Health and social care workers in Scotland will be able to access a patient's full medical history with a click of a button once ministers kick-start a programme of NHS modernisation.

For the Þrst time, details of visits to the GP, immunisations, medication and test results will be available on a single electronic record, jointly managed by health workers and patients themselves.

Social workers and other social care staff will also have access to the records, provided the individual consents, under a pioneering initiative due to be put into operation this year.

The initiative, known as "national integrated care records", forms a major plank of Scotland's drive for a healthier nation. It runs ahead of similar plans in England. Scottish ministers hope the system will cut the country's high rates of death from cancer and heart disease by enabling easier access to patient data, allowing quicker exchange of information between professionals - particularly important in a region where clinicians may work in isolation - and involving patients in their care.

Under the project, which is being led by health minister Malcolm Chisholm, letters from hospital specialists will be available electronically from this spring. By the end of the year, GPs should be able to use their computers to access patients' test results. A summary of patient notes, including details of medication, should be available to GPs working out of hours, and to emergency departments by early 2005.

Information on children's health - with details of immunisations, screening and special needs - will be available online by September. And work has already started on sharing electronic records with local authorities. It is hoped that nine local authorities will be online by the end of March, with the remainder joining over the following 12 months.

ConÞdentiality safeguards are being built into the system to ensure records are only accessed by authorised staff. As a consultation paper notes: "Many professionals in many settings hold fragments of the record, but none have access to the whole record. This does not mean that all information about a patient will be held in one place, but it does mean that health professionals can access the information they need about a patient. Such access will be within a secure environment and deÞning access rights of users will ensure that it is limited to what any given professional needs to know."

Ministers believe the new system is fundamental to the modernisation of healthcare in Scotland. "We must replace outdated processes that in some cases are as old as the NHS itself with streamlined, patient-centric processes," Chisholm says. Patients' needs will only be met if staff have access to "the right information at the right time".

For more on healthcare in Scotland: www.show.scot.nhs.uk

For more about devolved government in Scotland: www.scotland.gov.uk