Safeguarding vulnerable people - a briefing for charities, patient groups and voluntary organisations

An individual can request their records directly from their GP surgery. This has always been possible, and this option remains. In this case, the GP surgery will be able to give the individual a printed copy of their health records.

These changes apply across all primary care apps that allow access to medical information, including Patient Knows Best, Livi, DrIQ, Evergreen, and others. People can also access their health records through the NHS website.

People don’t need to wait until their GP has switched on access to their online health record. Anyone can ask their practice for access to their online health records, rather than waiting for their practice to give them access. To do this, they just need to speak to reception staff, or their GP during their next appointment.

There is no cost to accessing your GP health records through the NHS App or NHS Website. The NHS will never charge you to download an app, or use services within that app.

People will only be able to view information that is filed on their GP health record. This means that people will not automatically have access to their hospital records or social care records.

Sometimes, hospitals do send letters from specialists to GPs. This might include discharge letters or information on referrals. Any letters shared with GPs would be visible to patients through their online account.

This change to records access will only apply to people aged 16 years or older. If a young person under the age of 16 is believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment (known as being Gillick competent), they may already have, or may request, access to their records; this would be assessed by their GP.

People with online accounts set up before their 16th birthday will receive access to records entered after their 16th birthday.

These changes only apply to a person's own records.

Proxy access lets patients access medical services for someone in their care. Proxy access is unaffected by these changes, as we are only providing a person access to their own record.

If someone wants proxy access to another person’s record (for example, a child or person they care for), they will need to discuss this with their GP surgery. The process of applying for proxy access is different to seeing your own records, because GPs need to make sure it is in the patient’s best interest. If you have further questions, you should speak to your practice.

Proxy access can sometimes be given to care home staff for the people they care for. It can also be given to a parent or carer. Proxy access switches off when a patient reaches 16, unless specific consent has been given.

As with proxy access, these changes are only about giving an individual access to their own records. If someone wants access to the records of a deceased person, they can apply in writing to the record holder under the Access to Health Records Act (1990).

There are several reasons why a GP might decide a patient should not have access to their records. This is usually because the practice believes there is a safeguarding risk to the patient or to another individual if they have access.

A patient can contact their GP if they feel they should have access to their records to discuss why access has been revoked and can discuss with the GP to decide whether they should have access.

As mentioned above, there will be extra consideration to switching off access for some patients. This would include people who have or are currently experiencing domestic violence or sexual abuse, to minimise the risk of information sharing that could put them at risk. It would also include individuals with certain conditions to may mean they lack capacity to make safe decisions about access, for example individuals living with dementia, some mental health conditions, or significant learning disabilities. People can always speak to their practice if they want to discuss whether they should have access. If they disagree with the decision the GP has made they can complain through their practices complaints process.

NHS England have been working with GPs to help them understand these changes and to be aware that patients will be able to read information that has been inputted into the health record. There may still be some technical language, and we have provided resources to patients, including a list of commonly used acronyms, to help them understand their health record. We’ve also encouraged GPs, where possible, to use terminology and language that can be understood by patients.

The changes being made will only apply to records made from November 2022 onwards. Patients can continue to request access to historic information from their GP if they wish. However, this is not part of the automated changes.

If a patient does not want access, then they should speak to their GP surgery who can disable access to their records. 

A GP will review results from a test before uploading to the patient’s health record. This means that if results are sensitive or contain potentially upsetting news, the GP will try to speak to the patient before uploading onto their health record.

In some cases, the patient might see results before a doctor or nurse has had a chance to speak to them. Where this happens, the doctor or nurse will try to contact them as soon as possible. It might be that the test results are only slightly abnormal and are of little consequence, so we would always recommend that patients discuss test results they are concerned about with their GP.

Someone can only view the records associated with the GP practice where they are currently registered. When someone moves GP practice, they lose access to their previous records. If they aren’t registered with a GP, they currently won’t have access to any records.

A patient is always able to speak to their practice to correct information on their records. In some cases, if the information is not particularly sensitive, they may wait until their next GP appointment. Alternatively, they may prefer to speak to reception staff. 
For factual changes (for example, an incorrect allergy or medication), the GP will be able to make an amendment to the record. If a patient disagrees with information on their record (for example, around how a mental health concern has been described), then there is an option for the GP to note the disagreement.

We know that there might be instances where a patient wants to challenge information on their GP record, particularly in the case of mental health, trauma, sexual abuse or when discussing gender and sexuality. We would always recommend patients first speak to their GP, or to the practice manager. There is further guidance on amending patient records on the NHS website.

We have been working with GPs to ensure they are prepared for these changes. This includes issuing clinical guidance to support decision making around redaction (hiding information) and switching off records access for those who may be harmed by the change. We have also shared a range of resources to support practices through this change. We have been running webinars, sharing videos, and have a website with information and frequently asked questions.

We have also shared guidance with health and social care colleagues who may send information to GPs that could be added to a patient’s record. For example, secondary care specialist, mental health services, and sexual health services. You can view our webpage for health and care staff about these changes.

Most patients will not notice any changes until after November 2022, as only new activity will be uploaded after this date. As mentioned above, we will share information about these changes from November 2022 onwards in GP surgeries, through the NHS App, on NHS.UK and through social media - both NHS and partner organisation channels.

For patients that have been identified as being at risk to having their medical records available online, we will be working with third sector organisations, charities, patient groups and integrated care systems (ICSs) to spread awareness about what is happening and to make sure people are aware of their options, which can include how access can be switched off. We really appreciate any support your organisation can give to prepare people for this change. We are open to working with you to produce any materials you might need.