NHS patients should have right to see records online, says Andy Burnham

http://www.theguardian.com/society/2013/dec/01/nhs-patients-right-records-online-andy-burnham

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The NHS constitution needs to be expanded to give patients new rights, including a right to see their medical records online and to be cared for in the home if it is safe, Andy Burnham, the shadow health secretary, has said.

He said the rights would help rebuild the NHS to better provide integrated care which blends health, social care and mental health services.

"We have to make whole-person care a reality," he told the Guardian, adding he did not believe such a goal was possible under the coalition's NHS reforms. He predicted his vision of whole-person care would be the dividing line between parties at the election. "You cannot put the patients and the individual at the heart of the fragmented system," he said.

Burnham was responding to a pamphlet by the Institute for Public Policy Research thinktank calling for an integration of health and social care including an alignment of incentives. The pamphlet warns: "The current NHS system of paying hospitals for activity and paying community-based services under a block contract creates a financial incentive to treat as many people as possible in hospital and as few as possible in the community."

It also proposes that health and wellbeing boards take responsibility for high-level decisions signing off investments across health and social care, starting with spending on older people and people with long-term conditions. The incentive to treat patients in hospitals should be removed by linking payments for more integrated providers to the outcomes they deliver, rather than paying individual providers for the activities they undertake.

The simple guarantees, or rights, would promote the benefits of whole-person care, Burnham believes. He proposes:

• Each patient should have a single health and care co-ordinator, not necessarily of a clinical background, with authority to get things done. Burnham said: "A single point of contact for patients would remove one of the single greatest frustrations in the NHS."

• Online access to personal health and care records with an ability to share these electronically, sweeping aside some of the data protection rules that prevent co-ordination between organisations. The patients would have a clear right to own their own records.

• A personalised care plan covering health and social care, so care needs are tailored to personal circumstances, and not restricted by service boundaries.

• Access to other people with the same condition who can provide peer support.

The current NHS constitution includes a right to be treated within 18 weeks, the right to choose a hospital, the right to view personal health records and the right to have a complaint addressed within three days.

Burham has been talking about whole-person care for over a year, but insisted the plans need not cost extra money. He said: "We know that 30% of beds occupied in the NHS are occupied in an inappropriate way either because they need not have been admitted or they have no system of care if they go home."

Burnham said he was anxious that whole-person care should not result in another major reorganisation of the NHS.

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