Book Description

In England, implementing Electronic patient record (EPR) systems is one of the main aims of the 10-year National Programme for Information Technology (NPfIT). The main plank of the NPfIT programme is the NHS Care Records Service (NCRS) which will create two separate EPR systems: a national Summary Care Record (SCR), containing basic information, and local Detailed Care Records (DCRs), containing more comprehensive clinical information. NCRS will also include a Secondary Uses Service (SUS) which will provide access to aggregated data for management, research and other 'secondary' purposes. On the SCR, this report finds: a lack of clarity about what information will be contained; consent arrangements for creating and adding information have not been well communicated to patients or clinicians; important components have not yet been completed; maintaining security is a serious challenge. The DCR systems are to replace local IT systems across the NHS, but the report points to delays in trials and implementation, difficulty in establishing either the level of information sharing that will be possible, or how sophisticated local IT applications will be. There has also been a lack of local involvement in delivering the project, with hospitals often left out of negotiations between Connecting for Health (the body delivering NPfIT) and suppliers, leading to a lack of enthusiasm for deploying the systems. The Committee recommends Connecting for Health focuses on setting and ensuring compliance with technical and clinical standards for NHS IT systems, allowing local users the final say over which system is procured and how it is implemented. The report points to some notable successes too: agreement on a universal coding language for the NHS, and a single unique patient identifier, the NHS number; and the potential for the SUS and health research is significant.