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Summary Care Record application (SCRa) COVID-19 Exemptions Information

We've updated one of our systems, the Summary Care Record application (SCRa), to record and display essential information about a patient's COVID-19 exemption status to support patients who are exempt on medical grounds to be recorded for exemption from COVID-19 vaccines or COVID-19 vaccines and testing.

Department of Health and Social Care (DHSC) guidance explains those patients with a recorded medical exemption will be:

  • work or volunteer in a CQC-regulated care home from 11 November 2021
  • be exempt from self-isolating for 10 days if they are a close contact of a confirmed COVID-19 case
  • be exempt from self-isolation and completing a test on Day 8 if they travel from a non-red list country 
  • enter a venue in England that requires the NHS COVID Pass as a condition of entry

The service will help identify those individuals who are unable to be vaccinated and/or tested for COVID-19 for medical reasons and will provide a means of proving their exemption through the NHS COVID Pass. The NHS COVID Pass that is generated for individuals with a medical exemption will be indistinguishable from that of people who are fully vaccinated.

The COVID-19 Exemptions tab is available to health and care staff using the SCRa, following a recent development supported by the Department of Health and Social Care (DHSC), NHS England and NHS Digital and in consultation with clinicians. This will provide a nationally available mechanism to record and display COVID-19 exemptions information.

COVID-19 exemptions process

  1. The citizen calls the COVID-19 Covid Pass Service on 119 to request an exemption application form from COVID-19 vaccines or COVID-19 vaccines and testing.
  2. The 119 operative performs a non-medical pre-screening assessment and captures details about the citizen’s request, determines which GP/specialist clinician/midwife should review the exemption application, and any written communication accessibility preferences. The 119 operative will inform and explain to the citizen if they do not meet the pre-screening assessment criteria.
  3. An application form, pre-populated with information recorded by the 119 operative, will be posted to the citizen.
  4. On receipt of the application form, the citizen will add any relevant information/evidence required to support their application to the form and will send or otherwise deliver it to their GP/Specialist Clinician/midwife (the citizen is not required to make an appointment for this).
  5. The GP/Specialist Clinician/midwife will assess the application against the clinical guidance provided by DHSC, the citizen’s medical records, and any evidence/supporting information provided by the citizen.
  6. The GP/Specialist Clinician/midwife (or a colleague with delegated authority) will then record the outcome of the clinical assessment (i.e. exemption accepted or declined) on the Summary Care Record application (SCRa).

Following this action, the citizen will automatically receive a notification by letter of the outcome of their application and, if their application was accepted, this will display on their NHS COVID Pass available in the NHS App or non-digital alternatives. There is no further action required from the clinician.

covid-19 exemptions process diagram this image is also explained in 6 supporting steps.

COVID-19 exemption process diagram. 

Information for healthcare professionals using SCRa

The COVID-19 Exemptions tab includes functionality to record and display whether an individual has been exempt from all COVID-19 vaccinations and/or COVID-19 testing.

Each time an individual’s record is opened, a COVID-19 Exemptions tab will be available, allowing the user to record or view COVID-19 exemptions information.

The COVID-19 Exemptions tab will be available on the same row as the Key Demographic Information tab.

The primary purpose of the COVID-19 Exemptions tab is to allow GPs or specialist clinicians or midwives involved in processing exemption applications to record the outcome of their assessment.

This will trigger an update to the individual's NHS COVID Pass and the individual will also receive a letter confirming the outcome of the assessment. However, it should be noted that the outcome may also influence subsequent patient and clinician decision making with regards to COVID-19 vaccination and testing.

Learn more about how to access SCRa.

How to record an COVID-19 exemption application clinical assessment outcome

Please review patient applications against the COVID-19 Exemptions clinical guidelines published by the Department of Health and Social Care (DHSC) which have been provided to all GP Practices and NHS Trusts. These guidelines are also available within the Summary Care Record application (SCRa).

To record the outcome of a COVID-19 Exemption application clinical assessment (i.e. exemption approved or declined) on the Summary Care Record application (SCRa). 

  1. Insert your smartcard, authenticate using identity agent, and select an appropriate role.
  2. Navigate to the Spine Portal:
  3. Click on the Summary Care Record (SCR) link.
  4. Search for the patient whose application form you are processing by entering their NHS number and clicking on Find.
  5. Check that the demographic details of the patient displayed in SCRa match those on the application form and on your local clinical system.
  6. Click on the COVID-19 Exemptions tab and follow the on-screen instructions to record the outcome of the assessment.

Please record this decision on the Summary Care Record application (SCRa) within 10 working days of receiving the completed form from the patient.

To remove a previously recorded exemption, click on the Remove COVID-19 exemption application outcome button.

To exit the COVID-19 Exemptions tab without recording or removing an exemption, please click on the Patient Details tab to return the patient Key Demographic Information screen.

Access to COVID-19 exemptions

Only users with appropriate access rights will be able to access the COVID-19 Exemptions tab.

Users will need a smartcard to access SCRa and the following access rights (as a minimum) to trace a patient and access the COVID-19 Exemptions tab

  • Patient trace (B0264) - access SCR application (perform patient trace)

This information is separate to that held in the Summary Care Record (SCR). The individual’s ‘Permission to View’ will not be required to access this specific tab.

Smartcard access rights are linked to the organisation (ODS) code(s) and role profile(s) on your Smartcard. If you are unable to view the COVID-19 Exemptions tab because you do not have the correct access rights Patient trace (B0264) - access SCR application (perform patient trace) associated to the role(s) that you have selected, the following message will be displayed:

“User does not have a role which allows access to SCRa”

If you think you do need access, please discuss this with your local smartcard sponsor (for example GP practice manager) to establish who will process the COVID-19 Exemption application forms in your organisation and whether you require access, as colleagues within your organisation may already have access. To request the additional B0264 code, where required, please contact your local smartcard sponsor and Registration Authority (RA).

Actions for registration authorities

Access to SCRa is governed by the RBAC Activity Code B0264 (“Access SCR Application (Perform Patient Trace”). Currently, any user with access to SCRa can access the new “COVID-19 Exemptions” functionality by default. To ensure appropriate usage, NHS Digital has implemented a change to restrict access to the exemptions functionality to those with ‘B0264’ and ‘B0380’ activity codes in SCRa.

  • GP organisations will require RBAC activity code B0264 (“Access SCR Application (Perform Patient Trace)” Only
  • Non-GP organisations will require RBAC activity code B0264 (“Access SCR Application (Perform Patient Trace) and B0380 (“Perform Detailed Health Record”) to access this functionality

For clinicians to delegate the task of recording the outcome of the assessment on SCRa to non-clinical/administrative colleagues, services may choose to nominate a small number of administrative staff members who will process completed application forms in batches. Registration Authorities may therefore see requests for such staff members to be granted RBAC Activity Code B0380 (in non-GP organisations) for this purpose. Please continue to follow local and national RA policy in dealing with such requests.

Support for potential problems

If you try to access SCRa using an internet browser type that is not supported by NHS Digital web sites and applications, you may encounter the following warning message or some features may not work correctly (for example, screen rendering issues or functionality such as dialog or buttons not responding etc).

Please also note that Microsoft Internet Explorer is now end-of-life, and Microsoft is withdrawing support for it. As a result, NHS Digital is no longer offering support for Internet Explorer in its products, and web-based services produced by NHS Digital may not work correctly. 

Find further information about withdrawal of support for Internet Explorer.

SCRa unsupported browser warning message

Image text

Warning: Unsupported browser or browser compatibility view mode.

Your browser or its compatibility mode is not supported, and some features may not work correctly. See the HSCIC Warranted Environment Specification or contact your local support for more information.

In these circumstances, do not attempt to access or use the SCRa COVID-19 exemptions functionality with this internet browser. Instead, exit the application and access SCRa using an internet browser type that is supported. Supported internet browser types are Google Chrome (versions in support), Mozilla Firefox (versions in support) and Microsoft Edge (versions in support). Your local IT helpdesk will be able to provide support where needed and escalate issues.

Further information can be found in Spine technical information: Warranted Environment Specification (WES).

User screenshots of the SCRa COVID-19 Exemptions tab

Upon searching for a patient and selecting the “COVID-19 Exemptions” tab, the user will see this screen.  

covid-19 exemption tab nothing recorded

Figure 1: COVID-19 Exemption tab with no exemption information recorded.

This image, figure 2, shows the options available when recording a COVID-19 Exemption application assessment outcome.

add exemption

Figure 2 – COVID-19 Exemptions tab available options

Once a COVID-19 Exemption application outcome has been recorded, a green banner will be displayed confirming that the information was added successfully. 

exemption information recordedFigure 3: Exemptions tab showing exemption information recorded.  

Following this action, the individual will automatically receive a notification by letter of the outcome of their application and, if their application was accepted, this will display on their NHS COVID Pass available in the NHS App or non-digital alternatives.

Information for healthcare professionals using National Care Records Service pilot or systems that use the 1-Click Service

COVID-19 Exemptions functionality will not be included in the National Care Records Service pilot product or systems that use the 1-Click Service.

Information for citizens

Summary Care Record application (SCRa) is a web-based application which allows health and care professionals to view clinical and demographic information, using a number of other services. They include the Personal Demographic Service, Summary Care Record, Child Protection – Information Sharing, Female Genital Mutilation - Information Sharing and Overseas Visitors and Migrants.

Information for citizens on medical exemptions from COVID-19 vaccinations and testing.  

Contact us

Please use your local IT helpdesk for SCRa related issues. However, if you believe your issue to be regarding smartcard access rights, please contact your local smartcard sponsor or Registration Authority (RA) in the first instance.

Our National Service Desk (NSD) can also provide support and can escalate issues, where required:

Telephone: 0300 303 5035
Email: [email protected]
Report via our customer portal

Last edited: 21 September 2022 11:42 am