Department of Health and Social Care
Central Government
Noted
The Department of Health and Social Care outlines existing NHS services and policies related to electronic health record transfer and access. (AI summary)
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Dear Mrs Hocking,
Thank you for your letter of 31 March 2022 about the death of Fadzai Chitakunye. I am replying as Minister with responsibility for Primary Care and Public Health, and I am grateful for the additional time in which to do so. I wish to begin by saying how saddened I was to read of the circumstances of Mrs Chitakunye’s death and I offer my sincere condolences to her family and loved ones. The circumstances your report describes are very concerning and I am grateful to you for bringing these matters to my attention. General practice is the cornerstone of our NHS and Government is committed to helping staff deliver for patients. The 2016 General Practice Forward View 1 strategy provided support for practices to build the capacity and capabilities required to meet patients’ needs. As part of the GP Forward View, a key aspect included investment in technology to improve patient care and work to increase the electronic transfer of records between practices.
The NHS Long Term Plan2, published in 2019, sets out further ambitions for general practice and builds on the GP Forward View. The Plan includes digital transformation programmes and technology opportunities to improve and support NHS care, including better access by clinicians to electronic/digital health records.
You may wish to note that the General Medical Services (GMS) GP Contract requires practices to use GP2GP for transferring electronic health records. NHS Digital provides the GP2GP service, which allows patients' electronic health records to be transferred directly, securely and quickly between their old and new practices, when they change practices. The GP2GP process is an automated ‘pull’ and transfer of the patient’s digital medical record that is activated when a patient is registered on their new general practice medical system
1 https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf 2 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
a n d t h er e h a s b e e n a s u c c e s sf ul m at c h t o t h e n ati o n al P er s o n al D e m o gr a p hi c s S er vi c e d at a b a s e. P ati e nt s e x p e ct g e n er al pr a cti c e s t o h a v e t h eir m e di c al r e c or d s a n d t h e G P 2 G P s y st e m h el p s p ati e nt s’ h e alt h r e c or d s t o arri v e s o o n aft er a n e w p ati e nt pr a cti c e r e gi str ati o n. N H S Di git al m a n a g e a n d m ai nt ai n t h e G P 2 G P s er vi c e a n d c o nti n u e t o i m pr o v e a n d d e v el o p t h e s y st e m.
Y o u m a y al s o wi s h t o n ot e t h at Pri m ar y C ar e S u p p ort E n gl a n d ( P C S E) pr o vi d e s a d mi ni str ati v e a n d s u p p ort s er vi c e s f or N H S pri m ar y c ar e o n b e h alf of N H S E n gl a n d, a n d i s r e s p o n si bl e f or t h e m o v e m e nt of p a p er m e di c al r e c or d s. It c a n t a k e u p t o t w o w e e k s f or a n e w pr a cti c e t o r e c ei v e a p ati e nt’ s p h y si c al m e di c al r e c or d. P C S E m a n a g e a s e c ur e d eli v er y s er vi c e t o e n a bl e t h e m e di c al r e c or d t o b e m o v e d c orr e ctl y, a tr a c ki n g l a b el i s a ut o m ati c all y g e n er at e d a n d s e nt t o t h e ol d pr a cti c e a n d d eli v er y arr a n g e d. P C S E h a v e a n o nli n e tr a c ki n g s y st e m t o all o w pr a cti c e s t o tr a c k t h e st at u s of i n b o u n d r e c or d s, vi e w a li st of o ut b o u n d r e c or d r e q u e st s a n d s e e w h at r e c or d s n e e d t o b e pr e p ar e d f or tr a n sf er. T h e l e n gt h of ti m e it t a k e s f or a p ati e nt s’ r e c or d s t o g et t o t h eir n e w pr a cti c e i s m ai nl y d e p e n d e nt o n h o w q ui c kl y t h e ol d pr a cti c e r el e a s e s t h e p h y si c al r e c or d.
Fi n all y, N H S Di git al al s o pr o vi d e t h e S u m m ar y C ar e R e c or d s ( S C R) s er vi c e. S C R s pr o vi d e a n alt er n ati v e o pti o n if h e alt h c ar e pr of e s si o n al s ar e u n a bl e t o a c c e s s a p ati e nt’ s f ull G P cli ni c al s y st e m r e c or d. S C R s ar e a n el e ctr o ni c r e c or d of i m p ort a nt p ati e nt i n f or m ati o n, cr e at e d fr o m g e n er al pr a cti c e cli ni c al s y st e m m e di c al r e c or d, a n d t h e y c a n b e vi e w e d a n d a c c e s s e d b y a ut h ori s e d h e alt h c ar e pr of e s si o n al s i n v ol v e d i n a p ati e nt’ s dir e ct c ar e fr o m l o c al r e gi o n al a n d n ati o n al h e alt h c ar e s y st e m a n y w h er e i n E n gl a n d. T h e S C R i n cl u d e s t h e f oll o wi n g i nf or m ati o n: c urr e nt m e di c ati o n, all er gi e s, pr e vi o u s b a d r e a cti o n s t o m e di ci n e s, n a m e, a d dr e s s, d at e of birt h a n d N H S n u m b er, a n d m a y al s o i n cl u d e, si g nifi c a nt m e di c al hi st or y, r e a s o n f or m e di c ati o n, a nti ci p at or y c ar e i nf or m ati o n, e n d of lif e c ar e i nf or m ati o n, i m m u ni s ati o n s.
I h o p e t hi s r e s p o n s e i s h el pf ul.
N EI L O’ B RI E N M P
Thank you for your letter of 31 March 2022 about the death of Fadzai Chitakunye. I am replying as Minister with responsibility for Primary Care and Public Health, and I am grateful for the additional time in which to do so. I wish to begin by saying how saddened I was to read of the circumstances of Mrs Chitakunye’s death and I offer my sincere condolences to her family and loved ones. The circumstances your report describes are very concerning and I am grateful to you for bringing these matters to my attention. General practice is the cornerstone of our NHS and Government is committed to helping staff deliver for patients. The 2016 General Practice Forward View 1 strategy provided support for practices to build the capacity and capabilities required to meet patients’ needs. As part of the GP Forward View, a key aspect included investment in technology to improve patient care and work to increase the electronic transfer of records between practices.
The NHS Long Term Plan2, published in 2019, sets out further ambitions for general practice and builds on the GP Forward View. The Plan includes digital transformation programmes and technology opportunities to improve and support NHS care, including better access by clinicians to electronic/digital health records.
You may wish to note that the General Medical Services (GMS) GP Contract requires practices to use GP2GP for transferring electronic health records. NHS Digital provides the GP2GP service, which allows patients' electronic health records to be transferred directly, securely and quickly between their old and new practices, when they change practices. The GP2GP process is an automated ‘pull’ and transfer of the patient’s digital medical record that is activated when a patient is registered on their new general practice medical system
1 https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf 2 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
a n d t h er e h a s b e e n a s u c c e s sf ul m at c h t o t h e n ati o n al P er s o n al D e m o gr a p hi c s S er vi c e d at a b a s e. P ati e nt s e x p e ct g e n er al pr a cti c e s t o h a v e t h eir m e di c al r e c or d s a n d t h e G P 2 G P s y st e m h el p s p ati e nt s’ h e alt h r e c or d s t o arri v e s o o n aft er a n e w p ati e nt pr a cti c e r e gi str ati o n. N H S Di git al m a n a g e a n d m ai nt ai n t h e G P 2 G P s er vi c e a n d c o nti n u e t o i m pr o v e a n d d e v el o p t h e s y st e m.
Y o u m a y al s o wi s h t o n ot e t h at Pri m ar y C ar e S u p p ort E n gl a n d ( P C S E) pr o vi d e s a d mi ni str ati v e a n d s u p p ort s er vi c e s f or N H S pri m ar y c ar e o n b e h alf of N H S E n gl a n d, a n d i s r e s p o n si bl e f or t h e m o v e m e nt of p a p er m e di c al r e c or d s. It c a n t a k e u p t o t w o w e e k s f or a n e w pr a cti c e t o r e c ei v e a p ati e nt’ s p h y si c al m e di c al r e c or d. P C S E m a n a g e a s e c ur e d eli v er y s er vi c e t o e n a bl e t h e m e di c al r e c or d t o b e m o v e d c orr e ctl y, a tr a c ki n g l a b el i s a ut o m ati c all y g e n er at e d a n d s e nt t o t h e ol d pr a cti c e a n d d eli v er y arr a n g e d. P C S E h a v e a n o nli n e tr a c ki n g s y st e m t o all o w pr a cti c e s t o tr a c k t h e st at u s of i n b o u n d r e c or d s, vi e w a li st of o ut b o u n d r e c or d r e q u e st s a n d s e e w h at r e c or d s n e e d t o b e pr e p ar e d f or tr a n sf er. T h e l e n gt h of ti m e it t a k e s f or a p ati e nt s’ r e c or d s t o g et t o t h eir n e w pr a cti c e i s m ai nl y d e p e n d e nt o n h o w q ui c kl y t h e ol d pr a cti c e r el e a s e s t h e p h y si c al r e c or d.
Fi n all y, N H S Di git al al s o pr o vi d e t h e S u m m ar y C ar e R e c or d s ( S C R) s er vi c e. S C R s pr o vi d e a n alt er n ati v e o pti o n if h e alt h c ar e pr of e s si o n al s ar e u n a bl e t o a c c e s s a p ati e nt’ s f ull G P cli ni c al s y st e m r e c or d. S C R s ar e a n el e ctr o ni c r e c or d of i m p ort a nt p ati e nt i n f or m ati o n, cr e at e d fr o m g e n er al pr a cti c e cli ni c al s y st e m m e di c al r e c or d, a n d t h e y c a n b e vi e w e d a n d a c c e s s e d b y a ut h ori s e d h e alt h c ar e pr of e s si o n al s i n v ol v e d i n a p ati e nt’ s dir e ct c ar e fr o m l o c al r e gi o n al a n d n ati o n al h e alt h c ar e s y st e m a n y w h er e i n E n gl a n d. T h e S C R i n cl u d e s t h e f oll o wi n g i nf or m ati o n: c urr e nt m e di c ati o n, all er gi e s, pr e vi o u s b a d r e a cti o n s t o m e di ci n e s, n a m e, a d dr e s s, d at e of birt h a n d N H S n u m b er, a n d m a y al s o i n cl u d e, si g nifi c a nt m e di c al hi st or y, r e a s o n f or m e di c ati o n, a nti ci p at or y c ar e i nf or m ati o n, e n d of lif e c ar e i nf or m ati o n, i m m u ni s ati o n s.
I h o p e t hi s r e s p o n s e i s h el pf ul.
N EI L O’ B RI E N M P