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Independents' Day

GPs to provide online access to coded information in patient record

GPs will have to provide online access to all coded information in the GP record by March 2016, but only if patients request it.

The 2015/16 GMS contract, announced today, promises a ‘further commitment to expand and improve the provision of online services for patients’, including extending online access to medical records and the availability of online appointments. 

But the GPC says that free text and third party information will be excluded.

GPs will also be able to withhold online access to coded information where it is deemed to be in the patient’s best interest, for example test results which haven’t been seen by the GP, or where there is reference to a third party.

Under the 2014/15 GP contract, GPs were required to give patients access to the information contained in Summary Care Records.

Pulse recently reported that since EMIS implemented the capacity to tailor record access, they have seen a dramatic rise in the number of GPs opting to go live with online patient records.

GPs will also have to extend the number of appointments available to book online, though what this means in practice has yet to be specified, and boost uptake of the Electronic Prescription Service.

GPC chair Dr Chaand Nagpaul said: ‘We have agreed that during 2015-16, and by March 2016, patients who make an active application to the practice will be able to access detailed records comprising of coded information.

‘Importantly, we negotiated that free text would not have to be accessible. This will avoid legitimate concerns regarding remote access to consultation free text entries.

‘Furthermore, GPs will have the option and configuration tools to withhold coded information where they judge it to be in the patient’s interests or where there is reference to a third par ty. This could include coded investigation results, for instance. We have agreed that prior to the scheme going live, GP systems will be re-configured to enable free text to be redacted.’

In a letter to area teams, NHS England states: ‘We have agreed that the GMS contract will be amended to expand the number of appointments patients can book online and to ensure that there is appropriate availability of appointments for online booking.’

NHS England said they would work with the GPC to promote uptake of other online and electronic services amongst GPs, including getting GPs to offer ‘consultations electronically, either by email, video consultation or other electronic means’.

They have also set the intention of ensuring GPs make 80% of their referrals through the new the elective referral system, E-referrals – introduced to replace Choose and Book after uptake struggled to get above 50%.

The GPC have also pledged that 60% of practices will be using the electronic prescription service  by April 2016, unless legislative or technical ‘enablers’ are yet to be put in place.

Readers' comments (7)

  • So paternalistic - in other countries, patients hold all their own notes and make them accessible to HCPs as and when needed. What's to hide?

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  • It's not that there is anything to hide it is just another load of work for us to manage particularly when patients then want us to explain what all the medical terms mean. Why anyone would want to look at their own medical notes is beyond me anyway.

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  • @Anonymous @ 11:30

    I think the concern is partly historical - some things may have been written in old notes on the understanding that they would never be shown to the patient. ("Call from wife, pt has stopped all meds and mental state deteriorating, does not want pt to know she has spoken to us due to his paranoia").

    Making such old notes available to patients could have negative consequences.

    Having said that, I would personally be happy for legislation to say that as of today, all pts can have open access to notes made today and in the future. Then we could just refrain from noting anything that would be harmful for the patient to see.

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  • I would be perfectly happy for my patients to hold their own records as above but would guess that there would be a fair number lost, stolen or destroyed. The notes are the property of the Secretary of State anyway so it is for him to decide what to do with them. I do not however wish to pay for an IT system capable of delivering this - if he wants to waste tax payers money, he should be responsible for doing this rather than passing the poisoned chalice.

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  • They will have fun with my notes as many entries are under 'discussion' . Read codes are so rubbish, I give up if I cannot get a relevant code.

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  • Peter Swinyard

    some of the colour went from medical records after the Access to Medical Records Act some years ago.
    A letter from a consultant psychiatrist in the 1960's which I found in some notes read: "Thank you for asking me to visit your patient at 3am. I found him sitting in the garden baying to the moon and wearing a crown of thorns and proclaiming himself to be Jesus Christ. I, however, knew that this was not the case as the latter gentleman was already an inpatient on my unit".
    You can't write that sort of stuff any more.
    Peter Swinyard - NFS (normal for Swindon).

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  • Am I being dim, but exactly how is this going to happen in practice? Nowhere does anyone give me, as the manager of my practice, any step by step guidance as to what I practically need to do to implement this? But I must have a plan. It says so in the contract. It's like trying to drive to a desitnation with no map and no address! Who's going to answer all the patients' questions??? Does this mean yet another mountain of daily 'tasks' from S1 to tell me who's looked at their record?

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