For a number of years, work has been ongoing to improve the way that medical records are made available to treating clinicians. Our main computer system is called SystmOne which has the advantage of enabling information to be shared between certain health professionals, and where necessary their support staff.
Enhanced Sharing (ES) enables us, with your consent, to share your medical records with those in the NHS who are involved in your care. NHS staff can only access shared information if they are involved in your care and records are kept showing who has accessed your medical records.
As the scheme has been designed to enhance patient care you have been automatically ‘opted in’ - details of how to ‘opt out’ is provided below.
For some time we have shared information for children for child protection reasons and also for patients under the care of the District Nursing Team. This has helped clinicians to make decisions based upon a wider knowledge of the patient and also helps to reduce the number of the number of times that patients or family members are asked the same question. In short it assists clinicians to provide more ‘joined up care’.
ES allows clinicians treating you, who have access to SystmOne to view and in some cases update your medical records. Locally this includes the Walk-In-Centre, many departments at local hospitals (including A&E) and community services, such as the District Nursing Team. It is anticipated that over time more health services will be able to benefit from ES.
Clinicians outside of the surgery who wish to access your medical records will ask for your consent to do so and will need to have been issued with a NHS Smartcard. This is a ’chip and pin’ card - similar to a bank card.
|Can I ‘opt out’ pick and choose who sees my record?
Yes, you can. Under ES there are two levels of consent. The first is to agree to sharing your medical records OUT. This is your agreement that records maintained by your GP can be seen, subject to your authority at the time, by clinicians working outside of the surgery. The second is agreeing to share your records IN. This means that your GP can see the records made by other health professionals who have access to ES.
However, as the treating Clinician needs to ask your permission to see your records at the beginning of each period of care you are in control of who can see your medical information.
For example the diagram below shows that the patient has agreed to share his medical records with the District Nurse and the surgery. However, whilst he is happy for his GP to see notes made by the local smoking cessation adviser he doesn't want the adviser to have access to his other medical records.
|I can see the benefits of the other people treating me seeing my notes, but what if there is a matter that I want to stay just between me and my doctor?
You can ask for any consultation to be marked as private, this means that viewing is restricted to the surgery, but allows the rest of the record to be viewed by whoever else is treating you. It is your responsibility to ask for a consultation to be marked as private.
| Haven’t I agreed/disagreed to do this before?
ES may seem very similar to the Summary Care Record which went live some years ago. The Summary Care Record contains only a very small part of your record that is available to be seen by clinicians who might be treating you in A+E departments, Walk In Centres or if you register temporarily somewhere else within the UK.
The Summary Care Record allows other NHS Services to see your current medications and the drugs that you are allergic or sensitive to. Your Summary Care Record can be enriched by your GP to include information that it is important to pass on in the case of an emergency.
Yes, you can always change your mind and amend who you consent to see your records. For instance you can decline to share your records out from the surgery, but if you build up a relationship with the physiotherapist who is treating you and they asked you if they could look at an x-ray report, you could give your consent at that point for them to view your records. You will be referred back to us to change your preference, so the physio treating won’t be able to see your records instantly, but should be able to by, the next time of your next appointment.
| If I decline what happens in an emergency?
In the event of a medical emergency, for instance if you were taken unconscious to A+E, and the Clinician treating you feels it is important to be able to see your medical records he is able to override any consents set.
However, the doctor has to give a written reason for doing so. Where this happens an Audit is undertaken by the local Caldicott Guardian (the person with overall responsibility for Data Protection compliance).
| Can anyone else see my medical records?
On a daily basis, we get requests from Insurance Companies to either have copies of medical records or excerpts from patients’ medical records. This requires your signed consent.
Occasionally we are asked for information from the medical records for legal reasons, again this has to be done with your written consent, or in very exceptional circumstances, by court order.
If you have any questions, please speak to reception. If necessary the receptionist will arrange for someone to give you a call.