GP leads reject consent plan for care records

The national representative body of GPs has decided to reject Connecting for Health’s (CfH) modified plan for the summary care record because it is not based on an opt-in consent model.

The British Medical Association’s General Practitioner Committee (GPC) met last week to discuss the revised plans and said afterwards it had ‘strong concerns’ about the assumed consent model for the summary care record which meant that it could not accept the proposed pilot of the summary record in its current form.

The committee had discussed the latest briefing paper on the summary care record from CfH’s national GP clinical leads Prof Mike Pringle and Dr Gillian Braunold, in which plans for the summary record have been abridged, although still based on an opt-out premise.

The new proposal is that the initial summary record will only contain information on allergies and prescriptions in a text-based format, which will be uploaded to the spine on an assumed consent basis. This would be after a local publicity campaign. Explicit consent will be gained by practices as patients present in the surgery. The paper proposes a pilot of the record to begin later this year or early next year.

Dr Hamish Meldrum, chairman of the GPC, said they were unhappy about the premise of assumed consent that the pilot was built on. He said he would now write to Connecting for Health outlining the GPC’s concerns and making it absolutely clear what the GPC’s views are. He added: “A very very significant change needs to be made otherwise we do not feel it is an acceptable pilot.”

However Dr Braunold, who is a GPC member and was at the meeting, said that although they had solidified their position they were only one of a number of stakeholder groups whose views needed to be taken into account.

She told EHI Primary Care: “We need to look at the views of all the stakeholders including those who have views that run contrary to GPs such as patients, ministers and the Care Record Development Board of Connecting for Health who have been through all the various governance procedures in developing this policy.”

Dr Braunold said the proposed pilot for the summary record would explore all the issues of concern about the implementation of the summary record to see what would work including how long it takes GPs to discuss the consent issues with patients.

She added: “I tried to discuss the consent issue with my patients in surgery this morning just to see how it might work but after three or four patients I gave up because it became ritualistic and I wasn’t covering the ground properly.

"I asked them if they would preferred to have had lots of information they could read about the proposals and then come and see me if they had a problem, and to a man they agreed that would be much better.’

Dr Braunold said the GPC saw a change to an opt-in position as asking Connecting for Health to move just a little bit further towards their viewpoint but in reality it would be a fundamental shift in the whole basis of the proposals.

She said there would be no problems recruiting GPs for the proposed pilot, even if the GPC advised GPs against taking part, as there were many practices already very keen to do so.

She added: “We are listening to doctors and to patients about their concerns and trying to find a pragmatic way forward for what is an evolving problem.”

Dr Richard Vautrey, deputy chairman of the GPC and its lead on IT issues, said concerns voiced at the meeting included worries that information uploaded to the summary record could very quickly become out of date and inaccurate unless it was refreshed regularly.

He said the GPC recognised that the idea of piloting the summary record was a good one and in was vital that the pilot be robust and of an academic standard that would stand scrutiny.

Dr Vautrey said the GPC wanted to see a more detailed proposal of how an opt-in proposal would work and to be involved in the piloting process.

Related stories

Summary record delayed and abridged

Documents

Briefing paper on the new proposals for the summary record [PDF]