Automatic access to patient records

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Practices should bear in mind that the 1 November 2022 target for automatic access is not a contractual requirement, despite the large volume of communications received presenting it as a hard deadline.

Note: this page is now out of date, please see our most recent guidance.

Delivering on this target does impact on other areas where practices do have clear contractual, regulatory and legal obligations, such as having enough capacity to provide appointments, managing information in a way that does not adversely affect the doctor/patient relationship and working within the Data Protection Act 2018.

We understand that commissioners in London are also beginning to question the clinical safety of automatic and retrospective access.

While practices need to be able to show they are “working towards” automatic access, this does not have to be delivered on 1 November and certainly should not be delivered at the expense of all other considerations. The current system of requesting access to medical records satisfies the vast majority of patients and is a process that supports patients and practitioners’ shared objective of having informed discussions about health choices.

In recent days the BMA have issued this guidance and accompanying statement. The RCGP have also issued this statement.

Contractual obligations

Practices should be aware of their contractual requirements regarding offering online access to medical records. The Contract does not state that this needs to be universally activated for all patients which is the current NHS England proposal. The requirement of the Contract is to offer access to patients and enable this for those who accept the offer.

The specific requirements are set out in section 23 of the 2020 Contract variation notice.

Readiness for automatic access

Update: we understand as of 1 November those practices who have written to clinical systems providers asking them not to turn on automatic prospective access will still have it activated on 30 November. The only way to prevent automatic access on 30 November is to bulk flag all patient records as SNOMED code 1364731000000104 (“Enhanced review indicated before granting access to own health record”).

Those practices who have made no such request will have it activated on, or soon after, 1 November. On 31 October EMIS and TPP said they would not switch on automatic access for customer practices until asked to do so by a practice, this was then superseded by the above information on 1 November.

If you are not ready to give automatic access from 1 November you should contact your clinical system provider to say you do not want access turned on for all patients in the event they are planning to do this. You have the right to instruct them to do this as the ‘data controller’ for the patient records. You can then continue to give patients access on a case-by-case basis as they request it, following the completion of any redactions etc. There is a template letter from the BMA to assist with this.

“Working towards” automatic access

You need to be “working towards” providing prospective access to records for all patients. For example, agreeing a practice implementation plan which references staff training and a process for identifying and reviewing the records of all patients whose notes may contain sensitive or harmful information. This written plan would then be available to support any challenges you may receive regarding why you have not enabled universal patient access to records. You may wish to include the NHS Transformation data protection impact assessment template in your plans, which can be found on this page.

Patient access to records is a constantly changing area and we will share further updates as and when information becomes available, which may potentially supersede the information above. The deadline for automatic records access has moved several times before and may move again.