OK, a lurker joins in. I'm a fairly minor player in the NPfIT, but my job revolves around data quality. All that I can say, really, but I can say that it does give me a fairly large degree of 'I know what I'm talking about'. The data quality issues that are involved here are enormous. It's even worse when you are looking from the inside. There are so many issues, in fact, that it is difficult to separate them from each other. However, Axylotl has said some things that I wish to comment on. Firstly, your medical record is not yours. It belongs to the Secretary of State for Health. It is data held about you, and you have a perfect right to see it (phone your GP and ask - they will make an appointment so that you can), but you cannot copy or take it away. As strange and contrary as it seems, you do not own data that relates to you. Currently, if you wish to see your hospital records, you have to contact each hospital that you have been in, since they are all held separately. While it might be a laudable aim to have medical records more widely available in the NHS, this raises more concerns than just the privacy that has been mentioned. I shall use me as an example. I am anaphalactic, and this is stated on my GP records, and I wear a MedicAlert bracelet (look them up and support them if you can - they're a charity that does a lot of good). You might think that I should be grateful that a centrally held electronic NHS record would contain that data, but I'm not. This is simply because my day job involves sorting out medical records that have been duplicated, confused, mislaid or lost. Those who think that putting them online will sort this out are sorely mistaken. Our workload is increasing as more NHS clerical staff have access to the national systems, and they are creating more problems than ever before. In many cases, it's not their fault - John Smith walks into a surgery, he gets matched with another one with the same date of birth, and bingo. How does that affect me ? Well, if I can't trust that the information on my record belongs to me, and only me, then why should I be keen to trust the decisions made on this information ? This is aside from the security. As Tom has said, there are or will be issues in the clinical departments with sharing of cards, passwords and computers. I have an NHS Smartcard, and work in an environment where screwing things up will result in a swift dismissal. Not everyone is - in one PCT that I know of, a Smartcard was left in a machine in a public accessible area and the password was on a postIt on the monitor. The security protocols are there, but they will not be adhered to. There are 250,000 staff that will have access to these systems, and the training and controls are simply not in place to sort this out. As to role based access, if you fancy a laugh, have a look around the web for discussions on 'sealed envelopes' in electronic medical records. If you're a developer, have a good look, because if you can come up with a solution, then you've just made a fortune .... Sorry, I've gone on too long. I will say, finally :o) , that I believe in the good of electronic medical records for patient care, I just have too many concerns about it's implementation in the NHS. I will be opting out as soon as the summary care record programme starts uploading data.