Download Notes of meeting on 28 Oct 2015 v2

Parliament Hill Medical Centre
Note of patient meeting on Wednesday 28 October 2015
Present: 12 patients attended, as well as the three partners, Drs Graham, Chalmers Watson and
Johnson, as well as Pat Elliott, practice manager. The discussion was facilitated by a patient, Martin
Bould.
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Welcome and purpose of the meeting
Dr Claire Chalmers Watson welcomed everyone and thanked them for attending. Patients on the
practice list had received text and/or email notifications, if contact details had been provided to the
practice.
The meeting had been called on order to get patients' views on how their medical data was used at the
practice, and what it means for them.
By the end of the meeting it was therefore hoped to obtain:
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A list of issues for patients
Some pointers for online access to medical records (which was an NHS commitment for 2015).
Feedback exercise: on-line interface with the practice
As they arrived, patients were invited to mark on a ‘feedback wall’ their use of the ‘digital interface’ with
the practice, and their satisfaction with it. The areas were:
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Making appointments
Getting test results
Getting repeat prescriptions
Using the e-clinic and the administration email address for non-medical correspondence.
Most of those present had not made any extensive use of these on-line services. Those patients who
had, were mainly satisfied, notably with repeat prescriptions. Some had test results pending, but many
had not made use of the capability to have test results emailed.
Martin Bould explained this was not intended as a systematic poll, but as a way into discussion of the
main subject of the meeting.
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Issues raised by patients
Those present were then invited to feed back their main issues of concern. These concerned general
points about use of on-line services, and the specific example of test results.
Information for new patients about the services available
At the time of registering, as well as being given the leaflet, new patients could be reminded that they
could look on the website for more information, and also look at the TV screen in the waiting room –
both were sources of up to date information for all patients about the practice services, but especially
new patients, who had a lot to absorb when they first joined the practice list.
Some patients do not use the internet
The practice could be contacted in the same way as always by phone calls, letters and personal visits to
reception. It was recognised that some people did not use a computer or did not have the habit of using
the internet. Camden Council has a digital inclusion strategy and there are often courses for people
wanting to increase their skills – this may be helpful for some patients to follow up themselves.
Personal preference, and getting used to using on-line services to communicate with Parliament Hill
Medical Centre
Some patients said it would always be their preference to speak direclty to the practice about their
health. Some accepted that for on-line communication, familiarity may grow with habit and necessity,
in this area of life as others.
Did automated and digital methods of communication help the practice make the best use of resources
overall? Patients gave the example of the automatic check-in, saving reception time, and on-line
booking replacing telephone calls. Did this free up reception time? Dr Stephen Graham said the practice
wanted to be flexible, and would not railroad people into using these methods. However there was case
that since the reception team were usually very busy, and especially at peak times, so other forms of
contact could ease the load.
Test results
Stephen Graham explained how the practice communicated test results. All results were seen by a GP
and this determined the reply given to telephone callers by the reception team. However, if a patient
logged on and viewed their results, they would be there to see, with no personal explanation given at
the same time. For some this may be worrying; for others it may be more convenient. There was some
discussion about the pros and cons of seeing test results on line,
Confidentiality
There was considerable discussion of the ‘patient end’ of confidentiality. By accident or by agreement
some patients may in the habit of allowing their ordinary emails or indeed their texts to be read by
others, or may view them in a workplace or library where there were passers-by – whereas they may
not want someone to see their health information.
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On-line access to medical records
The practice was required to make some records available on line and to date this applied to
information about allergies and medications.
There was discussion about other categories that should be added and it was recommended that this be
extended to test results and immunisations.
There was discussion about access to documents. The practicalities of this were discussed, including the
date from which such access could start, and the possibility that some information may have to be
edited out because the content may not be appropriate to be viewed outside the context of a
consultation. Documents could stretch back for several years and by definition cover all aspects of a
patient's health.
At present the practice and hospitals copy correspondence to patients, so this level of access is not itself
new, only the way of accessing documents. (Patients also have for some time had rights to see their
paper records).
On balance, and at this time, those present felt that it would involve more complexity to make all
documents available on line, for a relatively limited gain. The view in this meeting was therefore that
documents need not be made available on-line.
The final on-line list (as suggested by the meeting) was therefore:
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Allergies
Medications.
Test Results
Immunisations.
Background information about records
As part of the meeting, the different types of record within the NHS were clarified
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GP record (the subject of the above discussion)
NHS summary care record (which could be seen by other NHS staff treating patient with their
permission)
Camden Integrated digital record or CIDR (to allow records to be seen by GPs, Royal Free, UCLH,
Camden social care, and CNWL community health services, with fixed levels of access and
patient agreement)
Care.data – the anonymous national data collected by the Health and Social care Information
centre, which was the subject of debate last year about the purposes for which the data could
be used, and by whom. Development is currently being piloted.
In many circumstance patients had been informed they could opt out of these data sharing
arrangements (Summary care record, CIDR, care.data).
There were a number of publications on the NHS Choices website which patients could consult about
access to records and safety of data.
It’s your record: a guide to accessing health records on line
https://www.myhealth.london.nhs.uk/sites/default/files/u3246/ItsYourRecord.pdf
Your health and care records
http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Pages/what_to_do.aspx
Keeping your online health and social care records safe and secure (A4 summary)
http://www.nhs.uk/nhsengland/thenhs/records/healthrecords/documents/patientguidancesummarya4.
pdf
Keeping your online health and social care records safe and secure (booklet)
http://www.nhs.uk/nhsengland/thenhs/records/healthrecords/documents/patientguidancebooklet.pdf