Birmingham rethinks failed record plan

Plans to establish a Birmingham central care record to share patient information across health and social care have been cut back after the region’s GP leaders raised concerns.

A proposal to hold data for the record in a central warehouse has been scrapped, while leadership of the project has been transferred to a new organisation.

In August 2013, 17 health and social care organisations across Birmingham, Sandwell and Solihull went out to tender for a joint central care record system.

The aim of the project, which was being run by NHS Central Midlands Commissioning Support Unit on behalf of local clinical commissioning groups, mental health, acute, community and ambulance trusts, as well as local councils, was for information to be recorded once and shared between the providers’ joined-up systems via a central data warehouse.

An updated notice on the tender now states that “the awarding procedure has been discontinued” and the contract may be the subject of a re-publication.

The Birmingham Local Medical Committee had expressed serious concerns earlier this year about the project, including patients being unable to give informed consent and which organisations would be given access to the record.

A spokesperson for the Birmingham CrossCity CCG told EHI it has now taken over sponsorship of the project from the CSU as “it seemed the best place to sit”.

The spokesperson said the project has now removed plans for a central data warehouse, instead focusing on a “look up and view” system.

“Appropriate health professionals” will be able to look up relevant information from a patient’s GP record at the point of care with a patient’s consent, with access terminated after a consultation.”

The spokesperson said the programme team has worked hard to address concerns about information governance and the opt-out process, and has finalised a data sharing agreement which it hopes can get “across the board agreement”.

The project will have an eight week opt-out period, with a direct mail letter and information pack being sent to each registered patient in Birmingham, Sandwell and Solihull.

If the opt form is not returned to practices, the organisations will assume implied consent. Plans to include social care providers in the shared record have also been changed, with the plan now to “look at social services joining at a later date”.

A proof of concept pilot will be run from the middle of January with about 120,000 patients from eight practices in Birmingham, Sandwell and Solihull, with plans to roll out the project to the rest of the population by the end of 2015.

The project has also been renamed from the Birmingham Central Care Record to Your Care Connected to “better describe the product”, the spokesperson said.

Dr Robert Morley, the executive secretary of the Birmingham LMC, told EHI the project team decided to “do a U-turn” when the LMC shared advice from the BMA’s ethics committee about the original plans.

Morley said the LMC now attends project board meetings to observe and provide advice as necessary, and he is happy that the group’s concerns were taken on board.

“The direction of travel on the new project is good, assuming the right processes are in place for information governance and the proof of concept goes well.”

The LMC will still seek advice from the BMA about the revised project to ensure it addresses all remaining information governance concerns, he said.