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Automatic patient access to records to be switched on by new deadline of 30 November

by Costanza Potter
2 November 2022

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GP practices have until Friday 4 November to request system suppliers EMIS and TPP delay automatic patient access to records, NHS England has confirmed in new guidance.

However, the functionality will be switched on at the end of the month on November 30, it said.

Practices wanting to push back the start of the Citizens’ Access programme, which allows patients to view their prospective GP record through the NHS app, can do so by informing EMIS or TPP by 5pm on 4 November.

GP practices that don’t meet this deadline will see the change introduced earlier in a phased manner, with prospective data entered into patient records from 1 November becoming automatically visible.

NHS England’s update follows confusion over the scheme, which was due to go live yesterday.

Both EMIS and TPP had said in recent days they would not be making any practice-level system changes, after ‘requests from many GP practices’ with ‘GDPR and/or patient safety concerns’.

Yesterday, the BMA said that the functionality would be switched on this month after all, despite the assurances otherwise.

Guidance updated last night revealed that NHS England has instructed EMIS and TPP to ‘pause’ the rollout until the end of the month for practices that ask them to do so by a set deadline.

NHS England said: ‘For those practices that ask EMIS and TPP by 5pm on 4 November 2022 to not enable the change, we have instructed both suppliers to pause.

‘These practices must use this time to engage with their local commissioners should they need additional support and agree plans to prepare before their systems are automatically enabled from 30 November 2022.’

All practices that do not meet the deadline will have the change introduced ‘in a phased way’, it added.

It said: ‘For all other practices that will not have informed EMIS and TPP to pause by 5pm on 4 November we will continue to work with EMIS and TPP to implement the change as planned, with prospective data entered into patient records from 1 November 2022 automatically becoming visible in a phased way.’

However, NHS England added that all practices ‘can locally disable the functionality’ and/ or ‘deny individual patient access’ if they ‘deem such action necessary’.

They can do this by:

  • Adding exclusion SNOMED codes to individual patients’ records or those of groups of ‘at-risk patients’ ahead of the switch on
  • Amending an ‘individual patient configuration’ or redact the records after the switch on
  • Updating the practices’ organisational settings to disable the record access functionality
  • Disabling access to ‘components of the record that may be of concern’ such as documents, depending on the clinical system being used.

Dr David Wrigley, deputy chair of GPC England at the BMA, said: ‘These day-by-day changes to the Citizens’ Access programme are incredibly concerning. It is absolutely not the way to handle such an important issue. Practices are understandably worried about what this means for them and their patients.

‘Fundamentally, the issue of safety remains. Safety for patients and safety for practices. The profession, as well as the BMA, has repeatedly raised concerns that practices who are not yet ready, need time to properly prepare and carefully review data in order to protect patients.

‘We need safe deployment when it comes to a system-wide change like this, not just high-level announcements with no detail for those actually involved in doing it. Implementing technical changes within live clinical environments in a way that could negatively impact patients’ lives is unacceptable. We urge NHS England to not only communicate, in detail, with the profession, about what is happening, but also to seriously reconsider the patient safety implications of hurrying out a programme like this.

‘In the meantime, the BMA is committed to supporting practices and has compiled guidance on what to do.’

Arrangements for practices which use Vision as their clinical system are still under discussion.

A version of this story was first published on our sister title Pulse.