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GP practices doing bulk opt-outs from records access told to report to NHS England

GP practices doing bulk opt-outs from records access told to report to NHS England

Exclusive GP practices that are doing bulk opt-outs from automatic records access are being asked to report to NHS England and ICBs, Pulse has learned.

Practices which have used the 104 codes – showing the message ‘enhanced review indicated before granting access to your own health record’ – to large parts of their patient population have had communications from their commissioners asking them for plans on how access is going to be given moving forward.

NHS England is currently pursuing a phased rollout of app records access, after being forced to abandon plans for all practices to go live in November due to concerns over patient data safeguarding.

Practices using SystmOne were due to have automatic access to prospective patient records via the NHS App switched on today (1 February) unless they had opted out. It was understood 946 practices were intending to go live on the date, while NHS England has previously said around 600 practices had already gone live.

A document sent to GPs and seen by Pulse, said: ‘Any practice who has excluded more than 50% of their patients will be required to submit an action plan for reviewing these patients and granting access to NHS England, the primary care team will be in touch with these practices shortly with further details.’

Pulse understand that practices will then subsequently have to submit a monthly report to NHS England on all 104 exclusions applied.

The BMA said it is working with NHS England to try to improve the programme and one part of this will be to determine ‘how to deal efficiently with the 104 codes that have been added in bulk by some practices’.

In an email to LMCs and seen by Pulse, the union said: ‘Some practices who have bulk added 104 codes to large parts of their population have had communications from their commissioners asking them for plans on how access is going to be given moving forward.

‘We would suggest a national approach is needed and the BMA is working with NHS England to achieve this. We advise practices do not need to take any action on this issue or any commissioner requests of you at the present time.

‘Practices who have not yet opted out, or who may wish to pause their systems at whatever stage of rollout they are at, may wish to write to their system suppliers to communicate this desire. System suppliers, as data processors, will abide by the instructions of the data controllers.’

NHS England declined to comment on the information, adding: ‘For all practices that have not requested EMIS and TPP to pause, we are continuing to work at pace to make the necessary changes to allow patients access to their information.

‘This will happen in a phased rollout, where suppliers will notify practices in advance of their planned switch on date.

‘Data will only be visible from the date of switch on, so there will be no additional requirement for practices to review information that may have been entered since the 1 November.

‘For those practices that have asked EMIS and TPP not to enable this change, we have instructed both suppliers to pause.

‘Recognising current pressures, we will continue to work with the BMA, RCGP and local commissioning teams to establish what further support is needed so practices can move quickly to offer all their patient’s prospective access.’

The BMA had previously suggested that an opt-in system might be the ‘safest and most effective’ way to roll out patient access to their records.

Last month, NHS England said more than 600 practices have now switched on access to new GP record entries, giving 2.3 million extra patients improved access through online accounts such as the NHS App, with ‘hundreds more’ practices set to join in February.



Please note, only GPs are permitted to add comments to articles

David Jarvis 1 February, 2023 6:22 pm

Surely the action plan is when we have some time to do it that is allocated funding commensurate with the volume. The big risk is in other parties details being within someone else’s records for many reasons but the biggest risk is in safeguarding. Checking every bit of every set of notes is a herculanian task. Who is responsible when it goes wrong? The people who decided this was a good idea or the GP ‘s as holders of the record within completely inadequate resources to thoroughly check all notes for problem?

Michael Green 1 February, 2023 9:09 pm

No means no

Paul Thornton 2 February, 2023 1:18 am

Given that the Information Commissioner is impotent, there is little to prevent patients being obliged, under financial, peer, familial, police and other societal pressures, to share their records. So called “enforced subject access” is supposed to be unlawful. This proposal that patients access their own records, in this particular manner, if adopted widely, has the potential to smash the remnant of privacy and confidentiality in our current medical records systems.

If a critical mass of patients sign up to this, others will be obliged to follow because it will become a requirement for accessing NHS and other services. “You have got to use the app”. It is that driver that underpins the proposal now.

It is pertinent to note, for now, that an individual’s decision, whether or not to use this records access facility, is itself a confidential, and potentially very sensitive, component of the patient’s record. So DH, NHS England, NHS Digital, Integrated Care Boards, Primary Care teams and others who want to force this roll out, have no entitlement whatsoever to be given identifiable (including “pseudonymised”) information about these choices.

A genuine, informed “opt in” requirement is the only safe, and legal, way for information sharing systems to be operated and the BMA’s apparent recognition of this, now, should replace their previous acceptance around “opt out” methods.

paul cundy 3 February, 2023 4:04 pm

Dear All,
And the answer to such an enquiry from your ICB or NHSE is this;

“We will provide access to patient records according to the terms of contract with you and the law.
Our contract with you requires us to respond to requests from individuals (i.e. no bulk exposure and no assumption that this is what patients want) and to provide access when suitable redaction systems have been made available by yourselves. That latter condition has not yet been satisfied.
When you have provided us with suitable redaction software we will then begin responding to requests from individuals.

The law says we must provide access via a SAR when requested. We do already and will continue to comply with that law. That law does not require us to provide live 24/7 access. That law says that if a SAR is requested only new data since the last SAR needs to be provided. That law also says if SARs are requested too often we may charge for them.
I hope this helps.”

by all means plagiarise or copy as you see fit.
Paul C