Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Michael Foley quotes from our guidance on confidentiality in
expressing his view that patients should be asked to ‘opt in’ to the new
NHS Care Record. This helpfully draws attention to the importance we place
on confidentiality as a key to relationships of trust between doctors and
However, we do not share his conclusion that to comply with our
guidance ‘explicit consent is required to enter [patients’] data into a
national computer system’. The means of storing information – whether on
paper or electronically – does not itself raise questions of
confidentiality. It is the robustness of the security systems which
protect records from improper access, and the rigour with which system
users follow confidentiality policies and procedures, which determine
whether patient’s right to confidentiality is protected.
Michael Foley points out some of the ways in which confidentiality
and security policies are currently breached. So, alongside the
development of new systems, consideration needs to be given to minimising
disclosures made by accident, or by careless application of security
policies. All healthcare professionals have an important part to play in
ensuring patients’ confidentiality, however the information is recorded.
I am Head of Standards and Ethics at the GMC