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Accelerating patient access to their record

Enabling patients to view their medical record through the NHS App and other online services.

From April 2022, patients with online accounts such as through the NHS App will be able to read new entries in their health record. This applies to patients whose practices use the TPP and EMIS systems. Arrangements with practices which use Vision as the clinical system are under discussion.

This is an NHS England programme supported by NHSX and NHS Digital.

The change supports NHS Long Term Plan commitments to provide patients with digital access to their health records. It means GPs will need to consider the impact of each entry, including documents and test results, as they add them to a patient’s record. Patients will not see personal information – such as positive test results – until they have been checked and filed, giving GPs the chance to contact and speak to patients first.

We also aim to enable patients to request their historic coded records in 2022 through the NHS App.

Research shows that increasing numbers of patients want easy access to health information about them, including 80% of the 20 million NHS App users. Better access supports patients as partners in managing their health, and can help reduce queries to general practice such as on negative test results and referral letters.

The change also supports existing GMS contract requirements to promote and offer online patient access to all future information, unless exceptional circumstances apply.


What general practice staff should know

General practice staff should:

  • be aware that patients will be able to see their future records
  • know how to manage this as a change to your workflow - ensuring sensitive information is redacted as it is entered onto the clinical system, or in rare circumstances know when it may be inappropriate to give a patient access to their record

Resources to support staff with providing online services

We are running a series of training sessions to support staff with these changes. Please book onto the session most relevant to your role.

Existing guidance and materials are available to support clinicians with providing online services.

NHS England guidance on offering prospective record access

Prospective record access guidance has been developed by NHS England and BMA General Practitioners Committee in England to support GP practices in meeting the commitment to give new registrants with full online access to prospective data, subject to existing safeguards for vulnerable groups and third party and system functionality.

GP online services support and resources guide

This guidance is for GPs, practice staff, clinical commissioning groups and commissioning support units who are providing support to GP practices implementing GP online services.

Patient online services toolkit

The patient online toolkit has been written by the RCGP with NHS England. It is for GPs, nurses and practice staff to offer patient online services to patients effectively, efficiently, safely and securely. The toolkit also includes clinical examples which demonstrate how online services can empower patients to take greater control of the management of their health conditions as part of a person-centred approach to care. This is general guidance that was developed before the changes giving people access to future information.

NHS App guidance

Find additional primary care guidance on the NHS App.

Existing guidance and materials are available to support administrative staff with these changes.


Guidance and materials are available to support administrative staff with these changes  

Patient information on accessing online services

This NHS website guide is for patients on what health services are available online and how to use these services to manage their own health care needs.

Patient guidance materials

This is a set of downloadable patient materials, some in easy read format. You can use these to help patients understand how GP online services work and how to use them to take more control of their health care.

Patient case studies

Several patient videos describing how access to GP online services such as GP record and online test results, helps patients to better manage different health conditions and surgery staff explaining how access to GP online services is revolutionising and improving care for patients with long term medical conditions. There are also videos on promoting online services.


Further guidance

Giving patients online access to their medical records

There are benefits to giving patients access to their health record, including improvements in a range of healthcare quality and safety outcomes, and enabling patients to take greater control of the management of their health conditions. We also know patients want to see their records. Over 80% of new NHS App users try to view their GP record but are unable to. A lack of record access is the most complained about feature in the NHS App. We want to make it easier for GPs to provide record access and for patients to get access to their records.

What records access will be given to patients 

From April 2022 we are giving patients with an online account access to their future, or prospective, full GP health record including free text, letters and documents. Patients will see new information once it is entered, or filed, onto their record in the clinical system. Patients will not see their historic, or past, health record information unless they have already been given access to it by their GP practice. Patients whose GP practices use the TPP or EMIS system will see new GP records entered from April 2022. 

Will patients automatically see all new information about them

Patients will only see their information once it has been checked and entered, or filed, onto the GP practice clinical system. This means general practice staff will continue to be able to prevent patients from seeing any sensitive information before patients can see it. General practice will also be able to remove access for the very small number of exceptional circumstances where access is inappropriate, considered harmful or where there may be safeguarding concerns. These changes only apply to a patient’s general practice record. Other health services records will not be visible to patients. Even if other services use the same clinical system, information will not be viewable by the patient, unless it has been filed into the general practice record.

Patient access to past or historic records

We are not changing patient access to their historic information until later in 2022. This will be phased in carefully, using the NHS App, to ensure that general practice is not overloaded with requests. Patients who already have access to their historic, or past, health records will maintain this access - nothing will change for them.

When historic access changes are made, these will apply to detailed coded records only. This is so staff will not need to spend hours looking through previous freetext record entries and attached documents to identify issues that may require redacting.

General practice as the sole data controller

These changes will not change the status of general practice as a data controller. General practice decides on what information is made available to patients, either as it is being entered onto the clinical system, or by reviewing and responding to digital requests for historic coded data. No data is made automatically available without being entered by general practice.

 

Updates to the general practice Data Protection Impact Assessment 

For the provision of access to future information, patients will access the same personal information as they do under current arrangements, via the NHS App and other existing record access apps. There is no change to the category of personal information being processed, the organisations involved or how that information is being processed and secured. These changes alone are not sufficient to necessitate an update to general practices’ DPIAs, however, as data controllers, each general practice should make an individual assessment of whether their Data Protection Impact Assessment (DPIA) needs to be reviewed and updated

 

Patients understanding their medical records

There is an existing professional responsibility to ensure that records are legible and patients understand and are informed about the care that is being provided - clinicians need to write notes bearing in mind that patients may see them. While this is a common concern, our engagement with practices where record access is routinely available, and as wide international experience suggests, this is not a significant issue for patients. Within the NHS App there is currently a ‘help with abbreviations section’ that supports users with abbreviations commonly found in medical records. We are continuing to improve our national resources to support patients to become more actively involved in their care, and as more people have access to their information this will help justify further investment into improving services and systems to improve the record access experience.

More information

If you have any questions or would like to discuss this further, email england.NHSXimplementation@nhs.net.

Last edited: 2 December 2021 5:30 pm