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GPs will have to re-redact records when patients move practice

GPs will have to re-redact records when patients move practice

GP practices registering new patients will have to repeat the work already done by the previous practice of redacting their record, official guidance has said.

From next month, patients will automatically be able to read new entries – including free text, letters and documents – in their GP health record through the NHS App. 

But official guidance has revealed that patients moving practice will lose access to any data from their previous surgery, meaning that if they request this again their new practice will have to repeat the process of redacting their records.

It comes as the BMA has called for the change to be delayed again and said it is having ‘urgent discussions’ around the new requirements, with guidance set to be issued within the coming days.

What does official guidance say?

NHS England FAQs set out that when patients register with a new practice, only new records from the date of registration will be visible, with any records previously accessed since 1 November lost. 

The guidance, hosted on NHS England’s closed FutureNHS portal and seen by Pulse, said: ‘When a patient registers at a new GP practice from 1 November 2022, they will lose any access they had to historical information but will automatically get access to their future record in full from the date they join that practice. 

‘If a patient would like to access their historical information (detailed coded record or full), they will have to request this and the new practice will need to review and redact if necessary.’

A local update from South West London integrated care board (ICB) to practices last week, also seen by Pulse, said that practices should alert the new practice to any entries they previously restricted since ‘online visibility settings’ are not part of a GP2GP transfer.

It said: ‘If a patient has some entries restricted online and leaves the practice, we recommend you have local procedures in place to contact the patient’s new practice regarding the matter. 

‘Adding a patient warning would alert you to any restricted entries when, for example, you load the patient record.’

Meanwhile, the SWL ICB update also revealed that all EMIS GP practices will need to make changes to their clinical system to enable record access in order to avoid breaching their contract.

Practices that do not ‘enable their global system settings’ will be ‘unable to meet their current GMS contractual obligation to provide full record access upon written request and patients will not receive access to their prospective records in November 2022’, it said.

It remains unclear whether the requirement applies to practices using systems other than EMIS.

London GP partner and GP Survival co-campaign lead Dr Nick Grundy warned that NHS Digital has not yet ‘put in place any of the tech required to make [prospective notes access] work’.

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He added that it is ‘pure comms crap’ to say people have full access to their notes when they will ‘lose it all again’ as soon as they move practice.

He said: ‘The whole programme is yet another PR exercise by NHS England and one which characteristically seeks to solve a problem which doesn’t exist.’

‘Characteristically, again, NHSE piles a load of pointless bureaucracy on practices, without any functioning IT to support, so they can witter on about the “transformative” programmes they’re embarked on.

‘This is not transformative. It is a waste of everyone’s time.’

Speaking at the Best Practice conference in Birmingham this week, GPC England deputy chair and IT policy lead Dr David Wrigley said the BMA is ‘having urgent discussions’ and ‘will be issuing clear guidance early next week’.

Dr Wrigley told Pulse: ‘The BMA is concerned that the proposed model to centrally switch on default access to all GP patient records from 1 November will put patient data and safety at risk, as it is not consent driven. 

‘There are also many concerns over the increased workload involved in this rollout and to expect GPs to review 61 million records is wholly unrealistic.’

He added: ‘We urge NHS England and Government ministers to reconsider the current go-live date and revisit the default access to records model for every patient in England.

‘We are, of course, keen to discuss possible solutions to design safe records access that works for everyone. As a consequence, we cannot support the project as it currently stands.’

The BMA previously said it had ‘not received satisfactory assurance that the citizen access to records programme scheduled to roll out on 1 November can go ahead’.

It said that the ‘necessary planning and resourcing required to launch the programme at this time cannot be put in place to enable a safe and successful rollout’.

At the same time, an NHS England blog this week committed to the rollout in ‘just under three weeks’ time’.

An NHS England spokesperson told Pulse: ‘Offering people access to their medical records is not only beneficial for patients in helping them manage their health, but it also helps practices manage demand better with people able to access information including their test results on their smartphones, where they feel comfortable to do so, instead of having to contact their practice.’

NHS England stressed that there has been extensive and ongoing engagement on records access and that it notified GP practices in July of the change coming on 1 November with all the detail they would need to prepare and comply by this date.

It added that it has worked closely with GP IT system suppliers to develop the required technical capability and that practices should contact their commissioner where they see challenges with providing the necessary safeguards. 

As well as prospective records access, Pulse revealed earlier this week that NHS England plans to enable patients to request their historic GP records through the NHS App from next year.



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

Darren Tymens 17 October, 2022 4:34 pm

And where is the extra staff and extra funding required to deliver this? how many appointments each week should we cancel in order to switch staff to redact thousands of notes?

Patrufini Duffy 17 October, 2022 10:21 pm

This is the wrong public to try this stunt on.
In your ivory tower and boardrooms it looks all tranquil and colourful on the bar charts and feedback pie charts. You haven’t got a clue about the service user. You think they’re all fairy tales. On the ground floor, you’re going to find this mess ending back at your door. Ignorance is painful, not bliss.

David Banner 17 October, 2022 11:43 pm

Since nobody in their right mind would spend endless unfunded millennia trawling through and redacting records, virtually everybody will cross their fingers, ignore it and hope it goes away.
And when the inevitable complaints come pouring in, NHSE will shrug, show the punters these ludicrous guidelines , then hang us out to dry.
This is the very definition of being set up to fail.

Nicholas Grundy 19 October, 2022 12:01 pm

Worth noting NHSE’s response: “Offering people access to their medical records is not only beneficial for patients in helping them manage their health” In fact, it’s not *at all* beneficial for patients – there is precisely zero evidence it helps patients manage their health. This is just a lazy, throwaway statement from NHSE in the hope no one will argue against ‘helping patients manage their health’ in a vague and imaginary way.

“but it also helps practices manage demand better with people able to access information including their test results on their smartphones, where they feel comfortable to do so, instead of having to contact their practice”

This doesn’t help demand, it creates demand.

Also, it’s not technically possible for patients to access results on their smartphone, I don’t think – NHSE literally don’t know what their own changes mean for patients.

Just Your Average Joe 19 October, 2022 1:26 pm

I bet pretty much No gp practice in UK has looked at any records and almost nothing has been done to prepare or redact records. Even if they paid it would be a waste of time and resources.

It’s a potential 5h1t show waiting to happen as wife accesses husband’s record online to find he is being seen for depression as caught STD after his last business trip.

Or patients see record about how they are hypochondriac after 15th consultation for tiredness and decide to sue etc

No real benefit to patients as patient records have 1 purpose only, to supporting healthcare professionals manage patients care, not for patients to see No matter what yhe fairy-tales NHSE are rolling everyone.

Richard Greenway 19 October, 2022 2:47 pm

Please postpone this.
It will expose GP partners to more litigation or fines from ICO -just for not being able to do the impossible.
If we add codes to records blocking online access, patients will challenge us -what do we say to them? they can just put in an SAR anyway.
There are also significant risks to allowing immediate access to all data in records -particularly in domestic violence and child protection scenarios, where access to data from perpertrators is likely.
To expect GPs to read all prospective (and shortly retrospective) records and redact /interpret is bonkers.

Malcolm Kendrick 22 October, 2022 10:20 am

As the NHS collapses and GPs leave the profession in droves the NHSE decides this is a perfect time to load on vast amounts of more unfnded work. Do they believe that actions have no consequences. I supose they must.

paul cundy 24 October, 2022 9:33 am

Dear All,
It matters not a jot what SWL ICB think or say. We are the Data Controllers of our patient records. Only a Data Controller can instruct their Data Processor what to do. Data Processors cannot lawfully respond to instructions from anyone except their Data Controller(s). If they did they could be fined up to 10% of their global earnings (think about that Amazon, who host EMIS’s documents). So unless we tell EMIS to turn on this access it won’t happen.
EMIS and TPP have helpfully provided e-mail addresses that we can send our instructions to;

and for TPP

Its all in para 59 of DPA 2018, notably sub para 6(a).
Paul C

Reply moderated
Gary Rogers 24 October, 2022 10:56 pm

I thought that GPs owned the copyright to their written notes. Which is probably why access is lost once a patient changes practice, as their new GP wouldn’t be able to give consent to access another GP’s (practices) copyrighted notes. It’s simply a matter of intellectual property then I suspect, and brought about by our independent status rather than being employed as Crown employees ( as the Crown would then own copyright).
Obviously this raises the question of whether we should place copyright notices on any such notes, so that patients can’t simply pass them on to commercial organisations such as insurance companies.
And has the problem of removing other copyrighted material, such as hospital letters , private letters and from non NHS organisations been sorted?