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Bexley Linked Care

NHS Bexley Clinical Commissioning Group (CCG) has been working alongside clinicians, practice managers and patient representatives to link together patient information and data to ensure patients receive the best possible care.

From December 2015, some doctors and nurses in Bexley may ask patients if they give their permission (consent) to the clinician treating them to have access to their GP patient record.

This includes doctors and nurses at Queen Mary’s hospital and Erith hospital Urgent Care Centres (UCCs) and GP out-of-hours services. It also includes doctors and nurses at Bexley’s community clinics. These clinics are provided from a Bexley GP practice setting and offer specialist services such as anticoagulation, dermatology, cardiology clinics and diagnostics, minor surgery, endoscopy, vasectomy and erectile dysfunction.

A GP patient record is the best, most complete and up-to-date health record and includes any treatment patients are receiving. Every resident registered with a GP practice has an online GP patient record, containing information and dates about their medical history. Up until now, this patient record could only be viewed by the registered practice.

Agreeing to share this record with other doctors and nurses will:

  • Improve quality of care and patient safety
  • Reduce the number of times patients are asked to discuss their medical history
  • Help ensure patients receive the most appropriate care and achieve the best health outcomes

Doctors and nurses will only ask to view a GP patient record if they believe they need a more detailed understanding of a patient’s medical history.

By law, data will not be shared any further unless permission is given by the patient and any information provided by the patient will only be used by the clinician to help treat them.

All NHS staff are duty-bound to protect patient information as part of the NHS Confidentiality Code of Conduct. There are a few exceptions in the NHS when treatment may be able to proceed without the person’s consent, even if they are capable of giving their consent. To find out more, please visit the NHS Choices website.

The CCG will be moving onto the second phase of the Bexley Linked Care project in 2016. This will consider how a GP patient record can be shared with those NHS organisations that are in regular contact with Bexley patients, for example, accident and emergency departments, local hospital trusts and NHS community trusts.

When and why a GP or nurse might ask a patient for access to their GP patient record

The following examples highlight when and where access to a GP patient record might be needed and how this helps the nurse or doctor to treat the patient.

Scenario one – Mrs Smith:

Mrs Smith lives in Erith and has recently been undergoing tests for some problems she has had with her stomach. She becomes unwell over the weekend and decides she can’t wait until Monday to see her GP, so she visits the urgent care centre at Erith hospital.

At the urgent care centre, Mrs Smith is seen by a GP who asks her about her recent tests and investigations. Mrs Smith can’t recall the names of the tests so the GP asks her if she consents for him to see her GP patient record. The GP is then able to learn more about Mrs Smith’s tests and check what type of medication she is taking. Based on the information in Mrs Smith’s record, the GP is able to prescribe some medication to help with the pain until she can see her GP again on Monday, when the results of her tests and investigations are due to be made available.

Scenario two – Mr Patel:

Mr Patel is 65 and suffers from a condition called atrial fibrillation, which can cause blood clots.

Mr Patel’s GP is based in Thamesmead and to prevent him from suffering from blood clots she refers him to an anticoagulation clinic based at a different GP practice in Welling.

The GP at the anticoagulation clinic asks Mr Patel if she can view his GP patient record so that she can learn more about his atrial fibrillation. Mr Patel gives the GP his consent to access the record.

As a result, GP is confident that there are no risks in providing the anticoagulant treatment she recommends and this also prevents Mr Patel from having to describe his medical history and identify any medications he is taking.

Scenario three – Miss Green:

Miss Green is 21, lives in Sidcup and has type one diabetes. In the early hours of Sunday morning, Miss Green’s sugar levels drop dramatically and she decides to visit her local urgent care centre at Queen Mary’s hospital in Sidcup with her mum.

When Miss Green reaches the urgent care centre she becomes increasingly unwell and is unable to respond to the GP. In order for the GP to find out more about Miss Green’s diabetes, he asks Miss Green’s mother if she consents for him to look at her GP patient record. The mother consents and within moments, the GP is able to look at Miss Green’s record and treat her appropriately.

Miss Green is treated quickly by the GP at the urgent care centre and feels well enough to return home shortly afterwards.

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