The Scottish Emergency Care Summary – an evaluation of a national shared record system aiming to improve patient care: technology report

Libby MM Morris, Colin Brown, Marysia Williamson, Jeremy C Wyatt


Background In Scotland, out-of-hours calls are all triaged by the National Health Service emergency service (NHS24) but the clinicians receiving calls have no direct access to patient records.

Objective To improve the safety of patient care in unscheduled consultations when the usual primary care record is not available.

Technology The Emergency Care Summary (ECS) is a record system offering controlled access to medication and adverse reactions details for nearly every person registered with a general practice in Scotland. It holds a secure central copy of these parts of the GP practice record and is updated automatically twice daily. It is accessible under specified unplanned clinical circumstances by clinicians working in out-of-hours organisations, NHS24 and accident and emergency departments if they have consent from the patient and a current legitimate relationship for that patient’s care.

Application We describe the design of the security model, management of data quality, deployment, costs and clinical benefits of the ECS over four years nationwide in Scotland, to inform the debate on the safe and effective sharing of health data in other nations.

Evaluation Forms were emailed to 300 NHS24 clinicians and 81% of the 113 respondents said that the ECS was helpful or very helpful and felt that it changed their clinical management in 20% of cases.

Conclusion The ECS is acceptable to patients and helpful for clinicians and is used routinely for unscheduled care when normal medical records are unavailable. Benefits include more efficient assessment and reduced drug interaction, adverse reaction and duplicate prescribing.


electronic health records; emergency care summary; medical informatics; medicines reconciliation; patient safety

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Morris L, Dumville J,MalcolmCampbell L and SullivanF. A survey of computer use in Scottish primary care: general practitioners are no longer technophobic but other primary care staff need better computer access. Informatics in Primary Care, 2003;11:5–11 PMid:16274587

Information Governance Exploring Public Attitudes to Sharing in the NHS.

Emergency Care Summary Patient Leaflet.

Coiera E. Medical Journal of Australia 2011;194:90–92 PMid:21241224

Greenhalgh T, Stramer K, Bratan T et al. The Devil's in the Detail: final report of the independent evaluation of the Summary Care Record and HealthSpace programmes. University College London: London, 2010.

Summary of the ECS usage figures.

FitzGerald K, Seale NS, Kerins CA and McElvaney R. The critical incident technique: a useful tool for conducting qualitative research. Journal of Dental Education 2008 Mar;72(3):299–304. PMid:18316534

Summary of evaluations on the ECS website. ECS

EHR Impact study. The socio-economic impact of interoperable electronic health record (EHR) and e-Prescribing systems in Europe and beyond.

Siegel ER, Rapp BA, Wallingford KT and Wilson SR. Use of MEDLINE by physicians for clinical problem solving. Journal of the American Medical Association 1993 Jun;269(24):3124–9. PMid:8505815

Managing the use of medicines in hospital – a follow up review.

de Lusignan S and Aarts J. UK's National Programme for IT welcomes recommendation for a more sociotechnical approach to evaluation: a commentary on the Greenhalgh evaluation of the Summary Care Record. Informatics in Primary Care 2008;16(2):75–7.'s%20National%20Programme%20for%20IT%20....pdf PMid:18713523

Hawking M. The single shared electronic patient record (SSEPR): problems with functionality and governance. Informatics in Primary Care 2008;16(2):157–8; discussion 159. PMid:18713532



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