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Essex LMC Document
National Patient Access To Records - a guidance document for practices
Author Karl Fuller
Date: May 23, 2024
National Patient Access To Records – Update

Accelerated access to GP-held patient records – update May 2024

BMA Update – May 2024

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BMA update – Thursday 2 November 2023

The Accelerated Access to Medical Records page on the BMA website has been updated today and can be accessed via the following link:

Accelerated Access to Medical Records – Latest BMA Guidance

The guidance covers:

  • Carrying out a DPIA
  • Implementing an opt-in model
  • Implementing an opt-out model
  • Providing access to patient records
  • Communicating with patients
  • Bulk enablement for EMIS practices

Further updated guidance

Accelerated Access to GP-Held Patient Records 2023

Accelerated Access to Prospective Records (PowerPoint Presentation)

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BMA update – Wednesday 11 October 2023

Following feedback received by the BMA, the Reference A part of the FAQ document was revised. The amended version is now live on the BMA website and can be found in the following link

BMA Guidance – FAQ document

The revised Reference A also speaks about what may happen after 31 October.

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BMA update – Saturday 27 May 2023

Please see the latest update from the BMA in our latest guide on page 25 which is available here: LMC Document – National Patient Access Records

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BMA update – Thursday 26 January 2023 – Reminder for TPP practices of their options before 1 February 2023 go-live date

The BMA has issued a further update:

As you will be aware, practices who sent in template letters asking their system suppliers not to enable the accelerated access programme are not currently part of this programme. Practices who did not send in letters (or equivalent) will have the accelerated access programme provisioned in due course. TPP is planning to activate the programme’s provisions on 1st February 2023 and affected practices should have been informed via a SystmOne Task earlier this month that this is the case. EMIS practices are being informed prior to going live when this will happen.

It is not too late to ask the system suppliers not to enact this change, assuming it has not yet happened. TPP has asked that practices make them aware via recordaccess@tpp-uk.com (please include a clear instruction, your practice name, address and ODS code), ideally by tomorrow (27th January). This date should have been communicated to you earlier in the year. The equivalent address for EMIS is aapostpone@emishealth.com. We have no oversight of how their rollout is progressing.

It has also come to light that some practices have added 104 codes in bulk (“Enhanced review indicated before granting access to your own health record”) but have not sent in template letters. This is sending a mixed message as the accelerated access programme will be provisioned, yet might have limited effect. If the code hasn’t been applied to 15-year-olds, for example, as they turn 16 they will get access automatically.

The BMA is working with NHS England to try to improve the programme and one part of this will be to determine how to deal efficiently with the 104 codes that have been added in bulk by some practices. Practices who have not yet opted out, or who may wish to pause their systems at whatever stage of rollout they are at, may wish to write to their system suppliers to communicate this desire. System suppliers, as data processors, will abide by the instructions of the data controllers.

Some practices who have bulk added 104 codes to large parts of their population have had communications from their commissioners asking them for plans on how access is going to be given moving forward. We would suggest a national approach is needed and the BMA is working with NHS England to achieve this. We advise practices do not need to take any action on this issue or any commissioner requests of you at the present time.

The original advice that the BMA issued last year remains available below:

https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/accelerated-access-to-gp-held-patient-records-guidance

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BMA update – Tuesday 29 November 2022 – Mass roll-out halted

The BMA has issued an update on the Patient access to medical records. Please find an urgent message from Dr David Wrigley, Deputy Chair, GPC England, regarding the roll-out of prospective access to GP Records, including FAQs, via the following link: GP access to records programme – GPC England statement (bma.org.uk)

A press statement can also be accessed here:  Halting of Citizens’ Access mass roll-out is the right thing to do for patients, says BMA – BMA media centre – BMA

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LMC update – Friday 4 November 2022, 10.30am

The issue of Accelerated Access to GP Records has caused a lot of anxiety and confusion for all. Whilst BMA/GPC are still in discussions, NHS England has published their guidance on it. As of the time of writing, if you submit a template letter to EMIS/TPP before 5pm today (Friday 4th November), you will not have the accelerated access programme turned on in the coming days. We understand practices who don’t send in letters will be contacted in due course by the system suppliers to inform them of their go live date. The template letter is available here and can be sent to:

EMIS: aapostpone@emishealth.com

TPP SystmOne: recordaccess@tpp-uk.com

NHS England continues to maintain that prospective access will be provisioned for all patients without the ‘enhanced review indicated’ SNOMED code (the one ending in ‘104’) at the end of November, regardless of whether any template letters were sent by the relevant practices to the system suppliers.

BMA guidance is here and also in the below link:

https://www.bma.org.uk/advice-and-support/ethics/confidentiality-and-health-records/accelerated-access-to-gp-held-patient-records-guidance

NHS England guidance is here:

https://digital.nhs.uk/services/nhs-app/nhs-app-guidance-for-gp-practices/guidance-on-nhs-app-features/accelerating-patient-access-to-their-record/update-from-nhs-england

We support patients accessing their records but feel that this should be done in a safe and phased manner; to educate patients, mitigate workload and risks involved with GDPR issues.  Patient Access to the Prospective Medical Record is on an “OPT-IN” and NOT an automatic basis. If you feel that you are not ready to offer access to all your patients, please send the template letter by 5pm today, or blanket code all patients with the SNOMED Code ending in 104. NHS England feel that this will bring additional workload by having to individually process requests from patients in future, but it will allow for practices to control workload and do so in a way that does not affect delivery of care in a safe manner.

If you have any questions pertaining to this matter, please do not hesitate to contact the LMC office or your ICB IG Lead/DPO:-

Mid & South Essex ICB                                Jane Marley                     jane.marley@nhs.net

Suffolk & North East Essex ICB                  Paul Cook                         paul.cook14@nhs.net

Herts & West Essex ICB                              Ruth Broughton               ruth.broughton@nhs.net

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LMC update – Monday 31 October 2022, 4.00pm

The LMC understands that there have been developments at a national level in regard to the roll out of Access to Patient Records which is scheduled to be implemented from tomorrow, 1st November 2022.  It is reported that both TPP and EMIS have announced that they will not be making any practice level system changes tonight and that discussions are ongoing.

This is obviously a rapidly changing situation, and we are awaiting further updates from the national team.

We are aware that North Central London ICB has issued guidance to its practices to apply a blanket SNOMED code 104 to all patients (attached).  We have also been copied into an e-mail to practices in Mid and South Essex this lunchtime from the ICB which highlights the potential workload associated with having to review patients individually following such action.

We will share any updates with practices as soon as we receive them but at this time are not expecting any further information until late afternoon today at the earliest.

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System changes in respect of patient online access to GP records are now expected to go-live on 1st November 2022. The NHS England letter dated 21st July 2022 here provides more information, and there are some useful links and resources in Annex A.  You can also find more information on the NHS Digital website:  Access to patient records through the NHS App – NHS Digital

The LMC continues to discuss with Jane Marley,  Head of IG and DPO for Mid and South Essex, how best to raise awareness, prepare and support practices in regard to the switch-on.  Jane, in turn, liaises with the DPOs for North East Essex (Paul Cook) and West Essex (Ruth Broughton).   The latest guidance and resources are currently being collated and we understand a dedicated page will be set up on the MSE ICS website.  This information is also be accessible via our continued updated version of the LMC Guidance Document, National Patient Access Records (see below).

To further support practices to prepare for the national switch on, the LMC will be running another series of  information sessions in early September 2022 facilitated by Jane Marley.  These will be open to all Essex practices, lunchtime and evening sessions will be available but places will be limited in order to aid any Q&As.  The booking process is again being supported by EQUIP and links to register for each session can be found below:-

Monday 5th September 1:00-2:00pm

Tuesday 6th September 7:00-8:00pm

Wednesday 7th September 1:00-2:00pm

Thursday 8th September 7:00-8:00pm

Monday 12th September 7:00-8:00pm

Tuesday 13th September 1:00-2:00pm

When registering, you will be asked to log in via your EQUIP account.  If you do not have an EQUIP account, it is a simple registration process.  (Please note that you need to book directly via the links above, the sessions are not visible on the Equip event pages).

For our full guidance document for National Patient Access to Records , please click on the following link below:

Latest Version

LMC Document – National Patient Access Records v7 30082022

Updates in this version includes:

  • Page   22- Summary of information/guidance for GP Practices on Patient Access to Records

Docman User Guide

The Docman user guide for Patient Visibility Functionality is available here

 

Getting ready for patient full access to GP records

The NSXI Implementation Team have produced a ‘Citizen Experience’ guide which can be found here.

 

Further Documents

Blueprint Document

Template Data Protection Impact Assessment

GP Practice Readiness Checklist

Process by which the instructions were created for the addition of the code, “enhanced review indicated before granting access to own health records” to the record of any patient that may lack capacity

 

Frequently Asked Questions

A detailed document of FAQ’s is available on this link: Accelerated Access to GP Records FAQs

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Previous Versions

LMC Document – National Patient Access Records v6 – 21072022

Updates in this version includes:

  • Page   21 – Offering patients access to their future health information (update: July 2022)

 

LMC Document – National Patient Access Records v4 – 08032022

Updates in this version includes:

  • Page   16 – Link to patient.info website with list of medical abbreviations added

 

LMC Document – National Patient Access Records v3 – 17022022

Updates in this version includes:

  • Page   5 – New page added for Risks, Exemptions and Serious Harm Test
  • Page 13 – New page added for Redaction in the TPP system
  • Page 14 – New page added for How to review what the patient will see
  • Page 15 – New page added for Enabling prospective access in System One/TPP
  • Page 16 – New page added for Docman user guide for Patient Visibility Functionality

 

LMC Document – National Patient Access Records v2 – 10022022

Updates in this version includes:

  • Page  3 – Opening paragraph amended
  • Page  9 – New page added – Exporting Patient Medical Records
  • Page 10 – New page added – Medical record documents (part one)
  • Page 11 – New page added – Medical record documents (part two)

 

LMC Document – National Patient Access Records v1 – 03022022

 


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