An NHS database of patients’ records – can it reduce medical mistakes in elderly and emergency care?

Posted: 05/09/2013

Lucie Prothero of Penningtons’ clinical negligence team shares her experience

Health Secretary, Jeremy Hunt, has announced a new push to create a complete database of NHS patients’ records. The Government is to provide a £1 billion technology fund for new IT systems to enable the database to be set up and operated nationwide.

The database is planned to contain the nation’s medical details in the hope that the sharing of such information will help ease pressures on A&E departments by cutting down on the paperwork that hampers clinicians. It should allow hospital consultants, GP surgeries, social workers and out-of-hours doctors to share patients’ electronic records routinely so that a full knowledge of their medical history is available. This is particularly important for patients in an emergency situation where knowledge of previous history or medication can be vital.

In support of the plan, Mr Hunt has highlighted scenarios where patients are dying because they are being prescribed the wrong drug and elderly dementia patients are turning up at A&E with no one able to access their medical history. These problems reflect Penningtons’ experience.

Privacy campaigners, however, are warning that identifiable patient data could harm the public and affect a patient’s willingness to be open when talking with their GP about issues that really concern them for fear that their notes may become available to external sources. There are also concerns that the system will only work if there is certainty that not only are all medical practitioners using it but they are also using it in the same way.

Lucie Prothero, associate in the clinical negligence team at Penningtons, said: “We see the catastrophic impact of Mr Hunt’s examples all too often. We see many sad instances where patients have been prescribed incorrect medication not just due to hospital errors but due to lack of information. Dementia and elderly patients who are hospitalised are provided with increasingly poor standards of nursing care because they cannot communicate their needs and difficulties. When close family members are not present, the admission is late at night or where a patient is transferred to a different ward in a hurry, the lack of vital information about their medical history and the risks affecting their management can have major consequences for them.

“Sadly, the number of elderly patients who suffer falls in hospital is rising prompting new NICE Guidelines this year on how to prevent them. While nurse staffing levels appear to be a key factor in falls, ready access to relevant information could improve standards. For instance, clear details about what has led to the hospital admission (i.e. was it following a fall at home?), whether there is any history of falling, details about how the patient normally mobilises (i.e. do they use a walking stick, Zimmer frame etc) or whether they are likely to forget instructions/become agitated or confused would be a huge help to hospital staff. This is just one area where we can see the benefit of hospital staff having ready access to a patient’s medical history in order to ensure the good management of elderly dementia patients.”

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