NHS England plans to enable patients to request their historic GP records through the NHS App from next year.
Automatic access to patients’ prospective GP records via the NHS App is due to be switched on next month, and many GP leaders are continuing to express concerns around the workload implications of this.
But NHS England has gone further, confirming that historic access will be brought in next year, although ‘phased in carefully’ to ensure general practice is ‘not overloaded with requests.’
The RCGP has supported the access to prospective records, but chair Professor Martin Marshall said retrospective access is an ‘entirely different’ and ‘much more complex proposition, especially at a time when GP teams are working under immense workload and workforce pressures.’
He said GPs would need ‘a great deal of time’ and ‘additional support’ to prepare for records access to be extended further.
Professor Marshall added that there are ‘technical issues, such as ensuring sensitive records remain redacted when patients transfer between practices, which would need to be addressed prior to any consideration of widening historic access to records.’
He said: ‘With the prospect of a very tough winter ahead for general practice and GPs already taking on additional responsibilities, such as managing cases of long Covid and the care of patients who are on long waiting lists for hospital appointments due to pandemic backlogs, it’s impossible to see how this could be prioritised and provided by 2023.’
Phil Booth, coordinator of campaign group MedConfidential, pointed out that ‘it can be a lot of work to remove the information about other people from a person’s GP record, which is necessary because you only have a right to see your own information.’
He said: ‘The Government seems to assume GPs will do all this work on access to people’s historic GP records for free – on top of everything else they must do.’
NHS England said enabling patients to request their historic records in 2023 through the NHS App will be ‘phased in carefully to ensure general practice is not overloaded with requests.’
It said: ‘We are not changing the need for a patient to request access to their historic information, and plan to digitise this process so that it is easier for patients and general practice.’
The change has been met with safeguarding and practice workload concern from clinical leads, with the BMA writing to NHSX last November to ‘outline concerns about the impact on patients and doctors.’
NHS England has acknowledged there may be ‘challenges for a minority,’ and said this is ‘especially true in relation to safeguarding vulnerable adults.’
It said that ‘GPs will need to consider the potential impact of each entry, including documents and test results, as they add them to a patient’s record,’ and will need to ‘know how to manage this as a change to workflow.’
Mr Booth said: ‘While patient access to their GP record is obviously a good thing in the vast majority of cases, there are some circumstances in which it can be medically unwise – or even unsafe – for a patient to be reading what their doctors are doing as they are doing it.
‘Also, a medical record can be pretty difficult to interpret, and no one at NHSE or DHSC seems to have considered the time, effort and resources it will take to support patients who need help with that.’
He added that they ‘don’t appear to have considered the possible chilling effects that “near real-time” patient access may have on clinical candour either.’
Recently-published guidance from the RCGP had said GPs will need to spend time redacting prospective records once automatic patient access goes ahead.
It comes after a study found that patient access to records could cause extra work and impact patient safety.
The road to automatic patient record access
NHS Digital had first intended for patients whose practices use TPP would be first to have access to new entries in their GP notes through the NHS App from December 2021 – with EMIS practices to follow this year.
But the launch date was delayed until April 2022 for both systems, after the BMA wrote to NHSX expressing its concerns about the timing of the rollout.
It was then delayed again, with NHS England recognising concerns around ‘safeguarding’, but it remained unclear when the launch would finally take place.
Under the plans, patients will not be able to make changes to their GP records at this time, although a Government white paper published in February said that plans were ‘underway’ for patients to be able to access and contribute to their shared care record.
In 2019, NHS England said GPs did not have to allow patients to access their full records if they contain sensitive information that can’t be redacted, despite contractual requirements.
A version of this story was first published on our sister title Pulse.
