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NHS IT Strategy

July 4, 2012

Cover magazine article June 2012


Another government, another NHS IT strategy….And as usual we lurch from one polarity to another. Back in the early 90s we had big regionally centralised IT projects which cost huge amounts of money and were then scrapped. The response was to move to localism and the result was lots of incompatible systems delivering different data. Then we had the previous government’s lurch in the other direction to a huge £15 billion centrally organised system. Again this did not deliver its promise in most areas. The Coalition scrapped it and in May published its new 10 year NHS IT strategy. For IFAs and insurers all this is of parochial interest in one particular area – patient records. If these were available on-line and free of charge to patients there could be a step change in speed and cost of underwriting and getting people on risk after initial quote.


So where are we now?  Pretty much where we have been for years, as the strategy points out. Records are kept electronically and on paper, in different care settings and different locations, and the quality of record keeping varies. People have the legal right to access information on health and care records, but currently this is not easy to do because it means asking for paper copies, and there is often a charge – especially for protection insurance. At the moment although over half of general practices use IT systems with the technical capability to provide electronic access to records, less than 1% offer this service.


The strategy says that all NHS patients will have secure online access to their GP records by 2015. Indeed from April 2013, anyone will be able to see which practices have online access to records on the NHS Choices website. So theoretically it could be possible to match which patients have access to the data before the 2015 deadline. Is the new dawn finally approaching?


Well maybe, but there are buts…First, what data will actually be on the on-line record? Here, buried in the report, is a classic case of the downside of localism. The headline commitment is qualified by the proviso that some GPs may decide that they can only provide access to data from a specific date, rather than to give access to all historical information. This will pose a challenge for insurers. Will they accept what is available and take the risk on what is not there – for speed of underwriting? Or will they still insist on full information? If the former is the case they will, of course, not be able to fall back on the full record at the point of claim. The FOS will see to that.


Second there is the attitude of the medical profession to patients sharing their records in this way. On this point the strategy is silent. Hardly surprising given what happened to most aspects of the current NHS reforms that related to the private sector. So what might happen? This is going to be very tricky. There is currently an agreement between the ABI and BMA on access and use of paper records. That agreement was never signed up to by the Royal College of General Practitioners (RCGP). They simple did not attack it. The strategy states that the RCGP has agreed to review guidance on access to records, including “safeguarding”, to lead the development of a plan, policy and procedures to support patient access and engagement with their GP records.


The prize is worth winning and I wish the industry and the ABI the best in handling the negotiations.


This article is by Richard Walsh,

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