Healthcare assistants’ access to SCR defended

Connecting for Health has defended the decision to allow healthcare assistants to access Summary Care Records (SCRs) in accident and emergency departments.

Royal Bolton Hospital’s A&E department has been criticised by BMA IT representative Dr Paul Cundy after a document, released under the Freedom of Information Act, revealed that healthcare assistants are asked to print out SCRs for clinicians.

Dr Cundy, chairman of the BMA’s GP IT committee, told the BBC’s Today programme that such a practice “breaches all common concepts of privacy and confidentiality.”

However, Dr Gillian Braunold, CfH’s clinical director for the SCR, claimed the policy had been approved by the SCR Advisory Group, which includes BMA membership.

She told EHI Primary Care: “Several months ago we looked at A&E departments around the country and took advice from the A&E consultant who is our adviser, to find out how easy it would be for clinicians in A&E to directly access records.

“The answer was that in the majority of cases they would need to have somebody print it out for them. We took that to the advisory group and got their approval for it.”

Dr Braunold said CfH did not dictate to NHS organisations which groups of staff should access records, leaving it to local organisations to decide for themselves following their own information governance procedures.

She added: “The NHS couldn’t function if people at the centre told organisations what roles people should carry out. We’ve tried very hard not to dictate who should be awarded access.”

She said that in her own practice healthcare assistants trained as phlebotomists had access to patient records and that it was common in general practice for receptionists to access records as part of repeat prescribing work. She said it was an “outrageous slur” to suggest that healthcare assistants were equivalent to receptionists.

The row over the Bolton procedures was revealed following a FoI request by Computer Weekly which revealed that the original leaflets sent out to patients on Bolton about the SCR promised that receptionists “will not need to see your full clinical records.”

When GPs in Bolton discovered that receptionists were printing out records for clinicians in the A&E department, they demanded that the PCT write to patients again to tell them of the change in plan. The PCT decided to change the procedures to allow health care assistants to print out the records.

Dr Braunold said the leaflets were being reviewed as part of the early adopter programme and there was no intention to mislead people.

She added: “The problem is you can end up misleading people by giving an example, for example saying a receptionist will not view your full record, rather than saying ‘only people who need to look at your records will do so.’”

Dr Cundy told EHI Primary Care that it was unacceptable for patients to be told that only clinicians would access their record sand then for that position to change within a few weeks of the early adopter site going live.

He added: “Will Gillian Braunold now write to every patient correcting the previously undelivered promise? This whole concept is based on trust and confidence and if promises aren’t delivered then confidence is going to be eroded.”

Dr Braunold said the procedures in Bolton would be reviewed by its own board and that the issue was likely to be discussed at the SCR Implementation Board due to meet this week. She added: “Nobody is trying to do anything wrong. The information governance environment needs to be audited and we are working very hard to make sure that happens. The trouble is there is a highly political agenda which sometimes makes it feel like we are fighting the Battle of the Somme.”

Fiona Barr