Birmingham SCR scare proves false

The summary care
record roll out

The vast majority of the Summary Care Records identified as out-of-date are actually up-to-date, an investigation has discovered.

An NHS investigation has found that the problem was caused by EMIS GP systems incorrectly logging SCRs as out-of-date.

NHS South Birmingham launched an enquiry into out-of-date SCRs after it emerged that 8,800 of the 82,000 created were logged as “out of date SCR items” by GP practices using the EMIS computer system.

However the primary care trust’s investigation has discovered that a message on the EMIS system was logging SCRs as out-of-date every time a repeat prescription was generated although there had been no changes to the medication on the prescription.

Dr Masood Nazir, a Birmingham GP and clinical director of IM&T for NHS South Birmingham, told EHI Primary Care that the PCT had so far manually checked more than 5,000 of the SCRs logged as out-of-date and 96% of those date were up-to-date. He added: “What was happening was that every time you issued a repeat prescription the system said it had to be updated to the SCR which was incorrect and in future they won’t go into the out-of-date queue. The only time it needs to change is when a doctor initially prescribes a repeat medication or changes it.

Concern over out-of-date SCRs led to the BMA’s General Practitioner Committee last month calling for access to all existing SCRs to be immediately suspended “until all patient safety issues have been fully investigated and satisfactorily resolved.”

Dr Chaand Nagpaul, a GPC negotiator and its lead on IT issues, told EHI Primary Care that the GPC was aware that the vast majority of SCRs were not out-of-date but still believed access to SCRs should be suspended.

He added: “Whilst the scale of the problem is clearly much lower than previously thought there are significant numbers of records that are not in date and if a clinician accesses that the record they have no way of knowing that the information is out-of-date and could make a decision based on out-of-date information. That is why we believe this should be examined as part of the government’s SCR review.”

Dr Nazir said the PCT had discovered that there were some technical problems with use of smartcards which were affecting the other records logged as out-of-date and that these had now been resolved and had led to the creation of a stronger checklist for practices. He said this would be considered by the next SCR project board which includes local medical committee representation.

He added: “We learn something new each time we upload a practice and we take it step by step. We have been very open about this and manually analysed every record. Our practices are happy about that and the majority of practices in Birmingham are still keen to go ahead. “

Dr Robert Morley, secretary of Birmingham Local Medical Committees, said: “We have been reassured on this one specific issue but even 4% of records being out of date suggests a fundamentally flawed system.”

A total of 83,795 records have now been uploaded in NHS South Birmingham and the PCT hopes to complete roll-out to its 360,000 patients in the next six months. Dr Nazir said the PCT was also working with its neighbouring PCTs and with the out-of-hours service to deliver wider SCR coverage across the city before access to the SCR is enabled out-of-hours.

Dr Nagpaul said the BMA believed the Scottish Emergency Care Summary system which enabled updating without smartcards was worth considering as part of the SCR review. He said he did not know whether the coalition government was committed to the future of the SCR.

He added: “I think the government will reserve its judgment pending the review but the fact that the government has halted any further roll-out and is implementing the review suggests that they wish to review the programme’s suitability and its fitness for purpose.”