Online Access to Medical Records – Safeguarding
Mass Roll-Out Halted (29th November 2022)
The BMA have reached a negotiated agreement with NHS England and DHSC over halting the mass roll out of the records access programme. Read the Press Release here: Halting of Citizens’ Access mass roll-out is the right thing to do for patients
The BMA have published a webpage on the current programme which also includes some useful FAQs that you may have on the current situation, depending upon what your practice has or has not yet put in place.
Accelerated Online Access - Safeguarding
As of November 2022, patients with online accounts, such as through the NHS App, will be able to read new entries in their health records. This applies to patients whose practices use the TPP and EMIS systems (practices using Vision [Cegedim] clinical system are under discussion).
NHS England recently wrote to general practice staff to detail the need to prepare for this change and the support available, including an updated RCGP GP Online Services toolkit, videos covering key topics, learning from early adopter sites and communication materials for general practice to use to inform their patients.
A GP practice readiness checklist has also been produced to help practices ensure they have completed all the necessary actions, such as staff training and reviewing of relevant policies and processes.
All staff, including locums, should receive the necessary training with regards to checking and entering information into patient records and familiarise themselves with any change in business processes and GP system functionality. To find out what the changes mean for you and what you need to do next, register for one of the upcoming awareness webinars
Accelerated Access to GP-held Patient Records A summary for the admin team
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Lisa Harding, Director of Primary Care at Wessex LMCs, talks with Caroline Sims, Information Governance Consultant and Data Protection Officer in the Hampshire & IOW area. Listen to the podcast here |
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Caroline explains:
Further Reading NHS Digital: https://digital.nhs.uk/services/nhs-app |
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104 and 106 codes
There has been much confusion about what Snomed CT codes can or should be used and what effect they have on the online access if you do. NHSE&I have produced a handy guide that documents these scenarios and this can be downloaded form the FutureNHS website.
Update - system changes for all practices using TPP and EMIS - June 2022
General practices were previously informed that from April there will be system changes for all practices using TPP and EMIS systems to provide all patients with easy access to their future health records. Go-live date is now expected to be 30th November 2022.
For more information please click HERE
There are a number of resources that NHSE&I have published on FutureNHS. This includes a useful FAQ document. we would recommend subscribing to this channel, it is quick and easy to sign up.
Proxy Access
This a topic referred to and the FAQs say that the new changes do not apply to proxy.
The accelerated access program is for those aged 16yrs+. However, we would recommend that this topic is reviewed and details can be found at: -
RCGP https://elearning.rcgp.org.uk/mod/book/view.php?id=13455&chapterid=770
We have raised concerns about certain aspects of this with both NHSD and the BMA, and in particular around safeguarding. We are currently awaiting further guidance on this issue.
In the meantime, we would recommend that practices
- Remember they are the data controller.
- Remember the patient will be able to immediately see any entry that is not redacted from online view.
- The “switch on” of the online access only relates to the GP record (not community modules, for example).
- Ensure all staff and clinicians are fully aware of the importance of what they write in the record and how to “redact” from online view anything that is sensitive and or safeguarding relevant.
- Be aware that all the following will be visible
- Consultations with full text – unless hidden at the time of entry
- Results- once filed in record
- Codes
- Documents – once filed in record
- Appointment Information
- Access to retrospective (historic) records can still be requested by patients.
- If documents are filed into the record, they will be visible to online view.
- Ensure all staff processing documents know how to redact from online view until the document has been reviewed for suitability.
- There is a code that can be added to a record that will hold back online access “Enhanced review indicated before granting access to own health records – Snomed code 1364731000000104. We understand that this code must be added prior to the launch date of 1st November 2022. However there has been confusion about the use of this code, see the section above entitled 104 & 106 codes.
- Possible uses may include but not limited to
- Patients that lack capacity
- Patients with safeguarding protections or concerns in place
- Patients in domestic abuse situations
Clinical System Guides
An EMIS guide for redacting a consultation
A TPP guide for redacting a consultation (Please note that due to the configuration of your system you may not have all 3 processes available to you)
Consider using a test patient in your clinical system and similarly a test patient in the NHS App to see how actions within your clinical system will look to the patient within the App. NHS Digital have full details of how to do this. The NHS App test patient can be set up on a computer or laptop, as well as a smartphone, android or tablet.
With our kind thanks to Dr Michelle Sharma from BSW who has produced 
a crib sheet or all healthcare professionals that shows how to “Redact from online view”.
Further reading
More information can be found on our page Wessex LMCs: Safeguarding: Children and Storing Information
Information Governance Lunch and Learn
Subject Access Requests & Dealing with Third Party Data recording
Data Sharing Update from Caroline Sims at the PM Conference, June 2022
Information Governance with Adam Horton-Tuckett - from PM Webinar 25 May 2022
