Academic says SCRs are 'problematic'

She told a panel debate at Smart Healthcare Live on 15 June 2010 that the report will be published on 17 June, and she was not able to talk about its contents until then. However, she said: "It looks like the SCR will go ahead, despite what's in the report," adding: "There's nothing wrong with the idea of the Summary Care Record, but note at the outset, it doesn't exist. It's something in a politician's head." In response to a question on this point, she said: "It's the difference between the idea and the reality which is problematic, and for that you will need to wait until Thursday." Greenhalgh, who is professor of primary healthcare and director of the centre for health services at Barts and the London's School of Medicine and Dentistry, attacked the idea that health records were analogous to banking records, where people needed some initial persuasion to use them online but would soon get used to the idea. "I think it has done a huge amount of damage, and we need to move on from it," she said, as the amount of money in an account is unarguable, whereas healthcare information is "fuzzy", often including opinions and being affected by its context. "We talk about ICT, and miss out the C," she said, adding that National Programme for IT systems were "fundamentally designed as data repositories. The fundamental issue is about communications. We haven't given it enough focus." Dr Phil Koczan, a GP and clinical lead for the London Programme for IT, said that SCRs were making good progress, with 29.8m patients contacted, and 1.59m records created as of 28 May 2010. He added that opt out rates were 0.6-0.7%, although "one of the big concerns of mine is we haven't won the hearts and minds of the patients". Koczan added: "In an ideal world, it would be an opt in situation," but defended the policy of creating records automatically if patients did not specifically apply to opt out. He said this was due to a need for "quick saturation". But Greenhalgh replied that the opt out rates were affected by the fact that, according to one piece of research, 88% of patients who had received letters about SCRs had either thrown them away unread or could not remember receiving them. "A 0.6% opt out rate has to be interpreted in the light of those wider findings," she said. Charlotte Aldritt, of the Commission on 2020 Public Services Trust, said that patients should have the option of a national service, possibly run by NHS Direct, which would given them access anywhere to a virtual GP surgery. But Greenhalgh described such a service as "the commodification of healthcare". A straw poll of the audience showed that several people would be interested in using a virtual GP service, although the great majority preferred the traditional local GP.