Integrated care record service (ICRS) and the NHS
Information Spine
One of the aims of the National Programme for IT (NPfIT) is
“to build a life-long health record service.” This has evolved into
the ICRS, which will also be linked with a nationwide shared
summary of patient information, the ‘NHS Spine.’ While this work is
ongoing the RCGP Health Informatics Group, Chaired by Dr John
Williams, has produced the following five principles which have
been approved by the RCGP Council in November 2003.
1. The integrity of information held on existing
systems must not be damaged through any of the actions related to
implementation of ICRS and the NHS Spine.
2. Automatic transmission of information
from local clinical systems to the national NHS Spine, outside of
any control by health care professional or patient, would breach
‘Good Practice guidelines for paperless practice’ and raise serious
ethical concerns because it would be impossible to obtain properly
informed consent prior to exporting the data.
3. Before signing up to its use, the profession
needs to be satisfied that the information held on the NHS Spine is
appropriate, that it is fit for purpose, and that it will not
endanger patient safety.
4. Secondary processing of information on the NHS
Spine should be subject to the same constraints and legal controls
(e.g. in relation to the 1998 Data Protection Act) as any other
secondary processing of clinical information elsewhere. Under no
circumstances should it be given Section 60 exemption.
5. The centrally driven Business Processing
Re-engineering approach adopted by the NPfIT managers tends to
destroy hard won corporate memory. High priority should be given to
the provision of education, training, change management that are
required to nurture an ‘information culture’ throughout the NHS.
Unless these are in place, it will be very difficult to achieve a
truly integrated care record service.
John Williams
Chair of RCGP Health Informatics Group
15/11/2003