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Patients told of health change
PATIENTS at several GP surgeries in Dorset will be sent letters about their health records.
Dorset Primary Care Trust is introducing a new system called the NHS summary care record which will allow NHS doctors and nurses to view vital health information.
Six sites are in the fifth wave of GP practices to take part and they include Milton Abbas, Gillingham, Newland in Sherborne, Cranborne, Swanage and Wool.
Patients from these practices are due to be informed by letter next week and they will also be provided with a leaflet telling them about the choices they have and where to get more information if they need it.
The new system allows authorised practitioners to share patient information electronically. Key information such as allergies, current prescriptions and previous adverse reactions to medicines will be available to those treating patients in need of urgent care, in a range of locations.
Patients registered with the named practices will have 16 weeks to make a decision about their own record from the time they receive their letters next week. Unless a patient dissents, these GP practices will automatically create summary care records. Patients who are happy with the process do not need to take any action after receiving the letter.
Dorset has been chosen as an early adopter site for the national project and the first practice due to go "live" is Sturminster Newton in mid-June. Patients there were consulted last autumn.
Under the new system, key health information will be identified in a summary care record on a secure NHS network. Staff will be permitted to access information only if they are involved in the patient's treatment.
3:30pm Sunday 18th May 2008
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CommentPosted by: maximus, Weymouth on 3:56pm Sun 18 May 08
After the shambles with the loss of various computer data over the past year, I am surprised that any-one would consent to having their medical data free for all despite the supposed advantages. There is no such thing as a secure computer network, the network is only as secure as the humans using it and all humans are fallible. Inevitably passwords get passed around or left on post-it notes next to the screen 'in the interests of efficiency' or 'I can't remember my password so I will write it down'. Even more sophisticated methods of security can be compromised by human error or human activity. Personally I have already chosen not to have my records entered on the system and my standard of health care does not seem to have suffered or changed, either at my local surgery or at County Hospital.
After the shambles with the loss of various computer data over the past year, I am surprised that any-one would consent to having their medical data free for all despite the supposed advantages. There is no such thing as a secure computer network, the network is only as secure as the humans using it and all humans are fallible. Inevitably passwords get passed around or left on post-it notes next to the screen 'in the interests of efficiency' or 'I can't remember my password so I will write it down'. Even more sophisticated methods of security can be compromised by human error or human activity. Personally I have already chosen not to have my records entered on the system and my standard of health care does not seem to have suffered or changed, either at my local surgery or at County Hospital.
Posted by: Tru Belle, purbeck on 4:44pm Sun 18 May 08
I see, another NHS big spend! This is nothing to do with curing disease or preventative medicine, we will all be another statistic courtesy of a very wasteful NHS. Data cannot ever be secure. Just regard how many people are involved in caring for a patient . All information should be only on a need to know basis. Why are the NHS squandering money in this fashion, is this another number crunching exercise that will make the general public even more vulnerable to identity theft etc?
THERE IS NO SUCH WORD AS SECURE- read my lips!
I see, another NHS big spend! This is nothing to do with curing disease or preventative medicine, we will all be another statistic courtesy of a very wasteful NHS. Data cannot ever be secure. Just regard how many people are involved in caring for a patient . All information should be only on a need to know basis. Why are the NHS squandering money in this fashion, is this another number crunching exercise that will make the general public even more vulnerable to identity theft etc?
THERE IS NO SUCH WORD AS SECURE- read my lips!
Posted by: Dorset Boy, Wilds of Dorset on 4:54pm Sun 18 May 08
My medical records are personel for my Doctor, Nurse and myself only. I would not agree for every Tom,Dick and Harry to have access to them. I also agree with Maximus and Tru Belle that this is another way of wasting NHS money, which could be used for research into curing diseases such as heart disease and cancer.
My medical records are personel for my Doctor, Nurse and myself only. I would not agree for every Tom,Dick and Harry to have access to them. I also agree with Maximus and Tru Belle that this is another way of wasting NHS money, which could be used for research into curing diseases such as heart disease and cancer.
Posted by: DingDonG, Wilds of Wiltshire on 5:45pm Sun 18 May 08
[quote]Patients registered with the named practices will have 16 weeks to make a decision ... Unless a patient dissents, these GP practices will automatically create summary care records[/quote] I wonder what the uptake would be if it required a positive reply to register?
Also, will a confirmation of registration be sent in 16 weeks time, just in case the 1st letter never arrived, or got forgotten?
Patients registered with the named practices will have 16 weeks to make a decision ... Unless a patient dissents, these GP practices will automatically create summary care records
I wonder what the uptake would be if it required a positive reply to register?
Also, will a confirmation of registration be sent in 16 weeks time, just in case the 1st letter never arrived, or got forgotten?
Posted by: Westie, West Dorset on 5:50pm Sun 18 May 08
Dorset Boy, Tru Belle and Maximus... Whilst you make very valid comments on this subject, this system is really designed to make access to your records readily available SHOULD the need arise. Fair enough, when you go to your own Practice to see either your G.P. or the Nurse, they will know all of your previous medical history BUT... if you were attend a different Doctors surgery (for whatever reason)whilst visiting another town, for instance, then they would not know anything about you, medication, allergies and suchlike. Whereas with this system, it would all be readily available to them. The same would happen if you were taken to the hospital casualty department unconscious, there would be NO delay in your treatment, surely in this instance it can only be a good thing.
At the end of the dayk, you have 16 weeks to decide, if you do not want your records shared in this way, then you do not agree to it. Trust this additional bit of information is of help to you.
Dorset Boy, Tru Belle and Maximus... Whilst you make very valid comments on this subject, this system is really designed to make access to your records readily available SHOULD the need arise. Fair enough, when you go to your own Practice to see either your G.P. or the Nurse, they will know all of your previous medical history BUT... if you were attend a different Doctors surgery (for whatever reason)whilst visiting another town, for instance, then they would not know anything about you, medication, allergies and suchlike. Whereas with this system, it would all be readily available to them. The same would happen if you were taken to the hospital casualty department unconscious, there would be NO delay in your treatment, surely in this instance it can only be a good thing.
At the end of the dayk, you have 16 weeks to decide, if you do not want your records shared in this way, then you do not agree to it. Trust this additional bit of information is of help to you.
Posted by: Tru Belle, purbeck on 6:04pm Sun 18 May 08
Westie, that was a kind thought- very relaxed and reassuring.
These are red herrings I fear , how do we know this is not an organ donation ploy, or a tracking device like a microchip? if someone were to be found unconcious without ID, how would they know anyway? will this link into all the other Depts like the inland revenue etc,DVLA? or info on drug treatments be sold on- the NHS is not that altruistic you know, and is such a huge body that it is out of control!!
Westie, that was a kind thought- very relaxed and reassuring.
These are red herrings I fear , how do we know this is not an organ donation ploy, or a tracking device like a microchip? if someone were to be found unconcious without ID, how would they know anyway? will this link into all the other Depts like the inland revenue etc,DVLA? or info on drug treatments be sold on- the NHS is not that altruistic you know, and is such a huge body that it is out of control!!
Posted by: Westie, West Dorset on 7:17pm Sun 18 May 08
Tru Belle, thankyou. As we all should know, organ donation can only take place with the relatives verbal consent.
As for your other comments, i cannot answer that, but yes it could possibly be linked into other systems for all we know, but i should very much doubt it. But then if you have nothing to hide, then you will have nothing to fear.
Tru Belle, thankyou. As we all should know, organ donation can only take place with the relatives verbal consent.
As for your other comments, i cannot answer that, but yes it could possibly be linked into other systems for all we know, but i should very much doubt it. But then if you have nothing to hide, then you will have nothing to fear.
Posted by: Tru Belle, purbeck on 7:49pm Sun 18 May 08
[bold]Westie,[/bold] thanks, but you know it is not the fear of something to hide, it is the worry of the state being in control of every aspect of our lives- and knowing that information can be sold on or lost and well just abused. [bold]There[/bold] is far too much carelessness over missing laptops and discs for me to feel particulary happy about the welfare of our nation being accessed by unscrupulous organisations. It is naive to use the nothing to hide, nothing to fear analogy nowadays. We must all be protective of our personal freedom!!
Westie, thanks, but you know it is not the fear of something to hide, it is the worry of the state being in control of every aspect of our lives- and knowing that information can be sold on or lost and well just abused.
There is far too much carelessness over missing laptops and discs for me to feel particulary happy about the welfare of our nation being accessed by unscrupulous organisations. It is naive to use the nothing to hide, nothing to fear analogy nowadays. We must all be protective of our personal freedom!!
Posted by: blank on 11:22pm Sun 18 May 08
It's not a matter of nothing to hide, nothing to fear.
It's a matter of privacy; that is why I have curtains on my windows, unlike Westie.
Neither is about indivdual pieces of information being used by those to who it was given it for that particular purpose. It is about aggregates of information from various agencies being pooled and put to alternative uses to which we would not have consented had the aggregate and its use been demanded or requested at the outset.
It's not a matter of nothing to hide, nothing to fear.
It's a matter of privacy; that is why I have curtains on my windows, unlike Westie.
Neither is about indivdual pieces of information being used by those to who it was given it for that particular purpose. It is about aggregates of information from various agencies being pooled and put to alternative uses to which we would not have consented had the aggregate and its use been demanded or requested at the outset.
Posted by: maximus, Weymouth on 12:34am Mon 19 May 08
Well said [bold]blank[/bold], individual pieces of information are like the bits of a jigsaw puzzle, it is when you put them together that they show the whole picture, for example, who is to say that some or all of the medical details will not be sold on to an insurance company which may then use these pieces together with data from another source to affect whether someone is insurable or not. Perhaps, Westie, you would like to type up your life history and publish it on these pages, after all, you have nothing to hide (or have you really got some little secret that you would prefer is not bruited abroad).
Well said
blank, individual pieces of information are like the bits of a jigsaw puzzle, it is when you put them together that they show the whole picture, for example, who is to say that some or all of the medical details will not be sold on to an insurance company which may then use these pieces together with data from another source to affect whether someone is insurable or not. Perhaps, Westie, you would like to type up your life history and publish it on these pages, after all, you have nothing to hide (or have you really got some little secret that you would prefer is not bruited abroad).
Posted by: techie, Weymouth on 12:55am Mon 19 May 08
If anyone wants to approach this with an open mind and avoid idel conjecture, I would urge you to read the Care Records Guarantee - http://www.connectin
gforhealth.nhs.uk/ni
gb/crsguarantee
I think Maximus mentioned forgotten passwords - this is simply not an issue as there are no passwords as such - all access to national systems at staff level is controlled using smartcards and PINs, and for patients (for Healthspace et al) using a passcode and unique number grids - this is compliant to E-Gif level 3 (http://www.govtalk.
gov.uk/documents/e-G
IF_version_3_approve
d.doc).
Loss of CDs or other media again is not really applicable to the NHS which has had its own secure pathology messaging system (using EDIFACT over DTS) for a number of years, and its own secure end-to-end encrypted email service (nhs.net).
If you're worried about electronic health records then bear in mind that your GP practice will already have your full record stored electronically - personally I'd rather have that stored in a secure national system where I can be sure that my medical information is available to those who need to treat me should I become ill.
If anyone wants to approach this with an open mind and avoid idel conjecture, I would urge you to read the Care Records Guarantee - http://www.connectin
gforhealth.nhs.uk/ni
gb/crsguarantee
I think Maximus mentioned forgotten passwords - this is simply not an issue as there are no passwords as such - all access to national systems at staff level is controlled using smartcards and PINs, and for patients (for Healthspace et al) using a passcode and unique number grids - this is compliant to E-Gif level 3 (http://www.govtalk.
gov.uk/documents/e-G
IF_version_3_approve
d.doc).
Loss of CDs or other media again is not really applicable to the NHS which has had its own secure pathology messaging system (using EDIFACT over DTS) for a number of years, and its own secure end-to-end encrypted email service (nhs.net).
If you're worried about electronic health records then bear in mind that your GP practice will already have your full record stored electronically - personally I'd rather have that stored in a secure national system where I can be sure that my medical information is available to those who need to treat me should I become ill.
Posted by: maximus, Weymouth on 7:43am Mon 19 May 08
[bold]techie, Weymouth[/bold] I read what you have written but how can you guarantee that fallible humans do not lend some-one their smart card or pin. There have been recent cases where (I believe) IR staff have been looking at other peoples' records out of curiosity, I remember being told by my son about his girl friend and colleagues looking at bank customers records for idle curiosity and I was myself once seconded to an accounts department and wrote a program to print out a complete listing of everybody's salary so that we could look at it. I prefer that chance to be limited to the people in my doctors surgery who after many years, I have no reason not to trust. As was said above, if you are unconscious when you arrive at a hospital, no records will help if you don't have some sort of ID. Did some-one say national ID cards? George Orwell must be spinning in his grave. There is discrepancy between the size of the population, which is estimated to be around 60 million, and national insurance numbers, of which over 80 million are in circulation. With ALL computer systems GIGO rules - (Garbage In Garbage Out).
techie, Weymouth I read what you have written but how can you guarantee that fallible humans do not lend some-one their smart card or pin. There have been recent cases where (I believe) IR staff have been looking at other peoples' records out of curiosity, I remember being told by my son about his girl friend and colleagues looking at bank customers records for idle curiosity and I was myself once seconded to an accounts department and wrote a program to print out a complete listing of everybody's salary so that we could look at it. I prefer that chance to be limited to the people in my doctors surgery who after many years, I have no reason not to trust. As was said above, if you are unconscious when you arrive at a hospital, no records will help if you don't have some sort of ID. Did some-one say national ID cards? George Orwell must be spinning in his grave. There is discrepancy between the size of the population, which is estimated to be around 60 million, and national insurance numbers, of which over 80 million are in circulation. With ALL computer systems GIGO rules - (Garbage In Garbage Out).
Posted by: nige, dorchester on 11:55am Mon 19 May 08
[quote]As we all should know, organ donation can only take place with the relatives verbal consent.[/quote] Try telling that to all of those parents who had children die in Bristol....try telling that to the mother of Scarlett Keeling.
I think that a truly robust, secure means of storing medical records is a fantastic idea but can you really have confidence that this is a truly robust and secure method.
As we all should know, organ donation can only take place with the relatives verbal consent.
Try telling that to all of those parents who had children die in Bristol....try telling that to the mother of Scarlett Keeling.
I think that a truly robust, secure means of storing medical records is a fantastic idea but can you really have confidence that this is a truly robust and secure method.
Posted by: Rowland, Dorchester on 2:57pm Mon 19 May 08
I have no problem with my records being available to medical services, as a diabetic it might come in very useful one day. About 50 years ago I worked for the NHS for a short while and we received suitcases full of medical records from various medical practices and who knows where they ended up. Security can fail on computer systems but that is no worse than hundreds of records lost in the mail. Recently a friend was taken to the emergency room and treatment was delayed until data could be retrieved on the medication that was being taken.
So you have a choice, refuse access and risk the serious consequences if the records are unavailable.
I have no problem with my records being available to medical services, as a diabetic it might come in very useful one day. About 50 years ago I worked for the NHS for a short while and we received suitcases full of medical records from various medical practices and who knows where they ended up. Security can fail on computer systems but that is no worse than hundreds of records lost in the mail. Recently a friend was taken to the emergency room and treatment was delayed until data could be retrieved on the medication that was being taken.
So you have a choice, refuse access and risk the serious consequences if the records are unavailable.
Posted by: Tru Belle, purbeck on 3:25pm Mon 19 May 08
Perhaps we all ought have something to wear on our wrist or round our neck which is then scanned if we were taken in as an emergency- and only that chip will reveal our personal details.
Like chip and pin etc, or microchipping the dog . We will then be the only ones to have our security 'key' on us at all times?
Perhaps we all ought have something to wear on our wrist or round our neck which is then scanned if we were taken in as an emergency- and only that chip will reveal our personal details.
Like chip and pin etc, or microchipping the dog . We will then be the only ones to have our security 'key' on us at all times?
Posted by: Fabian, Weymouth on 8:38pm Mon 19 May 08
[quote]There is no such thing as a secure computer network,[/quote] [bold]Maximus[/bold] I disagree.
Having been employed in network security myself, I can vouch for the very stringent procedures that are followed by professional network security personnel. I can't describe these as they are covered by the official secrets act.
However,of the recent leaks of data, in all cases I understand it was due to one individual within the organization carrying out a breach, rather than hackers gaining access to networks. I'm astonished that hard disk containing classified material were removed from site. But this is not a network security issue; it is more likely staff being inadequately trained to follow protocol.
There is no such thing as a secure computer network,
Maximus I disagree.
Having been employed in network security myself, I can vouch for the very stringent procedures that are followed by professional network security personnel. I can't describe these as they are covered by the official secrets act.
However,of the recent leaks of data, in all cases I understand it was due to one individual within the organization carrying out a breach, rather than hackers gaining access to networks. I'm astonished that hard disk containing classified material were removed from site. But this is not a network security issue; it is more likely staff being inadequately trained to follow protocol.
Posted by: DingDonG, Wilds of Wiltshire on 8:43pm Mon 19 May 08
[quote][bold]Tru Belle[/bold] wrote:
Perhaps we all ought have something to wear on our wrist or round our neck which is then scanned if we were taken in as an emergency- and only that chip will reveal our personal details. Like chip and pin etc, or microchipping the dog . We will then be the only ones to have our security 'key' on us at all times?[/quote] One step away from a tatooed number put on a race of people not too many years ago, in a country not too far away from us ??
Tru Belle wrote:
Perhaps we all ought have something to wear on our wrist or round our neck which is then scanned if we were taken in as an emergency- and only that chip will reveal our personal details. Like chip and pin etc, or microchipping the dog . We will then be the only ones to have our security 'key' on us at all times?
One step away from a tatooed number put on a race of people not too many years ago, in a country not too far away from us ??
Posted by: DingDonG, Wilds of Wiltshire on 9:04pm Mon 19 May 08
I've probably buggered up my maths, but here goes...
Maximus,Weymouth wrote... [quote] There is discrepancy between the size of the population, which is estimated to be around 60 million, and national insurance numbers, of which over 80 million are in circulation[/quote]Agree with a discrepancy, but I don't understand how there can be 80 million numbers in circulation with the format AA 123456, thats only 67.6 million combinations.
(26x26x10x10x10x10x1
0x10) (I understand the last letter,A B C D only represents the quarter isssued)
My old US Social Security Number, in the format 123-45-6789 looks like it can only cope with 100 million !
I've probably buggered up my maths, but here goes...
Maximus,Weymouth wrote...
There is discrepancy between the size of the population, which is estimated to be around 60 million, and national insurance numbers, of which over 80 million are in circulation
Agree with a discrepancy, but I don't understand how there can be 80 million numbers in circulation with the format AA 123456, thats only 67.6 million combinations.
(26x26x10x10x10x10x1
0x10) (I understand the last letter,A B C D only represents the quarter isssued)
My old US Social Security Number, in the format 123-45-6789 looks like it can only cope with 100 million !
Posted by: maximus, Weymouth on 11:28am Tue 20 May 08
[bold]DingDonG, Wilds of Wiltshire[/bold] Sorry about your maths, I got my figures wrong but what is a few 100k between friends? Lord McKenzie of Luton said in the House of Lords - My Lords, there are currently 76.8 million national insurance number accounts on the customer information system, of which 55.1 million are active.
DingDonG, Wilds of Wiltshire Sorry about your maths, I got my figures wrong but what is a few 100k between friends? Lord McKenzie of Luton said in the House of Lords - My Lords, there are currently 76.8 million national insurance number accounts on the customer information system, of which 55.1 million are active.
Posted by: maximus, Weymouth on 6:17pm Tue 20 May 08
Extract from a BBC news item today [quote]That doctor had given his password to the cover SHO, a female doctor, but the stroke unit nurse said she was not the doctor who checked Mrs Elliott's x-ray, as it was checked by a man.[/quote] As I said above, humans are fallible and the best security systems in the world won't prevent this sort of thing happening.
Extract from a BBC news item today
That doctor had given his password to the cover SHO, a female doctor, but the stroke unit nurse said she was not the doctor who checked Mrs Elliott's x-ray, as it was checked by a man.
As I said above, humans are fallible and the best security systems in the world won't prevent this sort of thing happening.
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