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Friday 25th May 2018

Spine database pilot underway

15th March 2007

The new controversial NHS medical records database is set to go live at two pilot sites.


A total of 14,500 patients from two GP surgeries in Bolton will become the first to have their confidential medical records added to the controversial Spine electronic database which aims to store details on every NHS patient in England by the summer of 2008.

Each patient has been written to regarding the trial, and given the opportunity to opt-out. They have eight weeks to lodge their objection. Those who refuse permission can choose from three options: no medical information, restrict disclosure or hold back certain sensitive information, such as HIV status.

To go ahead the pilot needs at least 60% of patients to opt-in.

The pilot will help inform how the NHS should handle patients who deny consent and provide an idea of how many people share campaigners' concerns over widening access to personal information.

England's remaining 50m patients will also be told how they can opt-out ahead of the roll out of the database. Patients should see their GP and fill out a form which will be recorded in the GP’s own database. Patients will be able to change their mind at a later date.

Connecting for Health, the NHS IT agency, said the records would be uploaded in July, with a further six or seven primary care trusts to follow.

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William Walbank

Friday 16th March 2007 @ 20:16

From the press one is given the impression that this is the national implementation of a proven system - not a very small scale pilot trial. The problems which have killed all such major systems start with data entry - how to code current files into the database. This can be done well with committed staff at the trial stage - but later on staff, particularly when working to performance targets, soon find out that they can enter anything with negligable risk of detection and the database soon drifts out of contact with reality.
A far better strategy is to retain the patient records in the surgery or hospital where there is an local and personal interest in maintaining integrity and then arranging for direct enquiry to all sets of a patient's records on a 'need to know'
As with all human activities, the Pareto Law holds - probably 1% of the patient base account for > 50% of the active records. Non-selective, one common standard for all, approaches are very wastful in resources, difficult to manage and over time become unreliable in large systems

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