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Health care is becoming more complex and is often delivered in different places by several professional groups. At present many records are still on paper and electronic records often do not link up. For example, although general practice electronic records are among the most advanced in the NHS,1 they are not normally available when the patient is seen out of hours or attends accident and emergency or another practice as a temporary resident. Electronic coded clinical communications between hospital and general practice systems are limited to pathology.

How should she choose what records the doctor can see?

Credit: MARK THOMAS/SPL

The NHS care records service lies at the heart of the national programme for information technology.2 The service will provide electronic summary care records and detailed care records that are available throughout the health service. The concept of appropriate electronic clinical information being available to legitimate healthcare professionals is not contentious. Most people agree that patient centred care requires comprehensive information to be available wherever and whenever care is provided. There is less agreement, however, on how patients should consent to use of electronic records and how the data can be kept secure.