Intended for healthcare professionals

Analysis And Comment Information technology

Keeping the NHS electronic spine on track

BMJ 2006; 332 doi: (Published 16 March 2006) Cite this as: BMJ 2006;332:656
  1. Michael Cross, freelance journalist (
  1. 1 PO Box 40073, London N6 5ZJ

    The NHS's “digital nervous system” is going through a jittery phase. Its next test will be its acceptance by the public

    This summer every household in England should receive a leaflet explaining the NHS's plan to make their health records accessible electronically. The new care records service will enable the computerised booking of appointments (based on patients' choice), electronic prescribing, the automatic transfer of complete records between general practitioners when a patient moves, as well as providing instant medical data when needed for emergency care.

    Looking further ahead, the records service will create a new medical evidence base, consisting of accurate data about consistently identified individual patients, collected across health and social care. Among the users of this resource will be patients themselves, who will be able to view their records over the internet. In short, the care records service will transform the purpose of the medical record from a record of information generated by health professionals primarily for their own reference1 into a shared resource produced and used by all concerned with the process of care.


    Opinion polls suggest that most medical professionals support the goal of an electronic record but have concerns about the NHS in England's strategy for building it.2 Many concerns arise from the national scale and mandatory nature of the national programme. This year the programme, run by a Department of Health agency called NHS Connecting for Health through private contractors, begins its main deployment phase.

    The government says that the care records service will be fully installed in the NHS by 2007, with health and social care information systems integrated by 2010. Liam Byrne, parliamentary under secretary of state for care services, spoke last month of “commendable progress” towards this aim.3 Achievements include the installation of a new broadband computer network, …

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