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Patient confidentiality is at risk every day in the NHS. The fact is that the old systems are not secure: paper records get lost, faxes are sent to wrong numbers, and letters fail to arrive. The concerns cite the all-too-familiar fears around ‘patient confidentiality’ 1 but such concerns are overstated and slightly hysterical. There is talk of shutting down NHS clinical groups and a suggestion of the NHS commissioning its own secured bespoke messaging system. So it is with the messaging system WhatsApp: the NHS does not approve. Today the NHS still remains behind the curve compared with other healthcare systems, still reliant on paper records, letters, and fax systems. Thankfully, clinicians simply ignored the advice and pushed on. Most of these leaps forward happened despite the flat-footed NHS with its constant resistance to change and its fevered mantra ‘patient confidentiality’ used as an avoidance strategy. I remember the dumb green and black terminals of the first version of EMIS, asking what a ‘website’ was, using AltaVista as a search engine, and searching CD-ROM MEDLINE, but most of all I remember colleagues’ resistance to all of these changes. I remember doctors using pay phones to call back to the surgery and mobile phones as big as suitcases. Today I look at the expressions on the faces of my younger colleagues and know they are thinking ‘stupid old fool’, but this is just the turn of life. I rolled my eyes as older colleagues spoke because I thought I knew it all, and I felt blessed with absolute certainty.
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