Patients’ lives are being put at risk by basic failures to link up medical records held by hospitals and those kept by their family doctors – many of whom are providing “unacceptably” poor care – the chief inspector of GPs warns today.
In an interview with The Independent, Dr Steve Field said it was absurd that consultants are still writing letters to GPs with details of the treatment that they have recommended for their patients, rather than adding them to a combined medical record.
Dr Field said it was equally detrimental to patient care that hospitals did not have access to routine information such as blood tests that were carried out in the community.
He said all patients across England should be given access to their own complete medical records and not in a piecemeal fashion, whereby some parts of the country have implemented such a system and others have not.
He also detailed how early trials of a new inspection regime for England’s 8,000 GP practices had uncovered widespread variations in care across the country, and a small minority of doctors who were unsafe to practise.
Among the problems found are out-of-date medicines in doctors’ surgeries, drugs not stored at the correct temperatures and some practices not having the expertise needed to deliver basic safe care.
Dr Field, who last year became the first chief inspector of general practice in the NHS’s history, was speaking as part of The Independent’s focus on the role of chief inspectors in the public sector.
Starting from next month, he will be rolling out a national scheme of inspection across around 8,000 GP practices in England. Under the scheme each practice will be rated “outstanding”, “good”, “needs improvement” or “inadequate”. Those judged inadequate will be placed in to special measures and could be shut down.
Dr Field said that, while he had been impressed by the quality of electronic records held in those GP practices he had inspected so far, he was much more concerned about how they linked up with hospitals and other services such as out-of-hours care.
“Shared records are the most important thing,” he said. “If you are seen in my practice and you get admitted to hospital – they should be able to have access to all your blood tests.
“In fact, they are all done on the same computer system but there is a ‘wall’ between the hospitals and the GPs. They should be able to have access to that. It will save money and it will save lives.”
He added: “Why are we sending letters to doctors or emails to doctors when it is actually in the same record? You should be able to read the plans in the record.
“In general practice we are finding the record keeping is very, very good but hospitals are behind us.”
Dr Field added that one way would be to give patients access to their own records – a system pioneered, in an attempt to restore patient confidence, by Amir Hannan, the GP in Hyde who took over the practice of Harold Shipman.
“It was very difficult to recruit to Shipman’s practice because of [the lack of] trust locally. But Amir went in and said, ‘Right from the start I will share everything with my patients, and gave them access to all their own records.
“He’s got examples of patients being admitted to hospital where they have had to show the consultants their record which may have saved their lives. It’s policy to try and make it happen. But it’s not moving quickly enough.”
