Things are finally getting going for the Summary Care Record. During the last few years, there have been pilots in Bury, Bradford, Bolton, Dorset, South West Essex and South Birmingham. But now we’re leaving the trial stage behind, and aiming for roll-out across London and then the rest of England in the next few years.

It’ll all kick off on Thursday, as the Princess Group Practice in Southwark will begin uploading information onto a Summary Care Records for every patient who has not opted out.

That last bit is key: every patient who has not opted out. In Southwark, as in the trial areas, patients are sent a letter 12 weeks before the creation of their record. It’s then left up to them to write in if they don’t want a record to be created. This form of implicit consent is a second best for many who want more control in the hands of patients.

But one thing has changed this time round. During the trials, once a record had been created, it could not be deleted. So if you were away for 12 weeks, or your address was wrong or your dog ate your letter and you missed the opt-out window, then tough luck. After changes in the rules in June, however, it became possible to delete a record after it’s been created – but only if it has never been used. We can see this in action now in Southwark. Patients who opt-out after Thursday will still have a record containing name and demographics, but the medical information can be removed. Interestingly, Southwark’s website does not go out of its way to make this detail clear, perhaps because they want as many patients to stick with the system as possible.

Despite London’s excitement at finally getting things off the ground, they’re still far behind Scotland where the ‘Emergency Care Summary,’ (which is roughly the same as England’s Summary Care Record) has been up and running for a while. Plans are even on the way to add an ‘end of life care,’ option where patients can give guidance on situations in which they would or would not like to be resuscitated. In Scotland, officials are congratulating themselves on a reassuringly low 0.02% drop out rate. But this is only reassuring if 99.8 per cent who do have a record know that they have one and understand how the system works.

Both England and Scotland seem to be steaming ahead on sharing important information about patients for use in emergencies. But the Summary Care Record is only one part of the grand IT scheme. Arguably much more valuable is the Detailed Care Record, which is meant to hold all of a patients’ medical record at a more local level. With this more in-depth information which will be shared between health professionals in a local area and possibly with care workers and pharmacists, it will be even more important to ensure we’ve got the consent system right.