| Press articles | Other ways to make your information available |
If you do not want to upload your medical records to the NHS Database but would still like to consider ways in which you could make your medical information accessible if you ended up in A&E, or if you needed to see an out-of-hours GP, then read on.
Because there are numerous ways in which you - or your GP - can make relevant medical information available to those who might find it useful, should you be unlucky enough to be taken urgently ill, without needing to upload your medical records to the NHS Database (or the Hampshire Health Record database, for that matter).
These ways are capable of providing information that :Is there a need?
First of all, have a think as to whether or not you even need to consider this. For the vast majority of children, teenagers and young adults - that is, the generally healthy population with little or no relevant medical history that would prove useful in an emergency - there is unlikely to be any material benefit from making your medical information available in any of the ways described below. If you are unsure as to whether your history or medication is of such significance then the best thing to do is to discuss this with your GP when you next see him or her.
Doctors spend years in training to be proficient at assessing patients without knowing any of their medical history, including unconscious patients or patients unable to communicate by virtue of their illness, and to administer appropriate and in some cases life-saving treatment confidently. That is how doctors are trained and that is why the training to be a doctor is so long and so demanding.
Information is already shared
If you become unwell and see your GP in your local surgery (or your GP visits you at home) and you are ill enough to need to be admitted to hospital then your GP (or surgery) will ensure that the hospital doctors have your relevant medical details either by speaking directly to the hospital staff, listing your details in a letter that you take with you to hospital, or by faxing those details straight to the hospital.
If you become unwell during working hours and end up in A&E then the hospital medical staff will not hesitate to ring your GP surgery for information if needed. Equally, your GP surgery will not hesitate to pass on full and detailed information (from one doctor to another) about any patient in that situation. GP surgeries can instantly fax printed details straight to the A&E department.
If you become unwell when your GP surgery is shut (for example, at night) then the hospital medical staff will not hesitate to ring your GP surgery for information the next working day if needed. Once again, your GP surgery will not hesitate to pass on full and detailed information about any patient in that situation.
Your surgery details
One of the simplest things that you can do it to keep a small business card or piece of paper in your wallet, purse or handbag detailing the name of your GP surgery, the surgery telephone number and the surgery fax number (see alert cards, below). If you are admitted to hospital then the medical staff will be able to contact your GP surgery easily.
Know your own history
The vast majority of patients presenting to A&E or an out-of-hours GP are adults perfectly capable of stating their own medical history, medications and allergies to medical staff, or are children accompanied by parents or guardians who can do so on their behalf. Know your own medical history, your medications, and your allergies. If you’re not sure, ask your GP for a summary (see below) the next time that you see him or her.
Make sure someone else knows your history
If you have a significant medical history - perhaps you have had multiple or serious medical problems, are on certain medications (see below), or would have difficulties communicating your medical details (for example, you have had a stroke affecting your speech) - then it is always advisable to ensure that someone else (such as a son or daughter, parent, relative, friend or neighbour) could detail your medical history if required. In an emergency, medical staff will always try to contact someone for more information. The easiest way would be to give a copy of your medical history (such as a brief summary, described below) to a trusted person. They could then read out details to medical staff if contacted, or even fax the summary straight to the hospital A&E department if they own a fax machine or PC.
And of course, many patients - particularly children and the elderly - are accompanied to hospital by parents, relatives, carers, friends or neighbours.
Repeat prescription
One of the easiest way to ensure that relevant information is easily to hand is to carry a simple summary of your medical history with you, for example in your wallet, purse or handbag. And one of the easiest ways to do this is to ask your GP or surgery for a duplicate copy of your repeat prescription request (the one that you tick and hand in to your surgery when you need more medication). Add to this page any significant allergies that you have and any significant past medical events or operations - all this information can be obtained from your GP the next time that you see him or her. Add next of kin details, your NHS number (your surgery can give you this) and ask your GP surgery to stamp it so that your surgery address and telephone number are there too. Keep that piece of paper (about ¼ of the size of an A4 sheet) with you, folded up in your wallet, purse or handbag. If you are visited at home by an out-of-hours GP then that information might be useful to the visiting doctor. Medical staff in hospitals are trained to check personal effects for such information when patients are admitted in an emergency.
A few GP practices routinely add medication allergies to the repeat prescription sheet.
"Brief Summary"
GP computer systems can easily print out a short summary (sometimes called a "Brief Summary") of important and relevant medical information for any of the practice's patients in a few seconds. This summary would include name, address, DOB, NHS number, diagnoses, medication, allergies and certain immunisations (such as tetanus). To this the surgery contact details could be added, as well as next of kin details. The printout is usually on an A4 piece of paper, and you would need to ask your GP in person for this. Once again, keep this summary with you, folded up in your wallet, purse or handbag. Give a copy to your trusted next of kin, relative, friend or neighbour.Again, if you are visited at home by an out-of-hours GP then that information might be useful to the visiting doctor, and medical staff in hospitals are trained to check personal effects for such information when patients are admitted in an emergency.
An example of a brief summary can be seen here.
A brief summary could be saved onto an encrypted USB stick as a .txt, .doc, .rtf or .pdf file. More detailed information can also be saved onto specially designed USB cards (such as Zaptag or Health eCard) and even bracelets (see here for some more examples). This effectively creates a portable emergency medical record.
Access your own information
More and more surgeries are offering their patients the ability to access and view their own records online - an example is EMIS Access.
If your surgery offers this, and you have asked to be granted access in this way, then in an emergency you could allow medical staff access to your records on a temporary basis, or a relative or friend could do this for you. No information is uploaded to the NHS Database for this. More details can be found in a factsheet that I have written for my own patients. EMIS is one GP software system that offers this, but other systems are doing this as well.
Zaptag is another example of online health records access. Information from your GP surgery is securely uploaded to the Zaptag server and available to you (or any medical staff you choose) as required. Once again, no information is uploaded to the NHS Database for this.
The big players are also on board. Google Health and Microsoft HealthVault both provide online health records access, although HealthVault is currently only available in the USA. And again, no information would be uploaded to the NHS Database for this. However, many would not be happy giving Google or Microsoft detailed information any more than they would uploading it into government hands on the NHS Database.
Emergency GP to GP information
All GP surgeries have mechanisms in place to send a brief summary about certain patients to the local out-of-hours GP organisation, so that if patients present there, or is visited at home, then the doctors and nurses already have information to hand. This is commonly done for patients with very complex medical problems, for those patients who are terminally ill, and for patients who are predicted to become unwell when their GP surgery is shut. An example of a form used to notify an out-of-hours organisation of such patients can be found here. If your medical history warrants passing information proactively to the out-of-hours organisation then your GP will discuss this with you.
GPs can also add information directly to the local out-of-hours database via a secure web portal, using Adastra's Web Access software (Adastra is the biggest provider of clinical systems to GP out-of-hours organisations). With the explicit consent of patients, GPs can login securely and add information directly to the database instead of faxing it through as previously mentioned. The out-of-hours database is only accessible by staff working in the local out-of-hours centre, and has nothing whatsoever to do with the NHS Database.
Adastra is also nearing completion of their End of Life Care Register, a more detailed version of Web Access but specifically for terminally ill patients. This may allow Advance Statements and Advance Decisions to be made available in detail to local out-of-hours clinicians, and once again has nothing whatsoever to do with the NHS Database.
Alert Cards
Simple credit-card sized cards can be used to store medical details (including GP contact details), for example:
There are a few medications that could be particularly useful for an A&E or an out-of-hours doctor to know about. Carrying information on you at all times that states this medication that you are taking is important, and nearly everyone prescribed such drugs will already have (or should have) such "alert cards" either from their GP, hospital specialist or pharmacist. A few examples are:
Corticosteroids: patients should carry a steroid alert card (an example is shown here).
Warfarin: patients should carry an anticoagulant alert card (an example is shown here).
Biological therapy: e.g. for arthritis, again an alert card (an example is shown here).
Alert cards can also be used for those suffering with rare or complex medical disorders (an example is here)
Medical Alert Devices
Medical alert devices provide a potentially life-saving identification and information system for individuals. Usually, people with serious medical problems (e.g. haemophilia or type I diabetes), severe and life-threatening allergies (e.g. peanuts or penicillin) or on long-term medication (such as warfarin) wear these devices, which take the form of bracelets, necklets, dog tags and even watches, inscribed with, or containing, the essential medical information, a unique ID, and a 24 hour telephone number for a call centre holding even more details about the person.
The two most widely used and recognised devices are:
Extensive information about medical alert devices can be found on these two websites.
All medical staff are trained to search for, recognise and use these alerts. They really are the best way to ensure medical staff have - quite literally - instant access to important medical information (as well as being able to identify you in the absence of any other form of ID). MedicAlert is endorsed by (amongst others) The British Association for A&E Medicine and The Royal College of General Practitioners.
Once again, if you think that a medical alert device would be appropriate for you then it is worth discussing this with your GP the next time that you see him or her.
Remember
But after considering everything you do decide that the NHS Database really is the best option for you, then tell your GP and give your explicit consent for your records to be uploaded.
Relevant press articles:
This non-commercial website represents the personal views of Dr Neil Bhatia, GP and Caldicott Guardian for the Oaklands Practice
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