The government has been given the green light to press ahead with plans to create a national electronic medical database using the controversial "opt-out" system for patients.
The opt-out system – initially introduced earlier this year – was suspended in April after the British Medical Association (BMA) warned it was being rolled out too quickly.
But it may now go ahead once a series of extra safeguards are introduced.
Critics fear the database – designed to give all GPs, hospital consultants, nurses and other staff electronic access to information – risks breaching medical confidentiality.
However, a Department of Health review declared that centrally held electronic records of core patient information could save lives and should be available in emergency situations.
A study of Summary Care Records (SCRs) found storing information such as medications, allergies and demographic details would be valuable in ensuring safe treatment.
A second review said additional safeguards should be introduced to make sure patients are sufficiently informed about what is being held on them.
A BMA spokesman said: "We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.
"Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation.
"It is essential that patients have genuine control over who has access to their records, and when changes are made to them."
As well as the initial opt out, people will be contacted by letter to tell them that a record will be created. An opt-out form and pre-paid envelope will be included.
An awareness campaign will be rolled out to notify those contacted during SCR's initial introduction that a record is being created for them.
The review, led by Professor Sir Bruce Keogh and involving leading patient groups, agreed that doctors should have access to essential medical information in emergency situations and that it should be clearly defined what is kept on a central database.
A second study into how patients are informed of their choices concluded that it would be a waste of money to write again to the 30 million people already contacted.
Instead efforts should be made at local, regional and national level to reiterate that they have a choice not to be included in the scheme.
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Your comments (terms and conditions apply):
"The opt-out form should have been included with the original roll out as we requested in the first place, the wasted resources by ignoring this are immense! Take note powers that be you have to do the job to know what you are doing! It's the usual run before you can walk idiotic mentality that will break the NHS into a thousand pieces. I am dreading the next few years in every single aspect of general practice :-( " – Nikki, Dorset
"The principle of allowing access to patients' records is sound out the number of people with access makes me believe that this is a system open to abuse. Roughly 1.3 million people are employed by the NHS. Assuming that, say, 500,000 are clinicians or others with high level access, the system cannot be secure. EMIS has a system that allows patients to view their own records anywhere that there is an internet connection. It works along the lines of internet banking with patients being in control of their password and PIN. The full GP record is then available to that patient. The patient is in control of his/her own records and the system is free. I appreciate that other system providers are not yet able to offer this but the costs of developing it must be way below those of the obscenely expensive CRS" – Name and address withheld