‘Permission to view’

Supermarket pharmacies are to get access to the records of millions of NHS patients for the first time this autumn amid concerns about confidentiality and the exploitation of the information for commercial gain.

The records – known as Summary Care Records – currently include details of all prescriptions in the last year, diagnoses, age and post code.

But there is already lobbying by pharmacist groups to expand the patient information available to them. And the NHS itself – which has repeatedly tried to set up a database of full medical records – may also expand the information available in Summary Care Records.

From later this year pharmacy teams in Tesco, Boots, Superdrug and Sainsbury’s will have access to the data online, using a special Smartcard. Patients are meant to be asked permission before a pharmacist can access the record – so called ‘permission to view’.

The large commercial pharmacists, like Boots, have already been making inroads into hospitals. Boots, for example, has recently opened a pharmacy inside the Royal Marsden cancer hospital in London.

Giving commercial pharmacists direct access to summary care records normally only available to NHS professionals will assist them in expanding into a more direct role in the NHS. In a controversial move, patients are assumed to give automatic approval for this access unless they opt out.

Major shift in use

It also signals a major shift in the use of Summary Care Records (SCR). These were originally set up to allow NHS medical professionals direct access to assist them during an emergency response.

Phil Booth from the monitoring group medConfidential told UNITElive, “ SCR was originally specified for emergency and out-of-hours use; we do not believe the intention at that point was to make it accessible to staff in high street or supermarket pharmacies.

“That is a more recent ‘innovation’, which appears at least in part to be motivated by political decisions to reorganise the provision of care away from GPs and the NHS itself.

“A hospital doctor giving you treatment asking your permission to look at your last year’s medical prescriptions is one thing – a high street chemist, or one in Tesco or Superdrug, is somewhat different.

Creepy

“A consent mechanism – where the doctor clicks a button to say they’ve got the patient’s consent – that may have been appropriate in the original intended context appear in this new context to be rather inadequate and, quite frankly, creepy to some patients.”

Public money will be used to train commercial pharmacists in how to access summary care records, with the access justified by the pressure on GP surgeries.

Health minister Alistair Burt told the Pharmaceutical Journal on August 6, “I regard pharmacists as an untapped resource in our health service. As experts in medicines, they can help people manage their conditions and take some of the pressure off our GPs.

“That’s why it makes complete sense to give them the ability to access patients’ summary care records, where appropriate.

“As part of his new deal for general practice speech, the health secretary announced that we are investing up to ÂŁ7.5m to give community pharmacists the training and tools they need to access a patient’s summary care record.”

Commercial exploitation

There are also concerns over giving commercial companies access to information held by public bodies like the NHS. The sale of this information to the private sector for commercial exploitation has caused concern.

Private companies can now, for example, pay to access vehicle records. The Student Loans Company has sold on information about individual students to banks and finance companies.

There was shock when it was revealed that the medical records of every NHS hospital patient covering a 13-year period had been sold to insurance companies. New technology and software is allowing a huge expansion of data collection which includes a controversial central database of all GP visits by patients and fuller – but not all – details of medical records.

The care.data scheme is currently stalled amid concerns over the sale of data to commercial companies. This allows ‘secondary users’ access to medical records, which includes using the information for commercial use.

But the government is likely to make another attempt at a care.data relaunch later this year. Such is the concern about confidential patients’ data by NHS England that there are a range of cases awaiting the decision of the Information Commissioner.

Unite national officer for health Barrie Brown said, “Unite has serious concerns about what is another step towards the accelerating privatisation of the health service, which we strongly oppose.

“We are unhappy about patient records being given to the supermarkets as we feel this could be open to abuse in terms of privacy and data protection.

“It is the thin end of the wedge, as there is a very real threat that patients’ records could be used to bombard unsuspecting people with the hard-sell for other products that the supermarkets may be promoting .

“If this goes ahead, the most stringent regulations need to be in place to stop any chance of mis-selling or the corporate hard-sell.”

All of the major commercial pharmacy chains have said the summary care records will only be accessed by registered pharmacists and will not be used by other parts of the business. All denied there would be any link between use of the in-store pharmacy and details held on their loyalty card schemes.