Welsh GPs put conditions on IHR

GP representatives in Wales have listed a series of safeguards that they want to see implemented before Individual Health Records are uploaded.

The BMA’s Welsh General Practitioner Committee said it was “supportive” of the emergency summary record system in Wales but wanted to see explicit confidentiality safeguards.

The committee’s six-point list of requirements is: a public information campaign before roll-out in any area; an absolute right for patients to opt-out at any time; explicit consent to view that applies only for the duration of a consultation and is obtained directly by the clinician carrying it out; and access restricted to clinicians involved in the direct care of the patient.

Dr David Bailey, chairman of the Welsh GPC, said: “Because it is a précis of the GP record, we feel that access must be restricted to clinicians only – by which we mean doctors and nurses involved in the direct care of the patient.

“Explicit consent to view should be restricted to the time and for the purposes of the consultation only and not extended to allow access subsequently, even for audit purposes. Explicit consent to view should be obtained from the patient by the consulting clinician.”

The IHR has been running in Gwent since 2007. This year it was introduced in Pembrokeshire and parts of North Wales. And it is currently being piloted in Cwm Taf and Cardiff.

The BMA said Welsh government policy was to roll-out the IHR across the whole country over the next 12 months, but it pointed out that GPs practices needed to consent to the uploads.

The IHR contains patients’ demographic data, medications, significant medical history, Read codes of the most recent consultations, allergies and recent test results.

It is designed to be available to clinicians in hospitals and out-of-hours services.

At the moment, doctors can print out the IHR either to inform an admitting clinician at hospital or for a home visit. Dr Bailey said this was “probably reasonable” but warned that there were major issues to be tackled.

He added: “There are major governance risks in this approach and it should only be continued until the technology to carry the data electronically on visits and the facility for admitting clinicians to access the IHR directly (with express patient consent) is available.”

The Welsh GPC said such developments should be made a priority in forward planning.

It said access by non clinicians, access without the patient present or giving clear verbal consent and access after the consultation, could all put GPs potentially at risk from the General Medical Council.

An NHS Wales Informatics Service spokesperson told EHI primary Care that the service had been working with the BMA and other professional organisations on the development and roll-out of the IHR.

She added: “Patient confidentiality will be maintained as the IHR is rolled out. Only health professionals involved in a patient’s care will be able to access the patient’s information, and only with the patient’s permission.

"This will have to be noted so that it can be checked at a later date, if required.

"A leaflet drop to each household will be delivered before the initiative begins in each area, and patients will have the right to opt out at any time by speaking their GP.

"The IHR will improve patient safety as it will give staff more information on the patient which will help inform the course of treatment or medication to use."