Date Published: 12 January 2011

(UK) NHS IT plans require safeguards, according to BMA

Plans to change the way healthcare information is collected, controlled and used in the UK will be difficult to achieve within the financial constraints on the National Health Service (NHS), and will require safeguards to protect patient confidentiality, according to the the BMA.

In its “Information Revolution” consultation, the government has outlined plans to give patients in England more access to NHS data and more control over their records. Proposals include allowing patients to access their records online and to share them with others as they see fit, and for more information to be recorded at the point of care.

In its response, the BMA says it agrees that the NHS should be more intelligent in its use of data, and that patients should in principle have easier access to and control over data.

However, it points out that many NHS organisations currently do not have the systems in place to realise the government’s vision, and that IT is often one of the first areas to be downscaled during times of financial difficulty. It argues that the proposals to allow patients to share their records online require safeguards to protect them against disclosing more information than they intend – either inadvertently or as a result of coercion. And it calls for more consideration to be given to the potential of the proposals to increase health inequalities, pointing out that a technology-driven policy will not deliver benefits to groups that do not have access to technology.

Dr Chaand Nagpaul, a GP and member of the BMA’s Working Party on IT, said:

“ Improving NHS IT while the NHS is under huge financial pressure will be extremely challenging. Delivering the information revolution cost-effectively and equitably will depend on building on the systems that are currently in place and working well, and on involving clinicians.

“ While the principle of patients controlling aspects of their records is a good one, there must be safeguards to reduce the risks involved in sharing such sensitive data. Even if a patient validly decides to share part of their records, for example via an online support forum, they will effectively lose control once posting it.

“ The role of clinicians in helping patients protect their own data, and interpreting and explaining information will be vital. The experience of doctors is often that when patients are presented with data to inform their choices, they still value the views of the professionals caring for them.”

The BMA response also welcomes the intention to improve patient access to NHS outcomes data, provided it is presented in a way that does not mislead or confuse. It points out that raw data can be misinterpreted and that external factors, such as the demographics of a hospital’s catchment area, can have a significant impact upon outcomes data.

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