GPs’ representatives voted overwhelmingly this week for a system in which patients opt in to any sharing of medical data with third parties—rather than one in which their consent is assumed unless they opt out, the system favoured by the Department of Health. Clinical confidentiality depends on GPs being the prime data holder of their patients’ medical records, said the BMA’s annual conference of local medical committee representatives in London. It also strongly opposed using implied consent as justification for releasing information on named patients.
Leading GP bodies have given their support to new guidance on how patients’ medical records should be used in medical research. The guidance, published this week by the medical charity the Wellcome Trust, aims to make it clearer to GPs and researchers how they can ensure that medical records are used safely in research. The report says that patients’ records in general practice are a unique source of information that can help medical researchers improve their understanding of disease, develop potential new treatments, and improve care.
New guidelines issued by the UK General Medical Council (GMC) will allow doctors to disclose genetic information to relatives - even when patients object, if there are compelling medical reasons for doing so. The guidance, which comes into effect on 12 October, acknowledges that confidentiality is not always absolute; disclosing information about a genetic link to a disease may protect another individual from serious harm. For example, if a patient is diagnosed with a hereditary form of cancer, a doctor will now be able to inform relatives about the potential risk the genetic link could carry. Awareness of such a genetic risk could prompt investigation for the genetic mutation responsible and regular screening, thereby improving the chance of early detection and long-term prognosis.
The Medical Protection Society (MPS) is seeking clarification about the position of doctors who become aware that their patient is considering ending their life in circumstances that might amount to criminal charges. The recent House of Lords decision requiring the Director of Public Prosecutions (DPP) to look at the factors which would be taken into account in deciding whether to bring a prosecution in such cases is helpful. Much of the debate so far has focused on whether relatives or spouses should face prosecution for assisted suicide, but there also needs to be discussion over the difficult position health professionals may find themselves in. Currently, most patients will travel outside the UK, for example to the Swiss clinic Dignitas for an assisted suicide.
Doctors are being warned not to respond to flirtatious approaches on social networking sites. The Medical Defence Union, a legal body for doctors, said communicating via sites such as Facebook may be a breach of ethical responsibilities. It issued the warning after a number of cases in which patients propositioned doctors after searching for their details on the internet. Regulators agreed that medics should be careful.
A woman who found out she had HIV when she was pregnant with twins was infected by her boyfriend who had known he had the virus for nine years. She was among four women unaware that Mark Devereaux, 41, had the virus when they had unprotected sex with him. The 28-year-old woman chose to have an abortion after discovering she had contracted the virus. Devereaux admitted four charges of culpable and reckless conduct. Sentence was deferred for reports.
The doctors' union claims that England's medical records database is being pushed through too fast, with details sometimes being uploaded without patients' knowledge. But those behind the new system say many patients are astonished that hospital doctors still do not have access to basic information, and the process to opt out is very straightforward. What are the issues?
Doctors leaders have called for a halt in the development of a medical records database for patients in England. The British Medical Association says the computer-based Summary Care Records are being set up at "break-neck speed", sometimes without patients' knowledge. Ministers have expressed surprise at fears of fast change after previous criticism that it was moving slowly. The NHS IT upgrade will link more than 30,000 GPs to nearly 300 hospitals through an online appointments system. It will also feature a centralised medical records system for 50 million patients, e-prescriptions and faster computer network links.
At least 100,000 non-medical staff in NHS trusts have access to confidential patient records, claim campaigners. Big Brother Watch, who based the figure on 151 responses from trusts, said it demonstrated "slack security". The group says hospital domestics, porters, and IT staff are among those with access to records in some trusts. The Department of Health says the report muddles paper files and the newer electronic systems for which access will be strictly controlled. Big Brother Watch asked every NHS Trust in the UK for the number of their non-medical staff who had access to confidential patient records.
GPs are considering whether to abandon their involvement in a scheme to put medical records on a computer database. BBC News understands that talks are continuing to try to make it easier for patients to opt out of the system. Thirty million people in England have already been formally contacted about the computer record. Health ministers from the coalition government insist the rollout will continue.
Patients in England will be able to inspect and correct their NHS and social care records online from 2015 if the coalition government’s vision for the use of IT in the NHS becomes reality.