Automatic access to patient records from 1 November 2022

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Note: this page is now out of date, please see our most recent guidance.

Patients with an existing online account will automatically be given access to future (prospective) entries to their patient record, including free text, letters and documents when a new system of access is implemented.  This was originally due to come into effect on 1 April 2022, but was delayed shortly before this deadline and is now confirmed to come into effect for EMIS and TPP practices from 1 November, following this letter from NHS Digital on 21 July. They have also produced this page of resources for practices, including a checklist, and are running a series of free webinars between now and November. The RCGP has produced a toolkit to assist practices.

In October 2022 Dr Lisa Harrod-Rothwell, our Deputy CEO, wrote a blog outlining the concerns she has been hearing from practices about whether giving patients access to records in this way is the best means of meeting the objectives NHS England have set out.

For GP practices which use the TPP (SystmOne) and EMIS clinical systems the access will be automated centrally, following the first patient consultation/entry to the record after the launch of then new system. Arrangements for GP practices who use Vision as the clinical system are under discussion.

If a patient asks to amend or correct information they can see in their record the GP considering the request may wish to refer to our guidance on the circumstances in which they can amend medical records and how to safely amend medical records. Retrospectively amending patient records is an area with a number of potential regulatory pitfalls and should be done carefully and precisely, even when at a patient’s request.

Key information for GPs and practice staff regarding this change:

  • For new entries after launch, a patient will be able to access free text, letters and documents. GPs and practice staff 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 be able to 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.
  • Practices will need to consider if any changes are required to the practice’s workflow, ensuring sensitive information is redacted as it is entered onto the clinical system, or know when it may be inappropriate to give a patient access to their record.
  • Practices will be able to customise or remove access for individuals if having access to future, or prospective, health information is inappropriate. More information on safeguarding concerns and access to records can be found here. Further materials are being produced in collaboration with the Royal College of General Practitioners and safeguarding experts, which will explain situations of potential safeguarding concerns, and the appropriate steps that clinicians should take to manage the challenge of vulnerable adults and medical record access.
  • Enhanced Review (SNOMED) codes can be used where there are safeguarding concerns, clinicians can prevent patients from having automatic access to new information by adding a SNOMED CT code to their record.
  • A patient can have an existing online account through the NHS App or any of the other approved patient facing services apps that provide record access.
  • New online users set up through the NHS App or other approved apps after launch will also receive this level of access by default.
  • Any person aged 16 or over who is registered with a GP practice in England can register for an online account to view their prospective (future) medical record from the point of the new system being launched. If a young person, aged between 13 and 16 years old, has been deemed competent by their GP to access GP Online Services they will also have access to view their prospective (future) medical record.
  • Patients will not see their historic, or past, health record information unless they have already been given access to it by their GP practice. NHS England/Improvement are aiming to enable patients to request their historic coded records in 2023 through the NHS App. This feature was originally expected to be enabled in 2022, but was later delayed.
  • Due to a pre-existing issue, patients that move practice will only gain access to prospective information entered at the new practice, with any information entered at the previous practice considered historic information.

The NHS Implementation team are running awareness sessions to support GP Practices with this change and the sessions can be booked here.

There is existing guidance and materials available to support clinicians with providing online services. In addition, NHS Digital have provided further guidance for GP practices on giving patients online access. We suggest practices read these in addition to the summary provided above.

Note: this page was originally published in February 2022 and has been updated periodically to reflect the shifting timeline for record access implementation.