Connecting for Health

We are writing to you with severe concerns over the coverage that NHS Connecting for Health and the issue of confidentiality controls has received this week in the February edition of the BJGP. The Journal contains an editorial that argues against the current proposals for the summary care record with no attempt to balance the debate or explain the systems that are being proposed.¹

It is irresponsible to publish commentary on such an important issue for patient safety and confidentiality without the necessary balance expected from an academic journal. To promote a single agenda in such a blatantly campaigning way without an accurate representation of the facts in our view does the Journal, the College, and our patients a great disservice.

The editorial by Professor Ross Anderson seriously misrepresents the current consent model of the summary care model. Professor Anderson who is an advisor to a political campaign to get patients to opt out of the current arrangements also encourages GPs to support the campaign. Even the Editor himself seems to promote this view in his own comments, he challenges; ‘Anyone going to join the opt-out campaign?’

The Big Opt Out campaign seems to be based on misinformation and has a much wider political context. To quote from the explanatory paragraph on the website:

‘The NHS Confidentiality campaign was set up to protect patient confidentiality and to provide a focus for patient-led opposition to the government's NHS Care Records System. This system is designed to be a huge national database of patient medical records and personal information [sometimes referred to as the NHS ‘spine’] with no opt-out mechanism for patients at all’.

We should be informing our patients that for the summary care record this statement is not true and as clinicians we have a professional duty to inform our patients in a responsible and balanced way, and point them to reliable sources of information.

The BJGP has given the impression of promoting a campaign to encourage patients to opt out of the summary care record in a way that risks undermining patient care on the basis of an inaccurate and biased position. There is no balancing of the Big Opt Out Campaign position with what is actually happening in the early adopter areas and what measure of control patients have should they wish to limit their participation. These measures are being independently evaluated and for an academic publication it is disappointing there is no mention of this.

In the same edition the article by Gordon Baird on the experience of an emergency care record in Scotland is equally biased away from central patient databases.² He even admits to encouraging his patients to opt out of the system by sending a letter to his patients that gave ‘a rather unbalanced view.’ This is particularly unfortunate as the Scottish emergency care record is widely felt to be a success. It is used by GP out-of-hours services and by emergency departments and is popular with both doctors and patients.

Dr Clare Gerada offered the support of the College only 2 weeks ago during the Summary Care Record Advisory Group when we discussed the problem of myth and misinformation that is clearly being pushed out at the medical profession.

Although we understand that the BJGP has editorial freedom, it seems to be embarking on a campaign and if this was not the intention then the judgement of the Journal must be called into question. It is worthy of note that last year an article that was offered on changing the face of referrals and Choose and Book by Dr Mark Davies, Medical Director of Choose and Book, at the time was turned down by the Editor on the basis that he was biased.

Since there is a full month until the next edition of the BJGP much harm could be done to the GP perception of the College position until that time. We have received a number of enquiries already asking us if this is the new RCGP policy position.

We would be grateful for a statement clearly distancing the College from the position taken by the editorial. We would also like an opportunity in the Journal to give a more balanced view and address some of the myths that have now been promulgated.