Balancing Act: GPs Face Ethical IT Decisions

by | Jul 4, 2024

The recent advisory by the British Medical Association (BMA) urging its members to disable certain functionalities in their IT systems has ignited a significant debate with NHS England. This controversy centers around the data-sharing capabilities of two widely used systems, TPP and EMIS, particularly focusing on the GP Connect feature. The new Update Record function within GP Connect, designed to facilitate data sharing between general practices and other healthcare organizations, has become a point of contention.

Dr. Katie Bramall-Stainer, Chair of the BMA’s GP Committee, has articulated her concerns through a YouTube video, explaining that the Update Record feature currently allows pharmacists to add limited data to GP records. The situation intensified when GP system providers informed the BMA that NHS England had proposed removing the ‘off switch’ for this function. This development has raised substantial ethical and operational concerns among general practitioners.

General practitioners (GPs) are legally recognized as controllers of patient data under the UK’s data protection laws. This designation imposes a responsibility on GPs to ensure that any updates from third parties to patient records are both necessary and appropriate. The potential removal of the ‘off switch’ could enable external healthcare providers to add diagnoses and treatments to GP records without the consent of the GPs, thereby increasing their workload as they manage and follow up on these external updates. Dr. David Wrigley, Deputy Chair and Digital Lead of the BMA’s England GP Committee, has underscored the necessity for GPs to maintain full oversight of their patients’ data. He remarked, “We are recommending to GPs that they turn off the Update Record facility on GP Connect at the present time while we engage in discussions with NHS England to better understand the implications of this software.” The BMA’s chief concern is that these changes could inadvertently add pressure on GPs to ensure follow-up and ongoing care for patients based on decisions made by other clinicians.

Operationally, the BMA is apprehensive about the ramifications of this change. Dr. Bramall-Stainer has highlighted the potential for an overwhelming situation where GPs could suddenly become responsible for managing extensive follow-up requests and support stemming from actions initiated by external healthcare providers. Historically, any modifications to GP systems have involved consultations with various subcommittees within the BMA and the Royal College of GPs. The apparent bypassing of this process by NHS England has only intensified the controversy.

Amanda Doyle, NHS England’s National Director for Primary Care, has refuted the BMA’s claims, labeling them as “completely inaccurate.” She asserted that there are no imminent plans to prevent GPs from disabling the GP Connect feature if they choose to. Doyle argued that the NHS introduced this functionality to ease the workload of GPs and enhance patient outcomes, questioning the rationale behind disabling a service intended to be beneficial. She also clarified that there are no current plans to extend the usage of this functionality beyond Pharmacy First and that any future changes would involve consultation with the BMA’s GP Committee and the Royal College of GPs.

This dispute over the data-sharing function in UK doctor software underscores the intricate balance between technological advancements, ethical considerations, and operational efficiency in healthcare. While the NHS seeks to streamline processes and enhance patient outcomes through technology, it is imperative to address the ethical and operational concerns raised by GPs. Ensuring that GPs retain control over their patients’ data and are not inundated with external updates is crucial for maintaining high-quality care and patient trust.

The ongoing discussions between the BMA and NHS England aim to find a resolution that harmonizes the advantages of technological progress with the ethical and operational requirements of GPs. In the interim, the BMA’s recommendation to disable the Update Record function serves as a precaution to protect patient data and manage GP workloads effectively. This situation highlights the need for collaborative efforts to integrate technology in healthcare while safeguarding the responsibilities and capacities of healthcare professionals.