An update from NHS England on Accelerating Citizen Access to GP Data, 1 November 2022)

There is widespread international consensus about the benefits to patients and the effectiveness of the health system to provide digital on-demand access to personal health information. Patients’ ability to directly access test results and referral correspondence saves workforce time fielding follow up enquiries. It can also support prevention and improving health outcomes, as patients can better manage their health and long-term conditions. This experience has been borne out by those practices who already provide this access, where over 100 million views of patient information have not led to increased enquiries or compromised safety.

Under the terms of the 2019/20 GP contract, practices have been required to offer citizens digital access to all their prospective data. Since 2021 we have been clear that we planned to enable this functionality nationally, in response to rising patient demand. This would be a purely technical change in GP IT systems to make it easier for the majority of practices and patients who would benefit to gain online access to their health information. As such, the instructions for GP IT suppliers from NHS Digital, on behalf of the Department of Health and Social Care, to implement the new functionality changes are legally binding. This change does not alter in any way access to historic data in the patient record.

General practice retains full local rights, with a range of options to disable the new functionality and/or withhold patient access to some or all of their health information, to meet their obligations as data controllers and to ensure safe access. This means that there is no conflict between what GP IT suppliers are contractually required to do and practices’ compliance with their responsibilities under data protection laws. NHS Digital have updated the guidance on their website to clarify this and why it is legal and safe to proceed. Additional information on the actions that practices can take to limit access can be found at the end of this update.

In agreement with both the RCGP and BMA in April, we agreed to further extend the preparedness period and continue work with professional bodies, patient groups and safeguarding leads to ensure practices have the appropriate guidance, support and time needed to prepare. On 21 July 2022, NHSE provided formal notification to general practice and ICBs that the functional change would be implemented from 1 November 2022, and published a suite of materials to support preparations.

We know that general practice supports the Secretary of State for Health and Social Care’s ambition to accelerate patient’s access to their records. We recognise there are a range of reasons why some practices feel they are still not ready to proceed. Practices should engage with their local commissioners, who can provide them with additional support and agree a way forward to enable the offer of prospective access to records for their patients.

All practices can locally disable the functionality provided by the technical change and/or deny individual patient access, should they deem such action necessary by:

1. Ahead of the technical change, practices can exclude individual patients by adding the appropriate SNOMED code to their records. The code can also be applied to groups of at-risk patients by using reports.
2. After the technical change has been implemented, practices can amend an individual patient configuration. They are also able to hide individual elements from patient view (redact).
3. Should practices wish to disable the record access functionality, there is guidance on where to update the organisational settings.
4. Depending on the clinical system being used, practices also have the option to disable access to components of the record that may be of concern - for example, if practices have not yet implemented processes to ensure screening of documents, access to documents can be disabled.

For updated support and guidance, please go to online access to patient records or email [email protected].