Dr Nigel Watson answers questions on record keeping, software for analysing computer records and NHSmail

Q We are making the move from paper notes to electronic records and scanning letters and so on to be kept as part of the electronic record. Once they have been scanned, can we shred the paper versions?

A Many practices are already ïpaperlessÍ or at least on the way to becoming so. The regulations covering record keeping were changed in October 2000 and practices are now permitted to keep electronic health records as the primary health record.1 To comply with the regulations practices must:

  • Obtain the written consent of their primary care trust before keeping computerised records
  • Use an accredited computer system
  • Comply with the Good Practice Guidelines for General Practice Electronic Patient Records.2

There is nothing in a GPÍs terms of service that prevents the shredding of paper records.

Q What is NHSmail and how does it work?

A NHSmail was launched in March this year. It is a new national email and directory service, available to the 1.2 million staff currently working in the NHS in England.

The features of NHSmail include:

  • A centrally managed directory service containing professional contact details of everyone who works in the NHS in England.
  • A web-based email service, offering all NHS staff an ï@nhs.netÍ email address that they can keep during their working life in the NHS.
  • An online calendar, for managing time, tasks, and resources, within and across organisations.
  • It is supported 24 hours a day, 7ædays a week.
  • The service levels are said to be guaranteed, including encryption for security and fast email delivery times.

NHSmail was designed to comply with the BMAÍs requirement for clinical emails sent between two organisations.

Information is automatically encrypted during transmission, which means that email can now safely replace paper communications, including:GP referrals to hospital; hospital to hospital or internal hospital referrals; discharge letters; and clinical enquiries.

Those wishing to register must do so via NHSnet: www.nhs.net. Hospitals are working with PCTs to set up hospital- and GP-based NHSmail services.

Q Practices in a local PCT are using software called ïRush for PracticesÍ to analyse computerised records. What is it, how does it work and how can we obtain it?

AïRush for PracticesÍ is a software tool that has been developed by two GPs (Dr John Williams of Guildford and Dr John Robinson of Wantage) in conjunction with PRIMIS.3

The software enables practices to run MIQUEST queries and allows data held on patientsÍ electronic health records to be extracted and analysed and the results to be displayed in a variety of ways including graphs and tables.

The MIQUEST queries are based on specific clinical topics, for example diabetes mellitus and coronary heart disease, and they enable the practice to identify individual patients who require intervention.

I find it a powerful and easy to use tool, and believe it will become more important as practices focus increasingly on the quality of care they provide to patients.

If you are interested in ïRush for PracticesÍ and your PCT is involved with PRIMIS, speak to your facilitator who will be able to obtain, install and support the software in your practice.


  1. The National Health Service (General Medical Services) Amendment (No. 4) Regulations 2000 (SI 2000 No. 2383).
  2. The Joint Computing Group of the General PractitionersÍ Committee and the Royal College of General Practitioners. Good Practice Guidelines for General Practice Electronic Patient Records. August 2000.
  3. Watson N. PRIMIS will ensure effective use of practice computers. Guidelines in Practice 2001, 4(7): 76-8.  

Guidelines in Practice, June 2003, Volume 6(6)
© 2003 MGP Ltd
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