A news story this week, highlights the dangers of having multiple, confusing systems of patient records in the NHS. As the specialist news website E-Health Insider reports:

A North London Mental health trust has said that any patients who refuse to have their data entered onto electronic patient records will not be able to receive treatment.

Barnet, Enfield and Haringey Mental Health Trust told a patient who asked not to have an electronic patient record that it would be impossible to provide care without using an electronic record.

The trust says that its RiO EPR system has entirely replaced paper patient records, making it impossible to provide care without using the system apart from in the most exceptional circumstances. [...]

A spokesperson said that the concerns most patients had related to fears about their record being held on the planned national care records system, rather than the local RiO system.

“People confuse the national record system being developed by NHS Connecting for Health with RiO the system we now use. We don’t keep paper records anymore.”

While Connecting for Health has been explicit about the right of patients to pull out of the national system of Summary Care Records, at the local level the situation is more murky. Trusts have been encouraged to move to systems of Electronic record keeping which are compatible with the national ’spine’ database. But unlike the ’spine’ which is an addition to existing systems, these local databases are, in some cases, the only form of records now available.

It is, of course, completely unacceptable if some patients, especially vulnerable patients like those with mental health problems, are unable to access care in a way that makes them feel safe. But it is easy to see the dilemma of a trust which no longer has an infrastructure for managing paper records faced with a patient who demands them.

In the end, cash-strapped trusts are unlikely to maintain an expensive parallel system of paper records for the few patients that demand them unless they are told to do so by the centre. Do patients have a right to demand treatment without agreeing to be on a database? It may be down to the courts or central government to decide.