Online records access

NCL Wide

From 1 November 2022, patients with online accounts will be able to read new entries, including free text, in their health record.

Existing online users will have access to their health information entered after this change is made. New online users will also receive this level of access by default.

General practice will need to consider the potential impact of each entry, including documents and test results, as they add them to a patient’s record. They will also be able to customise or remove access (redact) for individuals in exceptional circumstances.

This change will apply to patients who use the NHS App and all other approved patient facing services apps that provide record access (e.g. Evergreen, Airmid, SystmOnline, Patient Access). A full list can be found on the IM1 pairing integration page of the NHS Digital site. 

The GP IT system configuration is being changed to enable this access for patients.

Record access may be unsafe for some vulnerable patients. Redmoor Health has developed a set of EMIS searches to help practices identify vulnerable patients and decide whether it would be better if they do not have online record access to their GP medical record. 

The suite of searches are available in EMIS and can be downloaded and copied to your local EMIS folders to run and be used at your practice’s discretion.

Please note: The searches are provided to assist with identifying vulnerable patients for review; not all concerns will be coded and so caution should be taken. There is no data set that has been endorsed by NHS England.

Accessing the searches

Follow the steps in the image below to add the searches to your local EMIS folders.

See the Patient online access toolkit searches and Patient online access levels code list documents in the EMIS Global searches section for further information.

This information is for practices who use Docman 10 to manage their incoming clinical correspondence.

New features have been added to Docman to allow more control of document visibility to patients via Patient Facing Services (PFS). This is in preparation for the upcoming changes to patient access to online GP records.

See the Docman user guide in Docman 10 guidance and follow the enclosed steps to understand how to use the new features in Docman 10.

There has been an NCL-wide upgrade of Docman to enable the new features; if you do not think your software has been updated, contact GP IT.

Making annotations in Docman, including redactions and erasures

  • If a user makes an annotation to a document prior to filing to the clinical system, the annotation will be attached to the document and be classed as the original.
  • Any subsequent annotations that are made in tasks or updates to documents post-filing will not be sent to the clinical system as there is no ability to update EMIS with the latest version.
  • All versions of the document are available within Docman.

Making the decision on visibility to patients

  • When a document requires no further review (workflow/tasks) and is just being filed to the patient record, the filing user will need to make the decision on visibility.
  • If the filing user is not sure on patient visibility, they will need to seek guidance or send this on as a task.
  • With any documents that are sent on for review, the decision on visibility lies with the task recipient.
  • If no decision is made the default is set to visible.

Redmoor Health is running sessions that will offer a general overview of the changes planned for November 2022 and what practices need to be aware of.

There will also be an opportunity to ask questions and check understanding of the guidance issued by NHS Digital.

NHSE transformation directorate have produced a series of short YouTube "how to" videos to support staff (including locums) to receive the necessary training with regards to checking and entering information into patient records.

  • Conducting and documenting consultations that empower patients when they access their records: With the knowledge that all patients will have online access to their future patient record from 1 November 2022, Dr Brian McMillan details ways in which you can adapt your consultations to support this change. Specifically tackling medical jargon and ways to include the patient whilst recording patient notes.
  • Giving patients access to future general practice records: An introductory film outlining the change to patient record access. With prospective data being made available automatically for all patients from 1 November 2022, National Digital Primary Care Nurse Lead, Helen Crowther and Patient Access Programme Lead, Tristan Stanton detail the key aspects of this change to be aware of. These include details on the benefits for both patients and practices and the resources available to help navigate this transition smoothly.
  • How to redact in EMIS Web: Drawing on a wealth of experience, Dr Edward Clode-Baker provides a practical demonstration showcasing the features of EMIS web which relate to patient record access. The film demonstrates when information becomes visible to a patient, how to prevent information being made available and how to change visibility.
  • When to consider not providing record access to a patient: Relevant for all general practice staff, this film addresses potential safeguarding concerns surrounding patient record access. Deputy Director for NHS Safeguarding, Kenny Gibson and Dr James Higgins detail specific scenarios, including circumstances that may cause harm, changes in circumstances, vulnerability and coercion. Additionally, they discuss when to consider not providing record access to a patient.
  • Why and when to make information not visible in patient records: Local GP, Dr Phil Koczan, demonstrates how to record sensitive information to a patient record and the actions to take in particular circumstances where information may be deemed harmful or confusing to the patient or may breach data confidentiality.

For any queries relating to training requirements, contact Redmoor Health e: hello@redmoorhealth.co.uk

For general or clinical queries, contact the NCL Digital First team e: nclicb.digitalfirst@nhs.net


Review date: Thursday, 13 July 2023