Select Committee on Health Written Evidence

Evidence submitted by the Faculty of Family Planning and Reproductive Health Care (EPR 18)


  The Faculty of Family Planning and Reproductive Health Care (FFPRHC) of the Royal College of Obstetricians and Gynaecologists contributes to the National Advisory Group for Connecting for Health, and has been concerned about the slowness and uncertainty regarding the development of sealed envelopes to keep people's sexual and reproductive health secure. The majority of community contraceptive services are currently not supplied with computerised systems to manage appointments, collect and submit statistical returns, and do not have the capacity to operate electronic records; there is concern that the implementation of the EPR will depend on PCTs finding funds to purchase and support computers linked across localities, and uncertainties about details of what will be required have hampered services looking at interim solutions.

1.   What patient information will be held on the new local and national electronic record systems, including whether patients may prevent their personal data being placed on systems:

  1.1  Members of the FFPRHC work in areas of sensitive public health. This may be in services providing contraception and sexual health operating as one unit within a single unit commissioned by one health organization, or as a combined service across organizations.

  1.2  Research has shown that concerns about confidentiality, particularly where young people have chosen to access community/alternative services rather than their GPs, are paramount in whether or not health-seeking behaviour and disclosure of areas which may need protection, will be sought.

  1.3  Our understanding is that sexual and reproductive health data will be on a separate "work group" to other community or hospital electronic records, with access only by those working in that service.

  1.4  Many people access our services wishing to protect their identity, and register with false names, dates of birth and addresses, which may result in duplicate registrations even across different sites of the same service.

  1.5  If NHS number is to become a mandatory field, there are issues about people not registered with GPs, or who do not know this number.

2.   Who will have access to locally and nationally held information and under what circumstances:

  2.1  Our understanding is that at least initially no sexual health information will be uploaded onto the National spine, and that locally the only people to see any information about access to our services are those with a legitimate relationship defined by the work group, and not accessible by other people working within a community or hospital setting.

3.   Whether patient confidentiality can be adequately protected;

  3.1  There are issues about the timing and operation of sealed envelopes which need to be determined before clinicians can have confidence to use any local or national systems.

  3.2  Community services are likely to need to have access as a team rather than an individual to protected data due to the way the services run (ie often open access and as non-appointment sessions).

  3.3  Until this is agreed, it is difficult to envisage adequate continuity of patient care whilst preserving confidentiality.

4.   How data held on the new systems can and should be used for purposes other than the delivery of care eg clinical research;

  4.1  Central statistical returns (KT31 for contraception and KC60 for sexually transmitted infections) should as now be on non-identifiable aggregate data.

  4.2  The Common Data Set for Sexual Health is being developed to replace these returns which currently do not capture all the public health input in the 2 settings.

Alyson Elliman

Faculty of Family Planning and Reproductive Health Care of RCOG

14 March 2007

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