Increasing numbers of GP practices are revolting against the government's care.data scheme to extract and sell "pseudonymised" patient data to the private sector.
And GPs that refuse to comply with central government instructions to allow the Health and Social Care Information Centre (HSCIC) to extract and upload patient data have been warned that they are putting their jobs at risk.
According to an investigation by the Daily Mail, at least four GP practices will defy government instructions - with many more set to join them. A number have written to their patients to seek their consent, informing them that if they do not object within a month, their patient records could be taken by the HSCIC for its care.data database and sold on to researchers, insurance companies and other organisations.
One GP echoed a widely held belief that if it becomes known that medical record data is being sold by the NHS patients will be reluctant to tell their GPs everything.
"Patients will not feel they can tell us everything. They will lose confidence in medical confidentiality. Many patients will be very angry in a few months when they realise their information has been handed out to organisations for purposes they are not happy about," said Hampshire GP Neil Bhatia.
While the government has taken an approach of presumed consent, meaning that everyone is opted in unless they object, some GPs are proactively contacting their patients and distributing objection forms to make it easier for people to opt out.
A spokesman for NHS England confirmed that GPs that failed to comply with government orders to hand over patient data would be breaking the law - and could face action. GPs would be breaching the Health and Social Care Act, but NHS England would not start taking action until the data extraction process begins in March.
One GP, according to the specialist newspaper Pulse, has already been threatened with the termination of his contract over plans to opt-out all his patients.
According to Pulse, Dr Gordon Gancz has been sent a "notice of remediation" by NHS bosses in Thames Valley to force him to remove opt-out codes for care.data that he had added to all patient records in his practice's database.
They claim that he is in breach of his contract and have furthermore demanded that he must remove notices on the practice's website about his plan to opt all his patients out of the scheme.
He has been told that his actions are in breach of NHS England's requirement that "patients will automatically be included unless they indicate to their practice that they wish to opt out", according to Pulse.