Penalise lack of EPRs – report

NHS trusts that fail to make proper use of electronic health records should be hit with higher insurance premiums and a reduced Care Quality Commission rating, according to a new report.

The Sowerby Commission report also says that patients should be given a legal right of access to interact with and share their electronic record and new rights of redress if their data is misused.

The commission, a group of experts established by the Institute of Global Health Innovation at Imperial College London, undertook a year-long investigation to assess the benefits and risks of sharing electronic health records.

Their report says that wider use of shared electronic care records can help NHS England to lead the world in patient care by improving communication and coordination between clinicians and giving patients more information about their treatment. “Having the right information available at the right time and using the most clinically effective protocols are critical to providing safe and effective care.”

However, it says there are technical and cultural barriers to sharing records, including reluctance from doctors to give up control, while the records are currently separated in hospital, GP and clinic “silos”.

The report says a failure to use electronic record systems when they are in place should be considered a failure in professional standards and penalised accordingly, with a loss of training accreditation.

No trust should be able to be given an “outstanding” rating by the CQC if it does not have a comprehensive EPR and routine electronic access to GP record summaries, and trusts should not be rated “good” if they still lack an EPR after a certain amount of time.

The NHS Litigation Authority should also review its premiums for clinical negligence, charging trusts without electronic records a higher premium due to the risks to patient safety.

The report says while population-level databases of records, such as care.data, are essential to improving patient care, patient confidentiality must be “vigorously protected” by restricting access to those from the NHS or accredited academic organisations.

It recommends introducing measures to ensure nobody can be identified from data viewed outside the NHS, allowing patients to receive compensation through the NHS Litigation Authority if their data is improperly used, and setting up a website for patients to opt out of or back into national data collection schemes.

Other recommendations in the report include a greater focus on open standards and interoperability between systems and ensuring electronic record implementations are part of a collaborative exercise within regions. Lord Ara Darzi, director of the Institute of Global Health Innovation, said better data from shared records is key to improving care quality.

“We need to do everything possible to protect individual’s privacy, while explaining the good that sharing data can do for all patients. The development is vital to the future of the NHS and organisations that fail to live up to these high standards should be penalised and patients compensated.”

The report is based on a range of research, including interviews with NHS staff and a national survey of 150 GPs and 350 doctors in secondary care.