Public back ‘patient passports’ to share medical records with any doctor

Public back ‘patient passports’ to share medical records with any doctor

Every NHS patient should have their health information digitally stored in one place so that any doctor treating them can access their records no matter where they are, The Times Health Commission has concluded.

Eight in ten people support the creation of “patient passports” that would provide a single system to keep track of medical records throughout a person’s life, and which could be accessed seamlessly across GPs, NHS hospitals, pharmacies and social care.

The proposal is the first of ten key recommendations in the Times Health Commission Report, which is being published following a year-long inquiry and amid widespread backing for a data revolution in healthcare.

The commission, led by a panel of experts from across health and social care, spoke to more than 600 witnesses including senior doctors, hospital managers and politicians.

It concluded that “technology has the power to transform healthcare”, with an urgent need to overhaul outdated and fragmented systems that prevent data being shared freely between different parts of the NHS.

YouGov polling for the commission shows 81 per cent of the public back its key recommendation of NHS digital health accounts, called patient passports, with only 10 per cent against. Some 89 per cent said patients should automatically be allowed to access their own medical records.

The accounts could be accessed through the NHS App — acting as the gateway to the health service to book appointments, order prescriptions, view test results and contact doctors.

Similar systems are already in place in Spain, Singapore, Estonia, Israel and Denmark, empowering patients and freeing medics from bureaucracy. Presently there are “between 40 and 60” different types of electronic patient records within the NHS, the commission heard, while around ten per cent of hospitals are entirely paper-based.

Healthcare data revolution

Under a universal patient passport system, medical records could be stored on people’s phone or medical card, and pulled up on arrival at their hospital, GP surgery or pharmacy.

Polling shows that 56 per cent of the public agree that the convenience of being able to easily book appointments and access care outweighed any risk to the privacy or security of their medical records, compared to 22 per cent who disagreed. Meanwhile 68 per cent of the public would be happy for the NHS to allow other medical staff or clinicians to access their records.

The digital health record would also allow the NHS to make better use of its data for life-saving medical research, and 64 per cent said they would be willing for their own data to be used anonymously for research.

There is strong political appetite for the reforms, with Sir Keir Starmer, the Labour leader, telling the commission there should be a “seamless system” that securely shares NHS data across all GP, social care and hospital records.

On top of the need to embrace data and technology, The Times Health Commission has called for the system to be rebalanced away from hospitals and a greater emphasis put on prevention and community care.

It notes that reform of social care is essential, calling for a new “National Care System” giving the right to appropriate support in a timely fashion.

The Health Commission report in full

Among its other evidence-based policy recommendations, the commission calls for student loans to be written off for doctors, nurses and midwives who stay in the NHS, to tackle chronic workforce shortages. It also calls for new weekend high-intensity theatre lists for planned operations, to drive down NHS waiting lists of 7.6 million.

Sir John Bell, Regius professor of medicine at Oxford University and Times Health commissioner, said: “The commission provides an important set of observations and recommendations that could form the basis of a new strategy for the NHS. At the heart of these recommendations is the need for a dramatic improvement in the way we use technology and data.

“The NHS has fallen behind on the way it uses data and technology, yet it will be impossible to meet the health challenges of tomorrow without a full commitment to use these tools. Embracing new technologies could transform the way the health system functions and would improve health in a more cost-effective way.

“We also urgently need a shift to preventing illness, a more personalised approach to healthcare, and an NHS where patients are active participants in maintaining their own health and these things can only be achieved using data and technologies such as artificial intelligence. The commission’s recommendations on this issue need to be acted on immediately before the efficiency of the health system declines further.”

Hunt backs no-blame compensation scheme for medical errors

Dame Clare Gerada, former president of the Royal College of General Practitioners (RCGP) and Times Health Commissioner, said: “What an important report and I’m proud to have been part of the commission. The future health system must invest in technology, data and digitalisation if it to meet the needs of tomorrow’s patients”

Sir Patrick Vallance, chairman of The Natural History Museum, former government chief scientific adviser, who gave evidence to the commission, said: “Companies that invest in research and development tend to do better than those that don’t, and the same is true for healthcare systems. Investment and application of innovation from prevention through to cures is a route to sustainability.”

The reforms outlined by the commission would help build upon the success of the NHS App, which has gained 33.6 million registered users since its launch five years ago. The NHS is also launching a federated data platform, which will bring together different databases within the hospital system. However, this platform does not include GP or social care data.

Dr Vin Diwakar, NHS national director for transformation, said: “Technology offers a huge opportunity for the NHS to transform services for patients and we are already making great progress. Three quarters of the adult population use the NHS app to access health advice, manage repeat prescriptions, view their GP records and book appointments, and we are adding more functionality all the time.

“Our ambition is to go further still over the coming years to empower patients and support clinicians, using data and technology to provide compassionate care and to support people to keep mentally and physically well and get better when they are ill.”

Heart attack patient forced to wait days for cardiologist exam

On a Saturday afternoon in January 2010, Vipan Maini, an otherwise fit and healthy management consultant at PwC, suffered a heart attack (Georgia Lambert writes).

The 58-year-old had his blood drawn in hospital to confirm but was forced to wait until working hours resumed on Monday to be examined by a cardiologist. Four days after being admitted, Maini underwent an angioplasty procedure, during which the consultant said that it was unlikely he had suffered a heart attack because he was “too young” and didn’t present with the “typical risk factors”.

Within five minutes, the consultant told Maini that he had in fact, “defied the odds” and he had suffered a major heart attack.

“He told me I had so much damage that it was likely I had had a previous heart attack, so that was a double shock,” he says. “That was my first understanding of how dangerous people’s perceptions can be.”

Vipan Maini suffered a major heart attack

Vipan Maini suffered a major heart attack

Maini was given five coronary stents to prevent further blockages from occurring but suffered another heart attack 18 months later. During one check-up, a consultant asked if Maini had undergone a quadruple heart bypass — a procedure that is performed when four of the vessels in the heart are blocked. “I was completely flummoxed by that comment and I said ‘No, I haven’t had a quadruple bypass’.”

This error was not amended and it remained on his medical record. In 2019, Maini had a third heart attack but his heart was not immediately examined because he was treated under the assumption that he had a quadruple heart bypass.

“Because of that inaccurate information, the doctors were not initially going to examine my heart. They only changed their treatment plan after I told them my medical records were incorrect. Once they examined me through surgery, they discovered further blockages which necessitated three stents,” he said.

“Imagine if I were to have presented and I was unconscious? Fate and luck make such a difference in what happens to you, which shouldn’t be the case. A lot of people don’t speak up but you have to question them, they don’t know best all the time.”

Would you know if you were having a heart attack?

Maini believes that many of the problems that affected his treatment lie within the culture and leadership of the NHS. “The theory of expertise can lead to blind spots in decision-making … I guess it’s a lack of curiosity and proper analysis,” he added. “If you are not a typical patient like I was — as a youngish, fit man in his early 40s — there is a risk you will fall through the net as doctors may make false assumptions which then lead to inaccurate treatment.

“Subsequently, the hospital should have chased up to discover why my patient records were so inaccurate. I don’t know if my records still show I had a quadruple heart bypass. When they identify a problem, such as incorrect patient records, they don’t follow it up, so it continues to be there. The hospitals were aware of the bypass issue but failed to do anything about it.”

Maini spoke about the mismatch in ensuring the accuracy and completeness of data and how AI could be used to double-check patient records to identify anomalies and pinpoint risk factors. He also backed the design of a digitised patient passport.

“If done properly, it should give control to the patient over their records — making it easier and quicker for patients to share their medical details with relevant doctors, and specialists. It should also enable patients to see who has access to their data and why it is being used. Obviously, there needs to be a proper legal framework and privacy is critical to the success and viability.”

The Times investigates the crisis facing the health and social care system in England. Find out more about the Times Health Commission.

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