BMA Opposes NHS Plans For Patient Access

A consultation on the government’s plans to allow patients to access their own health care records online has been met with a barrage of warnings from the doctors’ professional organisation, the British Medical Association (BMA).

The BMA has insisted that doctors’ involvement in taking forward the government’s proposed information revolution is essential. It urges the government to learn the lessons of the National Programme for IT (NPfIT), which failed to include a role for clinicians from the outset.

Cash Strapped And Disparate

With the consultation on the “liberation” of the NHS due to close tomorrow, the BMA said that funds are not there and that safeguards will have to be introduced to prevent illicit access to patient records or leakage of information.

The professional body’s response to the government’s Liberating the NHS: a consultation on proposals questionnaire has been published on the BMA’s website. The points have been boiled down to six main concerns.

The BMA stressed that it has agreed that high quality care is dependent on good information and that patient access to their records is a laudable aim. However, the organisation has serious doubts whether this can be achieved within the current financial constraints being imposed on the NHS.

“Improving NHS IT while the NHS is under huge financial pressure will be extremely challenging,” said Dr Chaand Nagpaul, a general practitioner (GP) and member of the BMA’s Working Party on IT. “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.”

Quality imbalance

There is a concern that IT provision varies in quality throughout Britain. The BMA believes that this infrastructure needs to be brought up to the same level, both in terms of IT provision and staff training, before access should be allowed.

A more crucial warning is that patient records are not like business records because they are used as an aide memoire for doctors. A reminder to routinely screen for potentially serious or socially sensitive illnesses, such as AIDS or multiple sclerosis, may be construed by the patient as a diagnosis rather than part of an elimination process.

Often the records may contain personal assessments made by a doctor. If a patient takes exception to being classed as morbidly obese or as a possible hypochondriac, the patient/doctor relationship could be seriously undermined.

There is also a provision for patients to allow third-party access to their all or part of their records.

“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,” Nagpaul said.

“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,” he added.