What's all the fuss about?BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7557.42 (Published 29 June 2006) Cite this as: BMJ 2006;333:42
All rapid responses
Jan Wilkinson displays touching faith in the NHS connecting for
health care record guarantees. She states that patients should accept
that their records should be loaded onto the NHS care record scheme,
citing the guarantees as protecting the patient’s interests.
The Care Record Guarantee states, among other things that “From the
start, this new system will: ..keep a note of everyone who looks at the
records about you.”
Perhaps Jan Wilkinson would like to use her position to ask the Care
Record Development Board (CRDB) to investigate whether this guarantee is
being kept. What audit is being carried out?
For example, my Trust has implemented a PACS (which I think stands
for Picture Archiving Computer System) system for radiology. This PACS
system was purchased centrally by the Department of Health. Our Trust
(the Nuffield Orthopaedic Centre NHS Trust, Oxford) would have preferred
an alternative that linked into our Care Record, but we were required (by
the Southern Cluster) to take our current system despite misgivings.
I have been informed that the current PACS system used in our Trust
since December 2005:
• has no mechanism for keeping an audit trail (i.e. cannot record who has
looked at any record).
• has no control over who may access radiological reports; anyone who can
log onto the system (which is almost any clinical person working in the
hospital) can look at any patient’s radiological investigations.
• is to be installed in several or many other Trusts within the Southern
If my information is correct, then all radiology records in all
Trusts will be accessible to all people who can log onto the PACS system
in any hospital without anyone being able to know that they have looked.
This situation is well outside the care record guarantee. I
personally brought this to the attention of a CRDB member in November
2005, but as far as I am aware no action followed.
It therefore does not surprise me that General Practitioners are
being cautious about supporting the ‘opt-out’ policy when there is no
guarantee of reasonable control over access to sensitive information.
Derick T Wade
Competing interests: No competing interests