Online Access to Medical Records – Safeguarding

Accelerated Online Access - Safeguarding

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 November 2022, and GPs will be informed with 2 months' notice and provided with resources to support preparations.

For more information please click HERE

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 will be available for use by the launch date.
- 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”.