Documents in the NHS App

Documents are part of the patient’s health record. 

Health records is a core feature in the NHS App as outlined in the national operational planning guidance. As of November 2023, all GP surgeries in England must give patients online access to new information as it is added to their GP health record. This is known as prospective record access and does not automatically include historic entries.  

Turning on prospective record access means that patients can only see their documents or wider health record from the date the patient was given access. 

For example, Daniel registered at your GP practice in 2021 and does not need a safeguarding plan. He should be able to see his documents and the rest of his health record from November 2023.  

Patients who register at your GP practice after 2023 should be able to see documents and the rest of their health record from the date they registered. For example, Chenice registered at your GP practice in July 2024 and does not need a safeguarding plan. She should be able to see her documents and the rest of her health record from the date she registered.  

It is down to your practice to determine how you handle requests from patients for access to their historic documents or health record. Once you have decided that process, it should become your practice’s policy.   

To control how patients access their documents, in your GP IT system you can:   

• upload documents to a patient’s health record  
• choose the date from which patients can view their documents  
• hide specific documents or block access for patients at risk of harm   

Some documents may contain information about test results. If these are uploaded to a patient’s health record without proper review, patients may learn about the outcome of a test result before they’ve spoken to their GP. 

It is important that you establish a workflow for handling test results and documents. Follow our guidance to help you understand more about how you can create workflows that reduce the risk of patients finding out test results before they have spoken to their GP.

Before you give patients access to documents in their health record, you should consider whether viewing them could put the patient at risk. This is especially important for vulnerable adults where documents may contain sensitive information.   

Patients may already have a safeguarding or related care plan in place. When you identify a risk, access to documents or the full health record should be considered as part of your wider safeguarding planning to keep patients safe.   

Safeguarding guidance can help you:   

• understand where safeguarding concerns may arise and how to mitigate those risks   
• redact specific record entries in SystmOne and EMIS web for patients who already have online access 
• safeguard vulnerable patients who may have access to their online health record in the future 

Documents can only be viewed by patients in the NHS App if they have been uploaded in the right type of file. If it is not the right type of file, patients will see an error message in the NHS App when they try to access that specific document. 

The type of file and the size of file you can upload depends on which GP IT system you use. Some types of file can only be viewed and some can only be downloaded. 

Read more about the type of file and size of file restrictions for SystmOne or EMIS Web. 

Documents must be smaller than 2MB and in a supported file format. 

Follow these steps to upload documents to a patient’s health record in EMIS Web. 

Documents must be smaller than 4MB and in a supported file format. 

Patients can only view XX2 documents in the NHS App. They cannot download this type of file. 

Most problems with documents can be fixed by updating your GP IT system settings.    

If you do not have the right permissions to change the settings, speak to someone in your GP practice who does.   

Before providing access to historic documents, you may want to go through the patient’s record entries. This is so you can check for any information that may need to be redacted because of safeguarding plans.

If you've checked all the relevant settings in your GP IT system and followed the guidance on this page but the problem is not resolved, follow these steps.  

• First, check any guidance from your GP IT system supplier to make sure that the settings that should be turned on are turned on.  
• Then, use the NHS App test patient to check if the problem is still there.  
• If the problem persists, contact your system supplier (EMIS, TPP or Medicus) as they can help you with configuration issues.  

• Finally, if the supplier confirms settings are correct, gather relevant evidence of the problem, like screenshots, and contact NHS App support.  

Escalate to NHS App support immediately if:  

• the patient can see information that does not belong to them  
• the issue affects multiple patients  
• you are seeing error messages you do not recognise  

There is help and support available for patients.  

NHS App help contains information and guidance about viewing and using Documents. 

There are useful walkthrough videos that show patients how to access documents in the NHS App.  

You can also promote the NHS App using our promotional toolkits which contain a variety of materials you can use in your workplace and online.