[Med-privacy] merging Health and Social care records

[Peter Marshall]

>
>
> Work begins on merging Health and Social care records
> Floating ideas at the CRDB
> By Lucy Sherriff
> Published Friday 24th November 2006

> Work has begun on a social care equivalent of the care records 
> guarantee for medical records, paving the way for merging health and 
> social care records. The plans were disclosed as part of a debate at 
> the annual Care Records Development Board meeting in London, 
> yesterday.
>
> The work is still at a very eary stage, and no final decision has been 
> taken as to whether or not a single record will be created. But the 
> possibility of two services sharing data in this way illustrates 
> exactly those concerns about patient privacy and confidentiality that 
> have been raised by opponents of a centralised medical records 
> database.
>
> The workshop - a group of forty or so patients, health professionals 
> and other interested parties - was asked to debate the proposition 
> that there should be a "single holistic record" of patient care, 
> encompassing not just health records, but social care information. The 
> idea, the session chair explained, is that information should meet the 
> needs of the individual, rather than the other way around.
>
> It was during the ensuing debate that the news of the planned social 
> care records guarantee emerged.
>
> The care records guarantee (pdf) sets out the rules that will govern 
> the management of information in medical records when the NHS Care 
> Records Service goes live next year.
>
> It describes who may access medical records, what security will be in 
> place to protect patient confidentiality, for example. It also 
> promises that patients will have access to their own medical records, 
> and that they will be able to see who else has had access.
>
> Part of the guarantee is that only those with a "legitimate" 
> relationship with a patient may have access to the record.
>
> The ninth point states: "We will make sure, through contract terms and 
> staff training, that everyone who works in or on behalf of the NHS 
> understands their duty of confidentiality, what it means in practice 
> and how it applies to all parts of their work. Organisations under 
> contract to the NHS must follow the same policies and controls as the 
> NHS does."
>
> Putting together a similar guarantee for social care records, and 
> enforcing similar standards of social care workers, is the first step 
> in making sure the two organisations can have shared access to patient 
> data.
>
> Many of those attending the workshop were concerned that sharing 
> records would dilute the quality of care, and could compromise the 
> quality of a patient's relationships with his or her carers. Some 
> people might be reluctant to share information with their GPs if they 
> thought social services would also have access to that information, 
> one delegate suggested.
>
> Another said that she was fully supportive of a multi-disciplinary 
> approach to care. Health and social workers should work together and 
> share information, but the records must be kept separate, she argued, 
> to protect patient privacy.
>
> "Having a single record could also be a breach of the third prong of 
> the Data Protection Act - excessive information," she said. "And of 
> the seventh: unlawful disclosure."
>
> The advocates of the single record argued that with adequate controls, 
> this need not be a problem, and that sharing information would improve 
> patient care, not erode it.
>
> A vote at the end of the debate was narrowly in favour of a single 
> record (18 to 15, with seven abstentions). The session chair said that 
> plenty of valid concerns had been raised, particularly over the 
> questionable value of a single record being held by two separate 
> services.
>
> Related stories
>
> NHS record access pilot due next year (25 November 2006)
> Care Records conference opens and closes debate (24 November 2006)
> BMA kicks off patient awareness campaign (16 November 2006)
> UK promises care record 'opt-out' - again (27 October 2006)
>
>
>