Summary Care Record plods on

By Tony Collins

Pulse reports that the Summary Care Record database had 13.1 million records by 22 March 2012, which is around the number the DH had expected for April last year.

It reports that the figures have prompted David Flory, deputy NHS chief executive, to call for ‘rapid further progress’ on the rollout.

In his latest quarterly report on NHS performance, Flory highlighted the SCR as an area for improvement. “Implementation does not meet expectations and rapid further progress is needed,” said Flory. “While performance has improved, the rate of this improvement is beneath the expected trajectory.”

The number of patients with an SCR has almost doubled from around seven million a year ago. Sixteen PCTs have more than 60% of patients with an SCR.

Critical Mass

In February, Kilburn GP and SCR director Gillian Braunold was reported in Pulse to have said the rollout has reached a ‘critical mass’ in some areas. Out-of-hours providers, and those in urgent care and hospitals are viewing about 1,600 records a week.

Braunold said information within the SCR was changing some therapeutic decisions. She also said there was also evidence from areas where end-of-life care plans had been uploaded to care records that more patients were dying in their preferred place.

Nurses at NHS Direct are to have access to care records and the DH is working on plans to replace HealthSpace and enable patients to access their full patient record.

Comment – The devil’s in the detail

It is difficult to put Dr Braunold’s comments into context without published independent evidence of which there is little or nothing that’s recent.

In public, NHS Connecting for Health has never wavered in proclaiming the success of the SCR but it has sought to control authoritative information on the SCR programme.

CfH commissioned an independent UCL report on the NPfIT SCR  “The devil’s in the detail”, but asked researchers to, for example, delete the cost of the SCR programme. CfH also removed passages from official SCR documents it gave the UCL researchers.

The final UCL report , which said in a footnote ” financial data deleted at the request of CFH”,   found that there were inaccuracies in the SCR database. UCL researchers also learned that the SCR database could not be relied on as a single source of truth.

Some CFH staff found the notion of possible ‘disbenefits’ of the SCR difficult to conceptualise, said the UCL report.

There is no doubt that an accurate and well-populated SCR would be useful, especially for out-of-hours doctors. They need to know – at least – what drugs patients are taking and what if any adverse drug reactions they have had.

As the DH tells patients: “Giving healthcare staff access to this (SCR) information can prevent mistakes being made when caring for you in an emergency or when your GP practice is closed.”

But a national database is not the way forward. It is unlikely to be trusted as accurate or up-to-date. It would be better to give patients and clinicians access to locally-held NHS-sourced information. We’ll report more on this separately.

Meanwhile the SCR plods on at a high cost – more than £220m so far. BT, the SCR’s main supplier, will be pleased the programme is continuing, as will those civil servants and consultants who have been involved with the programme for several years. But whether the database is of real value to doctors and patients we don’t know for certain. The DH tends not to publish its independent advice.

Summary Care Record a year behind schedule, DH warns – Pulse

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