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17-10-2010 | Article

Scaling back Summary Care Record a wise move

A measured and sensible way of accessing medical records online has been announced by the Department of Health. According to univadis GP news (click here), the Summary Care Record will contain only basic information. This electronic distribution of medical information - aimed, for example, at approved urgent care providers such as accident and emergency departments and out-of-hours services - is a sensible step forwards. There are two major but equally important sides to this - easy but secure access to a current electronic health record available to authorised personnel, balanced with protection of patient confidentiality.

The government's compromise of having basic data available backed up with clear patient consent and approval is part of a serious effort to build a national network of electronic medical records. Public IT projects have frequently been controversial and costly and are not always appropriate to the task and it is important that we try and win over a potentially sceptical public. If the plan suggested by the Department of Health proves successful, by which I mean it is effective and used appropriately and securely, then maybe the electronic records can be populated with even more data, assuming of course that individual patients provide consent. I am sure that one day full clinical records will be placed securely online. We may already have the technology, but we need more experience of managing such a complex project and we also need the support of patients and the public. That will take some time and this cautious approach is the correct way ahead.

In other news, the government has dropped plans to allow pharmacists to substitute generics for prescribed branded drugs. Initially I was surprised, but after reading in the univadis GP news article (click here) perhaps it does make sense. With generic prescribing rates at nearly 85% on a voluntary basis, I doubt that the rate will get much higher with enforcement. I suspect the effort and political flack is not worth it for something that what would probably yield minimal savings.

Finally, biological agents have slowly but surely made inroads into clinical medicine and now one of these drugs has been given the blessing by NICE (National Institute for Health and Clinical Excellence) to treat postmenopausal women who are at risk of osteoporosis and its complications and cannot take oral bisphosphonates. According to the univadis GP news service (click here), it can be given by injection twice a year, and so could be administered by primary care providers. As with all new (and not-so-new) drugs, we should be looking for more data on both safety and effectiveness. Even so, it is always good to see new therapies becoming available that may broaden the therapeutic options we can offer patients.

Best wishes,


Dr Harry Brown, editor-in-chief

By Dr Harry Brown