Test results in the NHS App

Test results 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 test results or wider health record from the date access was switched on.  

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

Patients who register at your GP practice after 2023 should be able to see test results 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 test results 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 test results or health record. Once you have decided that process, it should become your practice’s policy. 

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

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

Documents can only be viewed by patients in the NHS App if they have been uploaded in an accepted file format. Go to the Documents features pages for a complete list of file formats that work in the NHS App.

Test results or information about a patient’s diagnosis can appear in the NHS App in: 

• Test results 
• Documents 
• Appointment notes and other updates 
• Appointments 

In Documents, patients may see correspondences relating to their diagnoses like a referral letter or clinician notes. 

In Appointment notes and other updates, patients may see consultation notes about their diagnoses or ordered test results. 

In Appointments, patients may see referrals to specialists, for example cancer services, because of a diagnosis. 

When a patient views an area of the NHS App where they can access information related to a diagnosis, they will see a screen explaining that they might see sensitive information. This video about test results in the NHS App shows you what that screen looks like.

The results of most tests appear in the NHS App if they were: 

• carried out at a GP practice  
• ordered by a GP and carried out at a hospital  

Not all tests will appear in the NHS App. Some test results may not appear in the NHS App if the test was: 

• ordered by a hospital, but it may be available through other patient engagement portals (PEPs) like Patient Knows Best (PKB) or MyChart 
• performed privately 
• a maternity check 
• a genetic test 

Patients also may not see some or all test results if you have redacted the result or marked them as not visible online in your GP IT system. 

In GP IT systems, test results are part of the patient’s health record. 

GP practices can be forwarded test results and diagnoses as documents from other care settings including hospitals and mental health services. For example, you might receive a clinic letter or an email from a hospital. If these documents are added to the patient’s health record in their practice’s GP IT system, they can appear in the NHS App. 

Some patients may also have limited access to test results that were ordered by a hospital. Patients may be able to access these results through a PEP like PKB or MyChart.  

How test results are released to a PEP is determined by local policy. However understanding the clinical guidance and how PEPs work can help GP practices better anticipate when test results may appear in the NHS App. 

Clinical guidance for automation of results release in patient engagement portals has more information on: 

• the principles for releasing information about test results 
• what PEPs should do 
• when different types of test results should be released to the PEP 

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

Patients may already have a safeguarding or related care plan in place. When you identify a risk, access to test results 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 TPP 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 

You control what patients see in their NHS App through your GP IT system. This includes which test results they can see and when. 

It is important to agree and understand a workflow for how test results are released. This is to reduce the risk that patients will find out about a diagnosis before they have been spoken to by a clinician. Speak to your practice manager if you do not know if you have a test results workflow. 

Workflows for the release of test results should be considered in both primary and secondary care settings. 

Workflows can be automated or manual and should include: 

• consistent rules on how long to delay releasing different types of test results 
• consistent rules on when and for how long to use embargo controls 
• how to manage documents or correspondences forwarded from different care providers about a patient’s diagnosis, including referral letters 
• when and if patients should be contacted about their test results 
• who is responsible for doing what at each stage of the workflow 

NHS England’s clinical guidance for automation of results release in patient engagement portals can help you create your workflow. This guidance was written in collaboration with: 

• cancer alliance 
• diagnostics teams 
• national and regional medical directors 
• chief clinical information officer expert advisory group 
• chief X information officer community 

The clinical guidance includes: 

• principles for the automatic release of test results 
• what processes should be followed when tests are ordered 
• timings for when different types of tests should be released 

Your GP IT system may have settings that let you control how test results are released. These are visibility controls and let you redact specific things in a patient’s clinical record.  

In SystmOne, you can redact information through Do not show in online record. Watch this video for specific steps on how to redact information in SystmOne. 

In EMIS Web you can redact information through Do not display on the online care record. Watch this video for specific steps on how to redact information in EMIS Web. 

Most GP IT systems allow you to hide test results and documents form a patient’s health record. 

Hiding a test result or document means the patient cannot see it in their NHS App but you can see it in your GP IT system. 

Most problems with test results 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 test results, 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.  

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

There are useful walkthrough videos that show patients how to access test results 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.