Opposing systems for sharing electronic patient records in the National Health Service are examined in today’s British Medical Journal. It says that while the potential benefits of sharing records within health systems are broadly agreed there are still concerns over patient consent and security. Experts writing in the Journal discuss how patients should consent to the use of electronic records and how data can be kept secure.The BMJ looks at the two broad schools of thought, the so-called opt-out and opt in models. Under the first of these patients would be informed of the NHS care records service and to be given a chance to opt out if they do not want their clinical records shared within the NHS. The second model is for no sharing to happen until people state their desire for this to take place

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A new publication calls for improvements to productivity in local services to be an integral part of modern service delivery but it warns councils to guard against a ‘one size fits all’ approach to measuring productivity. The call comes in a collection of essays, “Made to Measure: Understanding local public service Productivity” from the New Local Government Network.The essays have been written by key figures in local government and think tanks as well as academics, who assess the challenges facing local authorities in offering value for money, greater accessibility and more choice. Together they argue that local authorities should see increased productivity as a way to prove to a sceptical electorate that they can deliver even better services.

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By Ben Page This article was first published in Public Management and Policy and is reproduced by permission of the Association. http://www.cipfa.org.uk/pmpa/index.cfm Much has been done in recent years to develop more citizen-focused public services. Public participation is vital for developing a citizen-focus, but there have been varying degrees of failure to engage the public. The author looks at the reasons for the lack of public interest and suggests ways to improve engagement, including making councillors more effective.