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.
London GP partner and GP Survival chair Dr Nick Grundy warned that NHS Digital has not yet ‘put in place any of the tech required to make [prospective notes access] work’.
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 last 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 said: ‘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 said: ‘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, NHS England plans to enable patients to request their historic GP records through the NHS App from next year.
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, 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, 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.
A version of this story was first published on our sister title Pulse.
