National Record Locator (NRL)

The National Record Locator (NRL) is a national index of pointers to patient records.  It enables an authorised clinician, care worker and/or administrator, in any health or care setting, to access a patient’s information to support that patient’s direct care.

The NRL works by acting as a registry by pointing, or bookmarking, to show a user that a patient record exists and where it is held. The user can then use the information held on the NRL to contact the organisation where the record is held to request more information, or directly retrieve the record if the users system is enabled to allow this.

To make sure a record can be located a provider organisation adds a pointer, or bookmark, to the NRL when the patient record is created at that organisation.

• a Provider (for example a care coordinator in a mental health trust) creates a medical record for a patient.  At the same time as creating the record an "NRL pointer" can be automatically added to the NRL which points to or bookmarks the existence of this new medical record. 
• by adding this pointer users in other organisations (Consumers), for example a paramedic out on call treating the same patient, can then search the NRL to understand more about the patient's care. 

The NRL integrates patient record access across the NHS and Social Care without dictating where those records might be stored, thus realising a level of national interoperability across the service which has previously been unachievable.

NRL is NOT a central data store for patient records. It is an index that provides the location of records, the technical means to retrieve them, underpinned by an Information Governance (IG) framework to safely support sharing on a national scale. 

The NRL project (phase 1) started in October 2017 and went live with the beta version of the service in November 2018 connecting five mental health trusts (providers), two of which were through the local shared care initiatives, with four ambulance services (Consumers). 

Phase 2 of the NRL project started in December 2018 and went live in June 2019. This phase connected more mental health trusts and ambulance services directly to the service or through the local shared care initiatives.  

Phase one objectives were to: 

• build a national record index for data providers and consumers
• identify and review where the NRL can be integrated into existing clinical systems
• provide the technical capability to locate records by creating a new digital interoperability platform
• provide a national index to support the health care system
• provide a standardised pointer to the record, so information about patient records can be seen in date order
• allow users to locate patient records, including any additional supporting information.  

Phase two objectives were to:

• enable the secure retrieval of patient records from Provider health care systems to consumer health care systems
• enable the discovery and sharing of more types of patient records such as Digital Child Health records
• enable new pointer management features giving provider organisations even more control over the pointers they create on the NRL.

Before you are given access to the NRL service your organisation will have to complete an assessment.  The assessment will look at a range of criteria including:

• technical conformance
• data protection
• security
• clinical safety
• benefits measurement
• business process review and updates
• service operations

You can learn more about the whole process by reading the NRL onboarding guide. This guide also provides examples of forms and documents you may need to support your assessment.  Your assessment will be based on if your trust is a consumer, provider or software supplier. 

Some of the benefits of the National Record Locator for phase one include:  

• improved integration of care pathways across providers, including timely communication and collaboration between acute trusts, mental health providers, ambulance services, primary care, social care, public health (drug/alcohol services) and the voluntary sector

• patients spend less time in an inappropriate setting like Accident and Emergency (A&E) or police custody

• supporting more accurate understanding of local populations, allowing services to be designed more effectively around individuals’ needs

• preventing unnecessary conveyances to A&E by giving paramedics more information about the individual when making my clinical decisions. 

Find out more by reading our benefits statement. This work will be expanded as the NRL project continues.