Demos' Talking Cure pamphlet set out the changing dynamic of the patient-clinician relationship. Changing access to patient records will be one of many potential vehicles that will drive this change. This project will examine how a more equal partnership in this respect might aid the ‘co-production’ of health, looking at traditional written records that are accessible or indeed held by patients (such as maternity care, child health and increasing numbers of long-term conditions services such as diabetes) as well as the opportunities technology presents for reframing patients relationship with their healthcare.

Demos is currently conducting a short programme of work designed to inform and advance debates about the impact of changing patient access to records on the patient-clinician relationship.  

 Our project aims to: 

•  Map evidence of past, existing, and proposed approaches to giving patients access to, and control of, medical records 
• Map and analyse the evidence about the impact of record access and control on the clinician-patient dynamic 
• Analyse the professional and cultural rationales underpinning such approaches, and possible alternatives 
• Understand how patient access to / control of records changes the quality of care they experience 
• Highlight challenges to specific patient groups in accessing information e.g. minority or disadvantaged groups
• Suggest key areas for further research, development and innovation in this area.  

Rather than focus on the means to share records, such as looking narrowly at technology and electronic records, we are investigating the principles that should underlie how patient records are shared and used by patients and the health service. Our focus will be on record access as a means to an end, and how increasing patient access to records changes quality of care. 

Changing access to patient records will be one of many potential vehicles that will challenge the traditional patient-clinician power dynamic. This project seeks to examine how a more equal partnership in this respect might aid the ‘co-production’ of health. It will, therefore, look at traditional written records that are accessible or indeed held by patients (such as maternity care, child health and increasing numbers of long-term conditions services such as diabetes) as well as the opportunities technology presents for reframing patients relationship with their healthcare. In addition, we are also seeking to understand where these developments may impact on patients’ interactions with other elements of a joined up healthcare system, such as social care.  

The project will situate the issues relating to record access within a broader discussion of changing expert-public relationships, the politics of health information, privacy and security and patient centred healthcare. Taking a realistic and grounded approach to the technology, starting with current usage, our analysis aims to offer suggestions and recommendations for further action in this area.