Supporting victims and survivors of domestic or sexual abuse

Where a GP suspects domestic violence, they may consider redacting (hiding) any sensitive information on a patients record.

Where possible, a GP will speak to the individual about this. If a conversation is not possible; they may consider switching off access to protect the patient.

It should not be obvious to a patient if information has been hidden from view. It is not possible to redact part of letters or other PDF documents, so these will not appear in the record. Any notes from the consultation will  be hidden, rather than being obviously redacted.

If a letter is sent to a GP, such as reports from police, local government or other providers, then it could appear on the patient’s record. We have issued advice to colleagues that they should clearly mark if a letter should be redacted. GPs can also use their discretion to determine whether a letter should be redacted.

We understand that individuals who have experienced sexual abuse can feel a lack of control over what is happening to them. When a patient discloses trauma or sexual abuse we would encourage GPs, when safe to do so, to discuss whether or not they would like this information included on their online health record.

This redacted (hidden) information is visible to the GP but not the patient when viewing their online health record. The GP can also ask the patient if they would like access turned off entirely. The patient could always change their mind in the future, but this would be for the them to decide, not the GP.

There might be cases where the GP suspects domestic violence and therefore does not feel they can safely have the conversation with the patient. If this is the case, they might initially choose to hide the information without discussing it.

If an individual notices that there is information missing from their record, they can always approach the practice to ask that the redaction is lifted and that it is visible to them. Every patient has the right to see their record, and practices should facilitate that conversation.

The NHS App has stringent security protocols, including user identification when the app is installed. Users will usually have to log in with a password and thumb print, and there are advisory messages that pop up before a patient accesses their records.

We cannot prevent someone showing their records to someone else after they are logged in.