NHS

From Orgwiki

The National Health Service (NHS) is a state organisation that provides health care in Great Britain. Since devolution, the NHS has been split into three local divisions:

  • NHS England - managed by the Department of Health of the British government
  • NHS Scotland - managed by the Health Department of the Scottish Executive
  • GIG Cymru (NHS Wales) - managed by the Health & Social Care Department of the Welsh Assembly Government

Also see The Big Opt Out. A campaign set up to protect patient confidentiality and to provide a focus for patient-led opposition the government’s NHS Care Records System.

Contents

[edit] Care Records Service

As part of an upgrade of its IT network NHS England plans to create a centralised national database of patients' medical records, called the NHS Care Records Service. This move has proved controversial, with many people expressing concerns about confidentiality and choice.

British Medical Association's (BMA) chair, Dr Hamish Meldrum, has called for a halt to further implementation of the NHS summary care record, beyond six early adopter sites, until an independent review has been completed. In a letter to Ben Bradshaw, the minister responsible for the National Programme for IT (NPfIT), Dr Meldrum says that at a recent BMA meeting, doctors from primary and secondary care expressed their frustration with the programme and want a public enquiry to address problems. A BMA paper accompanying Dr Meldrum's letter says that one of the association's prime concerns about NPfIT relates to security and confidentiality controls.

Initially the Department of Health (DoH) stated that patients would not have any say in whether their records were included in the database or the content of those records but this position has since changed.

A pilot project begun in Spring 2007, at "early adopter sites"[1]. Patients at these sites will be able to "add comments to their record and request that any part be removed."[2] It's expected that there will be two options for reviewing records:

If neither of these options are taken up and the patient hasn't explicitly stated that they wish to opt out, it will be assumed that the patient is implicitly consenting for their records to be added without change.

The DoH intend to use the pilot project to inform their plans for implementing the service nationwide.

[edit] Documents

[edit] News

2008-05-15 - ZDNet - NHS stalls electronic record system rollout
Author: Nick Heath
Summary: The NHS has pledged to halt the further rollout of its electronic patient record system while it takes stock of criticisms in a report. A report evaluating the trial rollout of the Summary Care Record (SCR) system highlighted concerns that the system was clunky, interfaces poorly with other systems and was being foisted upon patients without their full knowledge.
2008-05-12 - Computer Weekly - The Sun reports on potential security flaw in NPfIT Choose and Book
Author: Tony Collins
Summary: The Sun has reported on a potential security breach with the “Choose and Book” system – part of the NPfIT - at a GP practice at Essex; and it has an editorial under the headline "Data Dunces". The editorial says: "There’s nothing more private than your medical records. Yet it seems anyone can access the NHS computer database. The Government promised it couldn’t happen. Yet a GP finds he can log in without security checks. Labour insist that the ID Cards database will be totally secure. But how can we believe them?"
2008-05-10 - The Sun - Crooks access NHS database
Author: Emma Morton and Andy Crick
Summary: The £12billion NHS computer system lay in tatters last night — as it emerged CROOKS may have accessed patient records. A security card flaw has left the system open to abuse for two years. Sensitive medical details, addresses and National Insurance numbers of every patient in the country could have been seen by ANYONE in a GP surgery or hospital without using the special swipe card. And the information could have been sold to ID theft gangs.
2008-03-14 - Kable - BT hires Patricia Hewitt as director
Summary: The former health secretary will join one of the main suppliers to the NHS National Programme for IT as a non-executive director later this month. As a politician, Hewitt has been closely involved with BT. The Leicester West MP was instrumental in the creation of Ofcom, the all-in-one regulator for telecoms and the media, while she was head of the DTI. Not only did she help establish the Ofcom constitution, but she also appointed its chair Lord Currie.
2008-03-03 - BBC - GP warning over database access
Summary: Ministers have been urged to tighten up access to the NHS database, amid concerns details are being seen by NHS staff without medical qualifications. News that healthcare assistants are getting access to patients' records "drives a coach and horses" through assurances on security, doctors say. The NHS says they have access only to basic details including allergies and medication, not full medical histories.
2008-02-29 - Computer Week - Patient database open to access by non-qualified NHS staff
Author: Tony Collins
Summary: A new national database of confidential patient records is being opened to access by NHS staff who need no professional qualifications - despite official assurances that records will only be accessed by specialists who are providing care or treatment. A document obtained by Computer Weekly under the Freedom of Information Act also provides evidence that NHS Connecting for Health - which runs part of the £12.4bn National Programme for IT [NPfIT] - has quietly decided to weaken assurances given to patients about the confidentiality of records. Doctors are angry because they say that patients were given an assurance that non-clinical staff would be unable to access the national summary care record database which is being trialled at NHS trusts in various parts of England.
2008-02-26 - Computing - NHS database must go ahead, say MPs
Summary: The chairman of the House of Commons Health Committee has brushed aside the confidentiality fears that have delayed the £12.5bn NHS summary care record database plan. Labour MP Kevin Barron attacked medical professionals for propagating " palpable nonsense" in suggesting the government will profit by selling the intended 60 million health records to pharmaceutical and insurance companies. He also accused the British Medical Association (BMA) of "scaremongering" with claims earlier this month that people were wrongly accessing records through the network. "My issue with some BMA members is that that is not a reason not to go ahead with using IT to bring health into the 21st century," he said in a Westminster Hall debate last week.
2008-02-20 - NO2ID - NO2ID calls on MPs to tackle hidden "SUS" database
Summary: With MPs due to debate Electronic Patient Records tomorrow [1], the privacy campaign NO2ID [2] says that they should be discussing how the relationship between doctor and patient is being subverted for management convenience and empire-building. The NHS database is not just used for patient care. The so-called Secondary Uses Service (SUS) does not provide a service to patients. It is a vast hidden system that distributes the most personal (and people think private) information to a horde of bureaucrats and other third parties. "Pseudonymised" patient information – and in some instances, identifiable patient information [3] – is trafficked for purposes including "clinical audit, performance improvement, research, clinical governance, planning, commissioning, public health and benchmarking" [4]. Via SUS, a wide range of non-clinical agencies, organisations and even private companies [5] have massively greater access to information on everyone than clinicians. Protection of confidentiality is utterly inadequate and it is unclear how, or even if, individuals can refuse consent for their most private details to be shared among thousands of bureaucrats. Phil Booth, NO2ID’s national coordinator, said: "That medics have access to a summary on "the spine" is just an excuse. It is only rarely going to be useful. Meanwhile dozens of bureaucracies and even private companies will get to exploit your whole medical history without your consent." "The Secondary Uses Service turns doctor's work and patients' lives into fodder for the bureaucratic machine, and professional standards and human dignity are irrelevant."
2008-02-20 - Channel 4 News - NHS multimillion pound IT: the risks
Author: Julian Rush
Summary: It's costing millions but the new NHS computer system in London and southern England poses a risk to patients say some consultants. The new NHS IT system is causing serious concern among clinicians. Last summer, the then boss of the National Health Service IT system, Richard Granger, candidly admitted he was "ashamed" - saying some of the hospital software was "appalling". Seven months on, Channel 4 News has spoken to clinicians who are seriously concerned about the system... The pressure is now on Connecting for Health to show that IT in the NHS brings real benefits. But the opinions of some doctors who've experienced the systems are making that difficult. Chris Taylor added: "Given that the system has been in some form implemented in hospitals for over a year and that there have been entire consultant groups who have raised their concerns, almost protests, it is beyond comprehension that this system, in its current form, is now being implemented. It just really is beyond comprehension. I have no other word for that." The stakes, then, couldn't be higher for the future of the NHS IT programme. Because unless the problems with the new hospital system are resolved soon, the chance of realising genuine longer term benefits of IT in the NHS could be in jeopardy.
2008-02-15 - The Register - 5,000 NHS records vanish with latest lost laptop
Author: John Oates
Summary: A laptop containing medical records for more than 5,000 people has been lost by a hospital near Dudley. The latest data giveway occurred on 8 January. The laptop was taken from an outpatients department at Russells Hall Hospital.
2008-02-14 - BBC - Medical records laptop is stolen
Summary: A laptop containing the medical records with information on 5,123 patients has been stolen from a Black Country hospital.
2008-02-13 - The Times - New database increases power of surveillance over citizens
Author: Richard Ford
Summary: ... Two national databases are also underway: the NHS Care Records Service and the Children’s Database. Connecting for Health will involve uploading medical records for more than 50 million patients on to an online database, allowing information to be shared among health care professionals. The NHS Care Records Service will contain a limited amount of essential information that can be combined with locally held care information. Patients will mostly be identified by summary care records containing only a few personal details. Their full medical history will only be available to doctors involved in their treatment using chip-and-PIN cards, which require a six-digit code to access some parts of the system.
2008-02-07 - ZDNet - NHS admits losing thousands of smartcards
Author: Tim Ferguson
Summary: More than 4,000 NHS smartcards used to access a range of electronic systems and applications have gone missing since they were introduced two and a half years ago. A freedom of information request by GP magazine Pulse found a total of 4,147 smartcards have been lost, 142 of which have been stolen. Of the 221 NHS bodies that replied to the freedom of information request, one in 10 said they had no idea how many cards had been lost or stolen.
2008-02-01 - eGov monitor - Doctors have no confidence in NHS database, says BMA News poll
Summary: Nine out of ten doctors have no confidence in the government’s ability to safeguard patient data online, a poll conducted by BMA News has revealed. More than 90 per cent of respondents (93 per cent) to the survey said they were not confident patient data on the proposed NHS centralised database would be secure.
2008-01-28 - Pendel Today - Warning to NHS chiefs after further data breaches
Summary: NHS get warning after more patient data goes missing, including data on 1.7 million patients, hard drives dumped in skip, disc lost, information left in pub, laptop stolen from locked room and and doctor's name linked to patients' details via 'google' search.
2008-01-18 - ZDNet - NHS loses patients' data on USB drive
Author: Nick Heath
Summary: NHS lose 4,000 medical and personal details on a USB drive Stockport Primary Care Trust (PCT) admitted it had not informed the thousands affected after it lost their names, dates of birth and details of medical conditions in December. The details, which also included NHS numbers and details of GPs, was on a USB drive that was dropped by an employee.
2008-01-03 - E-Health Insider - Four-fifths of doctors say electronic record insecure
Author: Joe Fernandez
Summary: Four-fifths of doctors are concerned that current plans for patients' health records to be available from a central database – the summary care record - will make them insecure, according to a survey for the Times. Asked what level of confidence they had that central health records will be secure, 80% of GP respondents said they not confident or they were very worried. In addition, 77% of consultant respondents also gave the same answers. Over half (57%) of respondents said that they felt that local NHS organisations will not be able to maintain the privacy of patient data within their area.
2007-12-31 - The Daily Mail - Revolt as 200,000 people demand to opt out of new NHS database scheme
Author: James Chapman
Summary: Intimate details of the first 100,000 patients have been uploaded to the controversial new NHS database despite a mounting revolt by doctors and campaign groups. ... There is growing concern about the security of the £12bn IT programme - the biggest civilian computer project in the world - which will ultimately contain the details of 50 million people.
2007-12-31 - BBC - NHS e-records programme launched
Author: Emma Wilkinson
Summary: The first patients' electronic records have been uploaded to the new NHS online database. Around 20 GP surgeries in Bolton and Bury have added 110,000 patients' details to the system, part of the £12bn NHS IT upgrade project. The e-records will eventually be available to NHS staff nationwide and contain details on medical conditions, current medication and allergies. In September, MPs criticised the slow progress of the e-records project. The health committee also raised concerns about security of the database.
2007-12-24 - The Financial Times - Concern over data handling grows in UK
Author: Jimmy Burns
Summary: The Department of Health confirmed that nine National Health Service trusts in England and Wales had admitted losing patients' records. The loss, thought to involve data on hundreds of thousands of adults and -children, emerged as part of a government-wide data security review following security breaches in other departments. ... Andrew Lansley, the opposition home affairs spokesman, said the latest loss underlined the case against the government developing centralised data bases. It also raised serious questions over how the planned electronic patients database in the NHS would be able to protect sensitive medical records, he said. "For over two years we have argued for data to be held locally, with networking rather than one central database. The government should accept that this would offer us greater protection," Mr Lansley said.
2007-12-24 - The Guardian - Primarolo admits ignorance over data losses by nine NHS trusts
Author: Patrick Wintour
Summary: The health minister, Dawn Primarolo does not know exactly what is has been lost by nine NHS trusts. Ministers will be worried that the loss will further undermine confidence in the department's plans for a new computer database of all NHS patients' records. ... The data losses appear to have emerged locally, with potentially the biggest loss by City and Hackney Primary Care Trust in London, which has reportedly mislaid the details of 160,000 children after a computer disc failed to arrive at its destination at St Leonard's hospital. ... The campaign group NO2ID, which opposes ID cards and moves to centralise all NHS records, said: "We are now starting to see the consequences of the government obsession with information 'sharing' and centralised IT in the NHS. If you care about your privacy, then keep your medical records between you and your doctor, and out of the hands of the Department of Health, if you can."
2007-12-23 - The Sunday Mirror - 9 trusts lose files
Author: Vincent Moss and Justin Penrose
Summary: Hundreds of thousands of Health Service patients' details have gone missing in a new data scandal. Sensitive details about adults and children were lost in 10 incidents at NINE separate NHS Trusts. Health Secretary Alan Johnson's department last night confirmed details - kept on computer discs or memory sticks - had gone missing. But the Department of Health refused to reveal how many patients were involved or the exact nature of the blunders. Cases include the loss of a CD holding 160,000 children's names and addresses by a Trust in East London and the loss of 244 cancer patients' details by the Maidstone and Tunbridge Wells health trust in Kent. In one case, in Norfolk and Norwich, medical papers on patients with lung, breast and colon cancer were dumped in a wheelie bin. ... THE TRUSTS: Bolton Royal Hospital, Sutton and Merton, Maidstone and Tunbridge Wells (two incidents), Sefton Merseyside, City and Hackney, Mid Essex, East and North Herts, Norfolk and Norwich, Gloucester Partnership Foundation Trust
2007-12-04 - Pulse - A spine waiting to snap
Author: Phil Peverley
Summary: Despite the loss of the disks by HMRC the government is continuing with its plans to upload the medical records of the entire population to another national database. What’s it for? What’s the point? And just who, in their right mind, would consent to their private medical records being logged on to a system to which tens of thousands of incompetent New Labour work-experience buffoons theoretically could have access? Not one of the patients I have discussed it with, that’s for certain. My personal medical records will not be joining this ludicrous Keystone Cops experiment. Neither will those of any of my patients. It is simply not possible that our government can give us any sort of guarantee that some berk in Birmingham will not download the lot and send it to his DVD rental club by accident
2007-11-26 - ZDNet - NPfIT: Doctors losing heart
Summary: Doctors' support for the National Programme for IT (NPfIT) is waning and they are becoming increasingly critical of the five-year-old scheme, according to a report by research company Medix. Whereas Medix research in early 2004 showed that 56 percent of GPs and 75 percent of other doctors were enthusiastic about NPfIT, the latest findings show this has dropped to 23 percent of GPs and 35 percent of other doctors.
2007-11-23 - Kable - Doctors' support for NPfIT falls
Summary: The latest Medix survey shows that doctors' support for NPfIT is falling, despite a general enthusiasm for new IT. Doctors' support for the NHS national IT programme (NPfIT) is waning and they are becoming increasingly critical of the five-year-old scheme, according to a report by research company Medix. Whereas Medix research in early 2004 showed that 56% of GPs and 75% of other doctors were enthusiastic about NPfIT, the latest findings show this has dropped to 23% of GPs and 35% of other doctors. ... Only 8% of the more than 1,000 doctors who responded said that information about NPfIT received from the Department of Health is reliable and accurate.
2007-11-22 - Kable - NHS in talks with IT suppliers
Summary: The three main suppliers to the health service's IT programme are in confidential discussions about contracts "resets" Connecting for Health, the agency responsible for delivering the NHS's £12.4bn IT programme in England, is making changes to contracts agreed with its three main suppliers.
2007-11-21 - BBC - NHS database 'could be targeted'
Summary:The man in charge of setting up the NHS medical records database has admitted that "you cannot stop the wicked doing wicked things" with information. Richard Jeavons, director of IT implementation at the Department of Health, said there were instances where staff "abuse their privileges". These had to be "pursued", he told the Commons home affairs committee. The plan to put 50 million patients' records on the database is part of a £12bn NHS IT overhaul. The scheme has raised concerns over cost and the security of information. A poll for the Guardian suggests that 59% of GPs in England are unwilling to upload any record onto the database without the patient's specific consent. Three quarters of more than 1,000 doctors questioned believed medical details would become less secure when they are put on a database that will eventually be used by the NHS and social services. ... Government chief information officer John Suffolk told the MPs "If we can avoid setting up large-scale citizens' databases, that would be a wise thing to do."
2007-11-20 - The Register - Most doctors plan to dodge health database
Author: Lucy Sherriff
Summary: The majority of family doctors have said they will shun a government plan to stuff a database full of all our medical records. According to a poll conducted by the Guardian, 59 per cent of GPs said they would not put records on the so-called spine without the consent of a patient, and fully three-quarters say records will be less secure once they are made available to NHS and social service staff on the central database. ... The newspaper reports that one of the doctors polled said: "Patients' confidential records will undoubtedly be at risk in the brave new world... I look forward to the innermost secrets of our politicians, actors and personalities being revealed to all and sundry." Another told the researchers: "Our current record confidentiality has been breached by a local primary care trust manager and we only found out by accident. I cannot trust the security of a national scheme."
2007-11-20 - The Guardian - Family doctors to shun national database of patients' records
Author: John Carvel
Summary: Nearly two-thirds of family doctors are poised to boycott the government's scheme to put the medical records of 50 million NHS patients on a national electronic database, a Guardian poll reveals today. With suspicion rife across the profession that sensitive personal data could be stolen by hackers and blackmailers, the poll found 59% of GPs in England are unwilling to upload any record without the patient's specific consent.
2007-11-14 - Pulse - Social workers to access new child health record
Author: Nigel Praities
Summary: A new comprehensive electronic health record is planned for all children, to be accessible by GPs, nurses and even social workers. But the ambitious Connecting for Health proposals have prompted concerns among some doctors at the prospect of broadening access to sensitive information about young people.
2007-11-13 - Kable - DoH accepts MPs' words on e-records
Summary: Among the other recommendations accepted by the department are that: * it should let patients know as clearly and quickly as possible that explicit consent is required for organisations to share their detailed care records (DCRs); * the summary care record (SCR) should have a standardised front screen; * only patients should have the right to break the "sealed envelope" of confidential records; * there should be an independent evaluation of the planned security system for national applications; * there should be custodial sentences for unlawful access to patients' personal information. ... it has turned down the MPs' recommendation that the Secondary Use Service, which makes anonymised data available for research, should not have access to data from "sealed envelopes". It also turned down recommendations that access to the SCR should be through the new health insurance card, and that implementation of shared records should be devolved to primary care trusts.
2007-11-12 - Pulse - NHS Care Record data safety fears grow
Author: Steve Nowottny
Summary: Staff from across the NHS are accessing sensitive patient-identifiable data through the controversial Secondary Uses Service. New guidance from Connecting for Health reveals three users in every organisation within the NHS have been given access to patient-identifiable information contained within Commissioning Data Sets and Payment by Results data. The guidance admits "this appears to be in total contradiction to the purpose of SUS", which was supposed to protect patient data through pseudonymisation. "Limitations of the current business function codes for SUS mean that it is not possible to restrict access to patient identifiable data other than through restricting the number of users," it states, adding that large-scale pseudonymisation would be rolled out "in coming releases".
2007-10-31 - Computer Weekly - NPfIT went ahead after Prime Minister had 10-minute briefing
Author: Tony Collins
Summary: Some in the IT industry may be surprised that the government made a provisional decision to invest billions of pounds in a technology-based programme on an apparently whimsical basis… If news leaked out that a fledging democracy had launched a technology project of enormous cost, size and importance on the basis of the informal style of decision-making that is parodied by the 10-minute presentation to the Prime Minister, its ruling party would, perhaps, be deeply embarrassed. Not the British government.
2007-10-25 - BBC News - NHS IT time-frame 'ludicrously tight'
Author: Erika Wright
Summary: The NHS National Programme for IT is the largest non-military project in the world and aims to revolutionise healthcare. But the budget for the massive project was never properly explained and it was given a "ludicrously tight" time-frame a new BBC Radio 4 investigation reveals. ... The director of the project, Richard Granger, resigned in June this year. ... In April 2006 Martyn Thomas was one of 23 computer science academics who wrote an open letter to the government, expressing concerns about the project and calling for an independent review. Professor Thomas has his own views on how big IT projects tend to go wrong. "Politicians like to do big things whereas introducing new computer systems is best done in the small. Deadlines are then set which are typically political deadlines." "Things have got to be in place for example before the next election - rather than having the timescales worked out for the project on the basis of proper engineering analysis."
2007-09-24 - E-Health Insider - Uncertainty over legality of NHS Care Records Service
Summary: Health minister Ben Bradshaw MP has refused to release information on the legality of the NHS Care Records Service (NCRS) and played down suggestions the NHS database will breach European law. Bradshaw was responding to Jeremy Wright MP who had contacted the health minister on behalf of one of his constituents Dr Paul Thornton, a GP in Warwickshire who is campaigning against the consent model for the NCRS.
2007-09-21 - Pulse - EU law could scupper Care Record
Summary: Health minister Ben Bradshaw MP has admitted the rollout of the NHS Care Record could be banned under European law. ... writing to Conservative MP for Rugby and Kenilworth, Jeremy Wright, Mr Bradshaw said the Department of Health still disputed Professor Korff’s claim, although he refused to reveal details of the Govern-ment’s legal advice.
2007-09-19 - The Guardian - Concern over NHS's IT systems after 50 view celebrity's details
Author: John Carvel
Summary: The case of a celebrity whose medical records were illicitly viewed by more than 50 members of an NHS hospital's staff raised doubts yesterday about the security of the government's £12.4bn scheme to upgrade the NHS's IT systems. The prying was revealed in board papers for North Tees primary care trust as a warning to managers to tighten procedures requiring doctors and nurses to log on individually before being allowed access to sensitive personal material.
2007-09-13 - House of Commons Health Committee - The Electronic Patient Record
Summary: Concludes that the NHS National Programme for IT (NPfIT) is failing to meet its stated core objective - of providing clinically rich, interoperable detailed care records. And that patient privacy’s is at serious risk.
2007-09-13 - Kable - MPs criticise e-health record progress
Summary: The electronic patient record project needs better planning, more consultation and a new timetable, say MPs
2007-09-12 - BBC News - Fears over NHS e-records system
Summary: A key plank of the £6.8bn NHS IT upgrade project in England has come under attack from MPs. The Health Committee said there was a "worrying lack of progress" and raised concerns about the security of patients' electronic records.
2007-09-05 - Kable - BMA call to halt e-record roll out
Summary: An open letter to government from the doctor's association wants a halt to the roll out of summary care records until a review has taken place. The British Medical Association's (BMA) chair, Dr Hamish Meldrum, has called for a halt to further implementation of the NHS summary care record, beyond six early adopter sites, until an independent review has been completed. In a letter to Ben Bradshaw, the minister responsible for the National Programme for IT (NPfIT), Dr Meldrum says that at a recent BMA meeting, doctors from primary and secondary care expressed their frustration with the programme and want a public enquiry to address problems.
2007-08-21 - Computer Weekly - What's in the Downing Street papers on the NHS IT programme?
Author: Tony Collins
Summary: A separate posting on this blog refers to a decision of the Information Commissioner to order the release of "sensitive" papers from a meeting at Downing Street in 2002 at which the NHS's National Programme for IT was given tentative approval. The meeting was chaired by the then Prime Minister Tony Blair and attended by several ministers, civil servants and business consultants. Computer Weekly requested the Downing Street papers in January 2005 under the Freedom of Information Act. The Cabinet Offfice, on behalf of Downing Street, rejected our request. We appealed to the Information Commissioner who has now ruled that the papers should be published. Today, 21 August 2007, we asked the Cabinet Office if it would appeal to the Information Tribunal against the decision of the Information Commissioner. It has until 10 September 2007 to submit a formal notice of an appeal. Its spokesman said only: "We are still studying the decision." He would not say whether the Cabinet Office will appeal. We would be surprised if it didn't. So what are Whitehall, Downing Street and the Cabinet Office hiding?
2007-08-18 - BBC - E-care records safety fear raised
Summary: More proof is needed that electronic personal health records are safe and effective, some doctors have said. Ministers are pushing ahead with plans to put personal medical records on a national electronic database, which patients can themselves access online. But Dr Claudia Pagliari, from Edinburgh University, and colleagues told the British Medical Journal that challenges still existed over the security.
2007-07-31 - Kable - Nurses show doubts about EPR
Summary: Nurses have strong reservations about the benefits of electronic patient records, a survey for the Royal College of Nursing has found. Although the survey, carried out by Medix, found that two thirds of nurses welcome the introduction of electronic patient records (EPRs), fewer than one in two felt they would improve patient safety. Almost a third of those surveyed were uncertain as to whether EPRs would be more secure than the existing paper based system. The survey also found that two thirds of respondents have yet to be consulted about EPRs, while just one in 10 had been consulted "quite a lot" or "to a great deal".
2007-07-23 - Kable - GP2GP nationwide roll out begins
Summary: NHS Connecting for Health has announced that the national implementation of the service for sharing electronic patient records has begun. GP2GP has been developed to allow patient electronic health records (EHRs) to be transferred directly and securely between GP practices. The roll out, announced on 23 July 2007, will initially comprise GP practices with the clinical systems EMIS LV 5.2 and INPS Vision 3, with other suppliers joining at a later date. A spokesperson for Connecting for Health (CfH) told GC News that the two systems constituted about 65% of the total number of GP surgeries.
2007-07-16 - Computer Weekly - Loss of 1.3 million sensitive medical files in the US - possible implications for the NHS's National Programme for IT
Summary: The disappearance of one external hard drive — the sort one can buy in PC World for about £100 — contained 1.3 million sensitive medical records. In England a loss on this scale could not happen with a breach of security at a GP practice. But the NPfIT's Care Records Service is due to store 50 million patient records.
2007-07-12 - Kable - New call for NPfIT review
Summary: The Liberal Democrat Party has repeated its call for a review of the NHS National Programme for IT. The party's shadow health secretary Norman Lamb used a recent interview with soon-to-be departing NHS IT chief Richard Granger in CIO UK magazine as ammunition to push for an independent inquiry. In the article, Granger admits: "Sometimes we put stuff in that I'm ashamed of," while labelling one contractor's equipment recently installed as "appalling". Granger is calling the contractor to account but Lamb, responding on 11 July 2007,said: "What is 'appalling' is that Richard Granger repeatedly defended the disaster prone NHS IT system when he was responsible for its delivery. Now that he has stepped down, he is more candid with the truth."
2007-07-03 - The Register - London NHS paper reveals plans to share patient data
Author: John Lettice
Summary: A document produced for London NHS reveals plans for extensive sharing of personal data between the NHS, social services, education and the police
2007-06-29 - E-Health-Insider - BMA votes for non co-operation on central records
Summary: Doctors have voted for a public inquiry into NHS Connecting for Health (CfH) and have called on the BMA to advise doctors not to co-operate with the centralised storage of medical records.
2007-06-21 - Computing - The NHS programme is like a Hummer, it will drive through anything
Author: Sarah Arnott
Summary: Granger has not been ashamed to get on with things and at no point has he tried to cover his arse, which is refreshing in the public sector. But we have to step back and do things the NHS way rather than dictating from the centre. That was a mistake from the beginning - A senior supplier .... The National Programme is like a Hummer: it is not subtle, it will drive through anything and will survive a few bomb blasts. But if you want to do anything with finesse, it is not the right vehicle. Now we need to change to something a bit more attractive, that people actually want to drive - A senior NHS source Granger did what he needed to do to please his political masters. He decided that his reputation and his relationship with the industry could be sacrificed to deliver what the political climate demanded - A senior industry source
2007-06-21 - Computing - NHS IT will never be the same again
Author: Sarah Arnott
Summary: No other public sector technology programme, however controversial, has generated quite the same furore as the £12bn National Programme for NHS IT (NPfIT). The project is held up as a paragon of tight contracting, technical vision and world-leading innovation. But it is also used as an exemplar of the worst excesses of disastrous government IT: autocratic, unworkable and a spectacular waste of money. Richard Granger’s combative stewardship of the programme for the past five years has created almost as much controversy. And his departure in a few months, announced this week, will have a significant impact.
2007-06-18 - Kable - CSC consents to iSoft merger
Summary: Following weeks of wrangling, NPfIT local service provider CSC has agreed to the merger of software partner iSoft and the Australian firm IBA Health. Soft and CSC have been locked in discussions over the development of aspects of the Lorenzo software, currently being delivered to the NHS as part of the National Programme for IT (NPfIT).
2007-06-14 - Computing - Bury patients join NHS records pilot
Author: Sarah Arnott and Lisa Kelly
Summary: Bury NHS Primary Care Trust (PCT) is joining the pilot of the electronic care record system at the heart of the £12bn National Programme for NHS IT (NPfIT). The Lancashire trust’s involvement comes at a time of continued controversy over the scheme. In a House of Commons debate last week, Stephen O'Brien MP called for an independent review. And NPfIT director general Richard Granger will be among witnesses at a health select committee hearing today (Thursday).
2007-06-05 - The Telegraph - Amateurs in charge of government business
Summary: The Government's chronic inability to manage costly IT schemes effectively is well documented - indeed, it has become one of New Labour's trademarks. This morning's report from the Commons Public Accounts Committee helps to explain why Whitehall gets it so wrong, so often. ... The committee highlights two specific areas of weakness in the management of complex IT programmes. ... The failure to do so has led to such well-documented disasters as the enormous cost and time overruns in the computerisation of NHS records and the multi-billion-pound fiasco of the introduction of tax credits.
2007-05-29 - Computing - CSC to block IBA Health iSoft bid
Author: Tom Young
Summary: Computer Sciences Corporation (CSC) is to oppose the £132.3m offer IBA Health has made for NHS software supplier iSoft. The services giant has step-in rights over iSoft's development of its 'Lorenzo' hospital administration software for the £12bn National Programme for NHS IT, of which CSC is a major contractor. CSC is yet to provide reasons for its opposition to the deal.
2007-05-23 - The Guardian - Anger at plans for NHS database of gay men
Author: John Carvel
Summary: An NHS database holding intimate information about the sexual behaviour of thousands of gay men is being planned by health trusts as part of a drive to encourage safer sex, a charity disclosed today. The possibility that sensitive data could be accessed by computer hackers is causing anxiety across the gay community in London, where it will be launched later this year.
2007-05-17 - The Guardian - Hewitt admits defeat on doctors' job fiasco
Author: Graeme Wilson
Summary: Patricia Hewitt, the Health Secretary, faced humiliation last night after being forced to jettison the controversial online job application system for junior doctors.
2007-04-27 - Kable - MPs warned about e-health records
Summary: The government has been accused of ignoring concerns about the privacy of the NHS e-care record. ... Andrew Hawker, an academic who has written about information systems and described himself as "an NHS patient", warned that the implementation of e-care records should be deferred until core IT systems are fully installed and it has been "thoroughly tested for privacy".
2007-04-27 - The ARCH Blog - Wasted opportunities
Summary: The Department of Health has apologised after a security lapse on the junior doctors recruitment website enabled confidential information on thousands of applicants, including their sexual orientation and previous convictions, to be accessed by the public yesterday ... As Mr Eugenides says: "Remember that these people want to record your personal details on a massive database. Not someone else’s: yours." "Do you trust them to do so? And if so, why?" That’s not quite accurate. They’re going to record details on two massive databases. Don’t forget the junior NIR, formerly known as the Information Sharing Index, now re-branded ‘ContactPoint’.
2007-04-27 - The Guardian - Junior doctors' personal details made public in website blunder
Author: Lee Glendinning
Summary: The Department of Health has apologised after a security lapse on the junior doctors recruitment website enabled confidential information on thousands of applicants, including their sexual orientation and previous convictions, to be accessed by the public yesterday.
2007-03-15 - BBC - Home access to NHS records plan
Summary: Patients are set to be able to look at their medical records on their home computer, it has been announced. The plan was set out by Connecting For Health, which is overseeing the introduction of the new NHS IT system - The Spine - which will cover England.
2007-03-15 - The Guardian - First test launched of NHS's controversial 'Spine' database
Author: John Carvel
Summary: The government's plan to put the medical records of every NHS patient in England on a central electronic database will begin first trials tomorrow at two carefully selected GP practices in the north-west. ... Three types of patient opt-out to be offered
2007-02-22 - BBC News - Hospitals pick hi-tech clipboard
Summary: Hospitals are to introduce and electronic clipboard - known as a mobile clinical assistant (MCA) - in the hope of cutting the time doctors and nurses spend on paper work. Onboard it has a scanner that can read RFID (radio frequency identification) tags that allows nurses to log on to the wireless system securely and quickly. It also has a barcode reader built in so it can read drug labels and patient wristbands and a digital camera to take pictures of wounds.
2007-02-20 - ZDNet - Doctors give NHS IT a cautious welcome
Summary: Two-thirds of UK doctors are confident that the National Programme for IT will make a positive change to the NHS, a survey has found. However, only 7 percent think the massive NHS IT overhaul should receive any further funding to ensure its success.
2007-02-13 - The Register - Fujitsu man condemns NPfIT as failure
Author: Lucy Sherriff
Summary: The government's pet technology project, the multi-billion pound NHS National Programme for IT (NPfIT), is in danger of failing, lacks the leadership required to stop it drifting off course, and is in danger of morphing into "a camel", according to a senior figure in one of the main contractors implementing the project.
2007-02-13 - Times - £6.2bn IT scheme for NHS ‘is not working and is not going to work’
Author: David Rose
Summary: The care of patients on the NHS risks being compromised by the Government’s flawed implementation of a multi-billion-pound computer system linking doctors and hospitals, according to one of the project’s senior executives. A lack of vision and poor understanding of the sheer size of the task meant that the IT overhaul “isn’t working and isn’t going to work”, Andrew Rollerson, an executive with Fujitsu, one of the system’s providers, said.
2007-02-11 - Blogzilla - NHS security constantly subverted
Author: Ian Brown
Summary: We have been told over and over again by the NHS that the highest security standards will be applied to centralised medical record databases, and that only authorised staff will have access to patient data. We have numerous practical examples showing this is pure fantasy. List with details...
2007-02-07 - OUT-LAW.COM - NHS asks Lords to clarify freedom of information and data protection clash
Summary: The House of Lords will clarify how data protection and freedom of information laws should work together if it hears an NHS appeal against an order to release clinical data. Any ruling would be a defining one for the two emerging areas of law.
2007-02-02 - ZDNet - NHS denies privacy risk over smartcard sharing
Author: David Meyer
Summary: NHS Connecting for Health has admitted that smartcards were shared between staff at a Warwickshire hospital, but denied that this compromised the confidentiality of patient data. ... On Thursday Connecting for Health (CfH), the NHS department administering the IT overhaul (the National Programme for IT, or NPfIT), issued a statement claiming that there was "no question of the confidentiality of patient data having been compromised" at the Trust, as the staff authorised by the board to share smartcards "were all clinical staff, bound by their professional codes of confidentiality, operating in a secure non-public part of the hospital". ... Previous statements from CfH had suggested that the sharing of smartcards would be treated as misconduct, requiring disciplinary procedures. However, Thursday's statement conceded that "responsibility for the security of patient information ultimately lies with individual Trusts, hospitals and NHS organisations".
2007-01-30 - Computer Weekly - NHS security dilemma as smartcards shared
Author: Tony Collins
Summary: An NHS trust board has approved the sharing of smartcards, in breach of security policy under the £12.4bn NHS National Programme for IT (NPfIT), because slow log-in times would restrict the time of doctors treating emergency patients. ... Paul Cundy, spokesman for the British Medical Association's GP IT subcommittee, said the actions of the trust "drive a coach and horses through the so-called privacy in the new systems". He said, "This is precisely what we have long predicted and shows that security systems, although highly specified on paper, need to be tested against live environments before they can be said to be secure."
2007-01-29 - Metro - Security fear for patients’ records
Summary: NHS staff are being permitted to breach security on the Government's patient records system, it was claimed today. Workers at one trust have been told they can share their shift leader's 'smartcard' which allows them to view individual patient records
2007-01-26 - OUT-LAW.COM - Patients can boycott NHS system, says Commissioner
Summary: The Information Commissioner has been told that patients will have the opportunity to refuse to have their details uploaded onto the new NHS medical records system. The news comes just weeks after the Department of Health refused patients that right.
2007-01-26 - ZDNet - Anger over EC medical data-sharing scheme
Author: David Meyer
Summary: The European Commission is about to call for proposals on how patients' medical details would be shared between its member states, with the UK almost certain to be included in the scheme. ... "If you're somebody with information that should be known, at present you will carry either a bracelet or a card in your wallet to say so," Anderson told ZDNet UK on Thursday. "It is foolish to move to a computer for the simple reason that, if you have the information either on an online database or sitting on a smartcard, then the computer could be down. Human-readable information which you can carry is the most appropriate technology."
2007-01-23 - The Register - Academics compile 'encyclopaedia of concerns' about NPfIT
Summary: A group of academics have issued a "dossier of concerns" calling for a technical review of the NHS National Programme for IT (NPfIT). Brian Randell, Emeritus professor of Computing Science at Newcastle University, told GC News that the 200 page dossier containing "everything said about the NPfIT over the last few years" will help Parliament's Health Select Committee with its pending inquiry.
2006-12-22 - out-law.com - BMA may seek NHS records system boycott
Summary: Doctors will be advised to refuse to use the NHS's computer system unless the Department of Health (DoH) changes its mind on behaviour which the British Medical Association says is unlawful.
2006-12-21 - ComputerActive - Opt out of NHS computer records
Author: Dinah Greek
Summary: Information about how people may be able to have a say in whether their medical records are added to the central database and what information those records will contain.
2006-12-19 - The Times - Patients can keep their details secret after computer U-turn
Author: David Rose
Summary: The Government has agreed to let patients keep details of their medical records private after they are uploaded electronically on to a new NHS database. In a policy U-turn, Lord Warner, a health minister, said that he had accepted the recommendations of a task force on the electronic patient records system. The Government is to stick to its plan that patients will have to opt out of the NHS Care Records Service — but there will now be the chance for patients to view their record and amend details online before information is uploaded for sharing. They will also be able to consent to how their information is shared with professionals across the NHS in England.
2006-12-04 - The Guardian - Health officials reject requests to opt out of patient database
Author: John Carvel
Summary: The Guardian's response to the government's response to letters sent to the DoH by Guardian readers expressing their concerns about the proposed database.
2006-11-05 - The Times - Help! They know all about me
Author: John-Paul Flintoff
Summary: Some of the things that we consider most deeply private are contained in our medical records: a history of depression, a sexually transmitted disease, a long-ago abortion, recovery from drug addiction or a suicide attempt. The National Health Service has embarked on a £12 billion IT project that will upload millions of patients’ medical records onto a database, freely accessed by 250,000 NHS staff and, to a lesser degree, by private health companies, council workers, commercial researchers and ambulance staff. It might as well be public. Thomas has already encountered cases of private investigators, aided by insiders, raiding government and company databases such as the police national computer and the DVLA’s vehicle computer, as well as those at the Department for Work and Pensions. Doctors fear that when the openness of the database is understood, patients may stop telling GPs their secrets. The health department is unbothered: “The citizen has no right to stipulate what will and will not be recorded . . . nor where those records will be held.”
2006-11-01 - The Guardian - Warning over privacy of 50m patient files
Author: David Leigh & Rob Evans
Summary: NHS England seems intent on adding the medical records of all patients to its new central database without allowing people a say in whether their own records are included or what information may be shared.
2006-07-11 - Computer Weekly - NHS trust uncovers password sharing risk to patient data
Author: Tony Collins
Summary: A report recognises that a culture of sharing codes which give access to medical systems and records is widespread across the NHS and that this poses a threat to the confidentiality of medical records which are due to be uploaded to a central patient database.

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