THE BLOG

Give Doctors the Confidence to Deliver Joined-up Care

03/12/2014 15:11 GMT | Updated 01/02/2015 10:59 GMT

Joined-up healthcare is something we all want and the NHS needs. Enabling the disparate elements of our healthcare system to work together and share information will save time and money and ultimately benefit patient care.

It's an objective that patients support. In fact a recent YouGov poll found that almost two thirds of people are worried that failing to share important information about their health, for example between GPs and hospital teams, could result in treatment delays or errors.

Better sharing of information isn't just about better treatment - it's also about cutting unnecessary admin. In a recent speech, Health Secretary Jeremy Hunt referenced the fact that 66% of junior clinicians' time is spent "finding, accessing and updating patient notes". This figure would be dramatically slashed if patient information (with consent) was shared across the health system. That's time saved that could be put back into patient care.

The results that can be delivered are impressive. In Camden, for example, patient information - with consent - is being shared across primary and secondary care services. In less than a year, the local diabetes service has reduced 'did not attend' rates by 16% and community teams are using the facility to create tailored care plans which are then shared with the patients' GPs.

By 2020, it is the government's intention that details of all consenting patients will be shared across the whole health system. The technology exists to make this happen and the case evidence is there to show that it will deliver care benefits for patients and cost reductions in the NHS.

Why then is progress so painfully slow? One of the biggest reasons is the problematic tangle of legal red tape that clinicians fear when it comes to sharing patient information.

Clinicians have numerous legal obligations (including those under the Data Protection Act) to control access to patient data, and to take appropriate measures to prevent data loss/exposure. This is especially concerning for GPs, as they hold the most extensive data on patients. The thing is, clinicians also have a professional duty to share patient data - and it seems to me that this is the often-forgotten element of this debate.

The Caldicott 2 report, commissioned to examine and advise on "service user" (i.e. patient) confidentiality in health and social care, states that "the duty to share personal confidential data can be as important as the duty to respect service user confidentiality", and that "health and social care professionals should have the confidence to share information in the best interests of their patients".

How can our clinicians have confidence? Against this backdrop of policy confusion, it's little wonder that record sharing seems to be stalling. While health professionals are trapped in this legal/moral/professional quandary, truly integrated care is never going to be possible at scale.

Greater clarity is needed. Healthcare professionals need to be supported when it comes to their handling of patient data, and not feel like they could be setting themselves up for a fall should they take progressive steps towards integrated care and appropriate sharing of medical records.

In my view, and I'm not alone in this, the ultimate answer lies in patient empowerment; giving patients more control over what they can see, what they can add and who else can use their information. It is, after all, their information.

New EU data protection regulations that clarify and safeguard the patient's right to access and use all their healthcare data (electronic medical records) are in prospect. They may help or hinder the situation but, in the meantime, there is much more that can be done.

Patients can, and already do, use proven technologies to view their records, make appointments, order prescriptions and now, record their own health data from wearable health tech online and via mobile devices. It's the obvious route to develop when it comes to records sharing and one which chimes completely with the view that 'patients as partners' are critical to the long term survival and effectiveness of our NHS.