Just 61 practices offer records access

Just 61 GP practices in England are offering patients full online access to their patient records.

The government has said on a number of occasions that all patients who want online access to their GP-held records should have it by 2015.

This pledge was one of the few commitments in the ‘Power of Information’ strategy published last year, and will be mandated for suppliers in the GP Systems of Choice framework replacement due by the end of the year.

However, data collected by the Health and Social Care Information Centre and revealed on its Indicator Portal, shows that one fifth of practices do not have the functionality to do this.

As of December last year, those practices listed as using INPS, Microtest, iSoft and Informatica did not have the ability to offer records access. The rest have the functionality, but of more than 6,200 practices, just 61 have actually switched it on.

The figures mirror a survey by EHI Primary Care and doctors.net.uk earlier this year, which also found that the overwhelming majority of GP practices are not ready to implement the government’s flagship NHS IT pledge.

It found that almost half of the 1,000 GPs surveyed said they had yet to address the issue, while just 4% knew that their systems supported access and had switched this on.

Another, more recent survey by the Medical Protection Society provides some explanation for the slow progress.

It found that doctors wanted to be able to continue to write notes in medical language to support their own practice, but 84% felt this would mean they would have to spend more time explaining the contents to patients.

Dr Nick Clements, MPS head of medical services, said that suggested that doctors strongly believed medical records were principally for health professionals and should be administered by themselves.

“This could be problematic as it is at odds with what it appears patients expect – that medical records are about them and should be written with them in mind,” he said.

“Doctors may have to be prepared to simplify and adjust how they write their notes, or spend more time explaining the record to the patient, which was a major concern for 84% of doctors surveyed.”

However, the EHI / doctors.net.uk story found that half of respondents felt that it would be useful to some extent for patients to have access to their records, with a fifth undecided and a third disagreeing.

Similarly, Dr Clements said that access could be beneficial, but the government would need to invest in it.

"Without comprehensive educational support for both doctors and patients, frustration, confusion and complaints will arise from what should be a positive step forward in healthcare,” he argued.

Although practices are making slow progress on records access, the HSCIC figures suggest they are moving faster on giving patients access to other types of information.

When it comes to viewing letters electronically, nearly half of all practices are listed as not having the necessary functionality. Only Emis practices can let patients see clinical letters online and just 58 are doing it.

But online access to test results is more widespread. Only the 51 practices listed as using iSoft systems did not have the functionality to do this and 40% of GPs – all on Emis and TPP systems – were using it. The numbers were the same for allowing patients to order repeat prescriptions online.

The Indicator Portal also shows that giving patients the option to book or cancel appointments online is reasonably widespread, with more than a third of practices offering the functionality. About two thirds – 61% – could offer this functionality but are choosing not to.

EHI Primary Care columnist Dr Neil Paul discusses some of the drawbacks of giving patients access to records in his latest column, and outlines some other ideas that he has for digital patient services.