

Patients will also be asked for their consent before information is uploaded.

The document says patients would not need to have a GP summary before release 2 information was uploaded because not all patients are registered with a GP.

Those that aren’t could therefore miss out on the benefits of a summary record, it argues.

The document says the clinical content of release 2 that has been endorsed by the SCR programme board and the National Clinical Reference Panel includes A&E discharge summaries, out of hours encounters, outpatient discharge letters and inpatient appointment letters.

The documents from a meeting in February between CfH and the Information Commissioner’s Office reveal that CfH is working with an A&E information system provider on the plans. It had hoped to pilot release 2 uploads in two A&E departments in May, followed by an evaluation.

However this week a Department of Health spokesperson told EHI Primary Care: “We have been looking at pilots in this area but we have not got any confirmed dates.”

Dr Bhatia said he was concerned that while those who had opted out would not have release 2 information uploaded, it was unclear what would happen to patients who had not expressed a preference.

In general practice there are currently three options which can appear on a GP record – implied consent to an SCR, express consent (the preferred option before GPs upload additional data) and dissent.

However, Dr Bhatia said he feared that patients who had simply given consent for the initial upload of allergies, adverse reactions and medication would now also be at risk of hospital information being uploaded.

He told EHI primary Care: “Doctors in outpatient departments or working out-of-hours are supposed to ask you before they upload information but is that always going to happen in a busy department and if not you could end up with sensitive information on your record that you didn’t want to be there.”

Dr Bhatia said his growing belief was that doctors should enter codes to automatically opt-out their patients, subject to running an information campaign in the practice that codes have been applied, as data could be uploaded to SCRs outside the practice where consent was initially recorded.

He added: “If you don’t want an SCR you need to opt out now – and not wait for the PIP to go live in your area. It might be too late by then, you might already have release 2 data about you uploaded.”