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CfH report confirms confidentiality risk

Keeping mum on care records

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Plans to upload medical records onto a central database - the so-called spine - will put patient confidentiality at risk, Connecting for Health (CfH) has been told by its own consultants.

In its own risk analysis of the project, the agency responsible for centralising the country's medical records has acknowledged that GPs' concerns about patient confidentiality have merit, and that it would be safer to store records locally.

According to Helen Wilkinson-Maker of The Big Opt Out, a campaign group opposed to the spine, the risk analysis was intended to consider two scenarios: a spine with and without "sealed envelopes", sections of the medical record marked by the patient as not to be shared.

However, during the consultation with health professionals, civil servants, and patient representatives, a third scenario was put forward for analysis: that of locally held, digital medical records. This was found to present much lower risk of confidentiality breaches, according to the report.

Wilkinson-Maker said: "One major result of the interviews was to start NHS CfH thinking of alternative solutions that would provide the desired confidentiality in a practical and effective manner without adversely impacting on patient safety."

The Risk Analysis was presented to conference for General Practitioners in Stratford upon Avon on Friday by Dr Paul Thornton, a GP critic of the Connecting for Health proposals.

Dr Thornton said: "These confidentiality risks to health have been found to outweigh the benefits from automatic sharing of health information on a national database. The more that information is accessible by all health workers, the less likely it becomes that crucial information will be divulged to any one of us."

The consultants identified a conflict between patient safety and confidentiality: records with some details kept hidden were found to put patient safety at a greater risk than those with all the medical information in the clear. This is because the potential for error in diagnosis or treatment is much higher if all the facts are not known, the report says.

Meanwhile, patient confidentiality is at its most secure when some information is not just sealed in a single envelope, but in a variety of envelopes, with data being stored locally, and therefore only being accessible locally.

The consultants concluded that the alternative sealed envelope solution (i.e. local storage of data) presented the lowest summed risk to patient safety and confidentiality.

The report was commissioned by CfH and produced by consultants DET NORSKE VERITAS. You should soon be able to read it here. ®

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