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Logo of brjgenpracThe British Journal of General Practice
Br J Gen Pract. 2007 February 1; 57(535): 156.
PMCID: PMC2034179

Connecting for health

Stephen Humphreys, Practice Manager

I really do not think that Connecting for Health's Care Record Guarantee1 has been properly thought out. I am particularly concerned about the final two commitments:

11. We will keep a record of everyone who accesses the information the NHS Care Records Service holds about you. You will be able to ask for a list of everyone who has accessed records about you and when they did so.

There may be times when someone will need to look at information about you without having been given permission to do so beforehand. This may be justifiable, for example, if you need emergency care. We will tell you if the action cannot be justified.

12. We will take action when someone has deliberately accessed records about you without permission or good reason. This can include disciplinary action, ending a contract, firing an employee or bringing criminal charges.

These commitments seek to protect patients from those who would abuse their positions with respect to other people's data, but they completely fail to protect the innocent who have to look at many patients' records for various reasons every single day. Those in general practice who have to look into records to understand why any particular patient was showing up as outstanding on one of the Quality and Outcomes Framework areas; to discover when a patient was last seen; to see if a patient was or was not on certain medication; to see if the patient usually has medication sent to a particular pharmacy; to check whether another member of staff had taken the correct action in relation to some matter regarding a patient; and so on and so forth, will simply not be able, days later, to recall why they did so, and so will be unable to justify themselves. I look at dozens of patient notes every day and as soon as the next day will probably have forgotten why I did so. In these circumstances — and I cannot believe I am unique in this regard — how will one be able to demonstrate that they looked at any given patient's records legitimately? One simply will not be able to. The care record guarantee is thus unrealistic and unworkable in this regard.

A senior information officer at NHS Connecting for Health merely tells me that in such situations the courts may have to decide whether I was guilty or not of any offence. He does not suggest what defences might be open to me when I say I cannot remember.


1. Care Record Development Board. The care record guarantee: our guarantee for NHS care records in England. London: Department of Health; 2006.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners