New rules on the security of information to be held in the NHS Care Records Service, which will start rolling out across England next year, were published by the Government yesterday. It hopes that the rules will calm fears of privacy abuses.

The Service, a nationwide patient health record system, is intended to update the existing eclectic system, which relies on a mixture of paper and computer records, and is not always available to doctors in an emergency, which is when they need it most.

The new service will be centralised, and available to all those authorised to access it. This triggered concerns about privacy so, in response, the Government has published the Care Record Guarantee. The Guarantee makes 12 commitments to patients about their records. Guarantor of these new patient rights will be the Secretary of State for Health, currently Patricia Hewitt.

The Guarantee provides:

• Individuals will be allowed access to their own records;
• Access to records by NHS staff will be strictly limited to those having a 'need to know' to provide effective treatment to a patient;
• Information will not be shared outwith the NHS unless individuals grant permission, the NHS is obliged to do so by law, or failure to share would put someone else at risk. Any sharing without permission will be carried out following best practice guidelines;
• If individuals are unable to make a decision about sharing health information on their own behalf, a senior health care professional may make a decision to do so, taking into account the views of relatives, carers and any recorded views of the individual;
• Where health care is provided by a care team including people from other services, the NHS and patient can agree to share health information with the other services, bearing in mind the effect failure to share might have on the quality of care received;
• Individuals can choose not to share information in their electronic care records, although this may have an impact on the quality of care received;
• A complaints procedure;
• That individuals are entitled to check and correct mistakes in their record;
• That the NHS must enforce a duty of confidentiality on their staff and organisations under contract to the NHS;
• That the NHS must keep the records secure and confidential;
• That the NHS must keep a record of everyone who looks at the information held in the Service. Individuals will be entitled to ask for a list of people accessing their records, and details of when they looked at the records; and
• That the NHS must take enforcement action if someone looks at records without permission or good reason.

According to Health Minister Lord Warner, the rules will be backed up with tough security measures, ensuring that everyone can have confidence in the new Service.

© Pinsent Masons 2000 - 2005

See: The Guarantee (Eight-page PDF)

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