Access to patient records: Responses to commonly asked questions

Patients are being given online account access to their future, or prospective, full general practice 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 general practice.

Patients whose general practice uses the TPP or EMIS system will see new general practice records entered. This will be made visible to patients through the NHS App or existing GP online services apps that already securely provide patients with access to this health information.

Full records access can include coded information, free text, consultations and documents. Patients with full record access will not see any change.

If you already provide detailed coded records (DCRs) access, patients will now be able to see their future free text and documents, in addition to their existing detailed coded records. 

We are not changing the need for a patient to request access to their historic information, and plan to digitise this process so that it is easier for patients and general practice. This will be phased in carefully, using the NHS App, to ensure that general practice is not overloaded with requests.

If you have already provided historic access to a patient, they will now be able to see their future free text, consultations and documents in addition to any historic access they already have. 

Future (prospective) records access means access to information and data added to the patient record from a set date onwards. This may be the date that a patient joined the practice or from a date when access has previously been granted.

Patients who have had future (prospective) assets set up before the change will continue to be able to view this information.

If a patient moves general practice the data previously disclosed will no longer be visible. Once registered with the new practice, the patient will be able to access all future/prospective information entered onto the new general practice system. The new general practice is able to manually provide access to historic information if this is appropriate. 

There are no changes to proxy access.  

This change to records access will only apply to people aged 16 years or older. If a young person is Gillick competent they may already have access to their records so it is still necessary to screen information for these patients.

People with online accounts set up before their 16th birthday will receive access to records entered after their 16th birthday when they turn 16.

The information governance (IG) portal has guidance on what this change will mean for IG, and the key things that patients, GPs and IG professionals should know.

A template Data Protection Impact Assessment (DPIA) is also available for general practice to use if required.

Through the GPIT Futures framework we have submitted requirements to the GPIT suppliers who have subsequently interpreted how best to implement changes within their software. 

The following provides more information on the technical delivery approach being adopted.

TPP already supports provision of records access, including the ability to redact information before it becomes available for patient view. TPP has identified that it is already possible to change existing user settings for groups of existing users to provide access to future information and change system defaults to provide this access for new users. No functional change is required to their software, and the requirements will be delivered through an SQL script.

EMIS already supports provision of records access, including the ability to redact information before it becomes available for patient view. While they support the concept of providing access to future information, this is provided alongside historic coded problems and consultation data. Their system therefore requires changes to support the concept of providing only future information, with additional related changes to the record access configuration screen. The requirements can then be delivered through an SQL script.

Vision does not support patient view of free text or documents. They are not currently fully compliant with the existing mandatory requirements of the GP IT Futures framework. Further work is required to identify an appropriate technical delivery plan that delivers benefit to general practice and patients.