Citizen access to records - advice for GP practices

From April 2022, patients with online accounts will be able to see new entries in their records. We answer your questions on how it'll affect your practice.

From April 2022, patients in England whose practices use the TPP and EMIS systems, and who have online accounts, will be able to see new entries made in their clinical records. Here are answers to some of the questions this may raise for practices.

Will patients have to ask for access to new entries in their records?

For existing patients already using online access, the change will be made automatically. New users set up with online access from April 2022 will have the same level of access by default. Clinicians and other practice staff will, therefore, need to bear in mind that patients will be able to see what is written in new entries. There is more information on the new access arrangement from NHS digital.

The MDU's advice on online access to records includes that those involved in creating the record think carefully about the purpose and content of the records and the impact they may have on patients reading them.

Will patients also have access to historic records?

The aim is that patients will be able to access historic records through the NHS app at some point during 2022. However, they will not see past health record information unless they have been given access to it by their GP practice. This will give practices the chance to review records to ensure access is appropriate.

Can online access be withheld?

Yes - where a practice believes that online access would not be appropriate, access can be customised or removed.

Will patients be able to see test results?

Yes, but these can only be accessed by the patient once they have been checked and filed. This is to allow clinicians an opportunity to contact patients and discuss their results with them first.

Will there be any benefits to the practice?

Yes. It is hoped that it will support patients in managing their own health, and will reduce queries to practices where test results are negative as well as queries about referral letters.

Will access only be available for patients using the NHS app?

No, it will apply to other approved patient facing services apps - for example, Evergreen, Airmid, SystmOnline and Patient Access.

What information will patients have access to?

They will have access to their full GP health records including free text, letters, and documents, but not administrative tasks or communications between practice staff.

What about proxy access?

The change does not apply to proxy access. It only applies to competent people accessing their own record through their own online account.

Can information in the notes be redacted (eg, third-party information) in the same way as for a subject access request?

There may be no way of redacting records successfully, and documents containing reference to a third-party should therefore be hidden from view, unless you have the consent of the third-party.

What if there's sensitive information in the records, such as child or adult safeguarding concerns?

Safeguarding the patient from harm is paramount. It may be necessary to hide documents from view, like those containing sensitive information or third-party information such as reference to family members or to remove online access.

These concerns have been acknowledged, and to help clinicians mitigate the risk, the RCGP is updating its patient online toolkit, in conjunction with safeguarding experts. This will help clinicians redact information in the record or prevent specific information, which has been entered into the record, from being shared within the patient's access to the system, preventing them from viewing it.

This page was correct at publication on 10/03/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Kathryn Leask MDU medico-legal adviser

by Dr Kathryn Leask Medico-legal adviser

BSc (Hons) MBChB (Hons) LLB MA MRCPCH FFFLM MRCPathME DMedEth

Kathryn has been a medico-legal adviser with the MDU since 2007 and is a team leader, trainer and mentor in the medical advisory department. Before joining the MDU, she worked in paediatrics gaining her MRCPCH in 2002 and did her specialty training in clinical genetics. She has an MA in Health Care Ethics and Law, a Bachelor of Law and a Professional Doctorate in Medical Ethics. She is also a fellow of the Faculty of Forensic and Legal Medicine and has previously been an examiner and deputy chief examiner for the faculty. Kathryn is currently a member of the faculty’s training and education subcommittee and a member of the Royal College of Pathologists (medical examiner).