sharing

Record Sharing on SystmOne

Please be advised that this page is in the process of being updated.

Resources

Summary Care Record    >

The Summary Care Record contains basic information including patient contact details, NHS number, medications and allergies. This can be viewed by GP practices, Hospitals and the Emergency Services. If patients do not want a  Summary Care Record, they can complete the appropriate opt out form.

The Summary Care Record with Additional Information can be added to create an Enhanced Summary Care Record. This can include specific read codes and care plans which will help ensure that the patient receives the appropriate care in the future. Patients must consent to enable this.

For SystmOne Users: To view & update a patient’s sharing preferences, just click the hand icon under the patient’s name. This will open the Ardens template where the SCR consent can be recorded.

SystmOne Record Sharing    >

This section will be updated shortly.

Patient information    >

In accordance with fair processing requirements, it is essential that patients are informed in an appropriate manner about the consent process.  The following resources can be used to assist Practices with this, so that patients are informed about the record sharing process and have the appropriate information to make an informed decision.

1. Posters for your waiting room
2. Leaflets for your waiting room – see here
3. On your surgery website – Please feel free to create a link to here
4. On your surgery TV screen
5. Message on prescriptions
6. Email and SMS to patients (please note posting information is not required)

Please also consider discussing this at your PPG meetings.

 

FAQs

What is the problem with ‘sharing’ on TPP?

The current sharing model in TPP enables a GP practice to ‘share out’ the TPP record to make it available to other health care providers.  Those other health care providers must ask for the patients explicit consent before accesing the record thus putting the patient in control of who sees their own record.  It was on this basis that Wiltshire CCG encouraged practices to share out the patient record at practice level on the basis of ‘implied consent’.  However, it has become clear that TPP does not allow the sharing out option to be limited to specific health care providers or providers within a certain geographical area – this leads to a ‘share all’ or ‘share nothing’ situation (allowing in theory a patient record to be accessed by any organisation anywhere in the country with access to TPP).  This had led to questions by the ICO, NHS Digital and the BMA over the validity of this sharing model and whether it potentially breaches the DPA.

As a result it has now been made clear that patients need to be fully informed of how their record is being shared and that they must give explicit consent for this to occur.

Why has this become an issue now?

The ICO and NHS Digital have been in discussion for some time regarding the sharing model with TPP.  However more recently there have been several articles in both the medical and national press which have pushed the issue up the agenda.  As a result, numerous Wiltshire practices are reporting that patients are contacting them for reassurance or to insist their notes are not shared.  However these decisions are often based on incomplete or inaccurate information.

So, should we turn off sharing and what happens if I turn off sharing?

Turning off all sharing in TPP effectively means that none of your patient records will be available to other health care organisations. Even where a patient wishes to share their record they will be unable to do so.

The current model of care across Wiltshire relies heavily on the sharing of records within TPP to provide safe, effective and efficient healthcare.  TPP and its sharing model is currently being utilised to enhance the level of  care in, amongst other areas;  GP surgeries, OOH services, palliative care/hospices, community services, leg ulcer clinics, community heart failure services and in the three acute Trusts across the county.

Wiltshire CCG strongly recommends that sharing is not turned off as this may have a significant and detrimental effect on patient care.

What should practices do now?

Whilst the ICO has been clear that turning off sharing is not necessary, it has been equally clear that doing nothing is not an option either.

Practices must therefore be taking active steps to:

  • Ensure all patients are fully informed about how their records are shared and,
  • Document explicit consent from patients regarding their sharing preferences.

Wiltshire CCG has released detailed guidance regarding the next steps practices should be taking to achieve these aims (http://www.wiltshireccg.nhs.uk/gp/gpedsm).

How can a practice ‘fully inform’ its patients regarding how their record is shared?

As things stand, the ICO is not expecting practices to write to every patient to fulfil requirements to fully inform them, but is expecting all other opportunities for fair informing to be utilised.  Wiltshire CCG will be providing materials to aid you in this respect but your approach could include:

  • displaying posters in your waiting rooms;
  • notices on your websites and other on-line services;
  • leaflets placed in waiting rooms;
  • advice on repeat prescription messages;
  • advice during consultations;
  • text (SMS) notices;
  • advising your Patient Participation Group (PPG)

How do I explain the sharing options to patients?

Sharing out:  “Would you like me to enable your records to be shared with other health care providers? These other providers will still have to gain your explicit consent to view your record but will then benefit by having access to your medical record to ensure they give you the best possible healthcare tailored to you. If it is an emergency situation and you cannot give consent, this can be overridden so that they can see your record, but we are informed of this and it is fully audited for everyone to see.”

Sharing in:  “Would you like me to be able to view your shared record from other health care providers?”

If we inform patients by mail and do not hear back from them can we assume they are consenting?

No.  This is still implied consent.  Whilst it is vital to provide patients with all the information they need to make an informed decision, only their explicit consent verbally or in writing is sufficient.

How can I reassure patients that their data is safe?

All NHS organisations have a robust approach to Information Governance where the confidentiality of patient data is key.  Any professional breaching the DPA puts their professional registration at risk.  TPP has recently introduced new restrictions so that any new user of TPP must first satisfy stringent IG requirements before being allowed to share out or share in records.  There is a fully auditable trail of who is accessing records, when they have been accessed and where they have been accessed from. You can also reassure patients that the practice is sent a notification if ever their consent is overridden to access their notes

A patient wants to know who has accessed their notes – how do I show them?

Patients with access to SystmOne online will now be able to review who has accessed their record simply by logging in. They will soon also be able to see their sharing preferences in the online view.   For patients without online access, a member of the practice team can easily access this information through the Administrative tab of the patient record.  You can also reassure patients that the practice is sent a notification if ever their consent is overridden to access their notes

Where can I find further information and guidance?

The BMA have released guidance including their own FAQs (some information from which is included in this document) which can be accessed here: https://www.bma.org.uk/advice/employment/gp-practices/service-provision/ttp-systmone-faqs

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