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GPs go forth

GPs must give patients online access to past medical records from 2020

Patients must have full access to their medical records retrospectively from April 2020, according to the new GP contract.

The five-year deal, agreed by the BMA GP Committee and NHS England, said patients must be able to see their full record, including past notes, in a change which will become a contractual requirement from 2020/21.

But GPs have warned this will have a huge impact on workload, and would require a dedicated staff member to digitalise the records and check there is no harmful or third party data included.

The BMA said practices should not have to pay to implement these changes, calling on CCGs to provide the resources for digitalisation ‘free of charge’.

Patients are expected to be able to access their medical records online from the NHS App, which is currently being rolled out nationally and should be available for all patients by 1 July 2019.

However, they will not get access to their past files until April 2020.

The GP contract said: ‘NHS England and GPC England expect practices to make progress in 2019/20 towards the digital changes that will become contractual requirements from April 2020 and April 2021.

‘All patients will have online access to their full record, as the default position from April 2020, subject to existing safeguards for vulnerable groups and third party confidentiality and system functionality.

‘All practices will be giving all patients access online to correspondence by April 2020, as the system moves to digital by default (with patients required to opt-out rather than in).’

Walsall GP and LMC medical secretary Dr Uzma Ahmad said: ‘This is going to cause a lot of workload, because practices will need a dedicated person to make sure there is no harmful or third party information that we need to see to.’

‘I think this will be a very difficult job, especially with a lot of other changes happening. I’m extremely concerned about doing this for my patients.’

But retired Loughborough GP Dr Dermot Ryan said it could actually decrease workload by reducing the number of times patients come back to GPs to ask questions.

He said: ‘It may to some extent decrease it [workload] for example results are filed within the medical records and tagged as no more action needed. That may stop patients having to come back to ask the results of their tests.

‘Of course there’s always a small danger that there will be an increase in patients not understanding what’s written about them,’ he added.

A BMA spokesperson explained there are many ways for practices to digitalise records, but it does not expect GPs to fund this themselves.

They said: ‘Some practices have received funding from their CCG to employ someone on a fixed term contract to digitise records. Some have received funding to outsource the digitisation altogether. NHS Business Services Authority has some process to assist with digitisation (currently at a cost).

‘We do not expect practices to have to pay for this themselves – as with other IT and software, it is CCGs responsibility to provide the resource to practices free of charge.’

‘There will also be added benefit for practices, who will be able to make use of current records rooms, as other space,’ they added.

As part of the new GP contract, NHS England and the BMA agreed to add £20m to the global sum each year for the next three years – to cover the costs associated with subject access requests (SARs).

According to BMA guidance, ‘this funding will remain within global sum until an IT solution is in place to allow patients to access their information without burden to the practice’.

See all the headlines from the 2019/20 GP contract here...

A version of this article was first published by Pulse's sister title Management in Practice.

Readers' comments (9)

  • Not going to work the clinical systems are creaking now, how will they cope, how much will this cost we cannot do this for free.

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  • If the notes have to be redacted to make past notes fit for patients to see, aren't we in danger of losing their purpose for medical decision making ?

    Also we are losing the historic record in its unadulterated form.

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  • What on earth are the BMA playing at? There is no way many of the notes are suitable for patients to read. Most was written in a time when GPs expected privacy and some of the content is not exactly flattering and therefore likely to cause distress and harm. We write in a far more restrained style now we know everyone is looking which might sound great but actually means that some important communication (e.g. safeguarding) has to occur off the records which are devalued as a result. Exposing retrospective notes is a total disaster and likely to lead to a break down in doctor patient relationships.

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  • National Hopeless Service

    It depends on what is meant by records. If its coded entries only that isnt a problem, but a list of forward thoughts and differentials including cancer/HIV etc is potentially harmful.

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  • AlanAlmond

    this will be a nightmare, notes written as an aide memoir for the benefit of the Dr with no knowledge they would later be poured over by a subgroup of obsessives who will flood surgeries up and down the country angrily demanding the wording is changed. expect an avalanche of complaints and negligence claims. we'll all have to take a month off everyone of us to write letters 'apologising' for hastily written notes that don't correspond exactly to the patient's own recollection of events - from their perspective of cause. there will be zero comprehension that notes historically were written from the Drs perspective and for their benefit to aid in future patient care. this is an idea pushed by people who are ignorant of half the reason why Dr's make notes in the first place and looking forward it will render medical notes half useless. it's total shit. allow access to a summary by all
    means but the general public does not have the understanding to interpret raw medical notes - that's a fact

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  • I'm sorry Dr Dermot, but I really don't give a monkeys what a retired GP thinks on this one.
    I can only help but think that many more GPs will retire early because of this regular shitshow.
    Its one thing changing the parameters as things go forward (but bad enough given the negative connitations this has for patient care) but quite another to change things retospectively.

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  • I am royally f*****d, I tend to be rather frank.......

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  • Scottish GP we are all royally F*****.

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  • I wonder if the pending decision about taking on historic liabilities is somewhat related to this. At lease there will not be a spike in insurance premiums after this goes live.

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