NHS England has published an update on the Citizens’ Access programme, intended to provide patients with automatic access to their digital medical records, including new entries made to the GP record.
The latest go-live date for the programme was 1 November 2022, however NHSE has stated that they recognise that there are a range of reasons as to why some practices may not feel that they are ready to proceed.
The NHS England statement notes: “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.”
For practices who do not inform EMIS and TPP to pause by this deadline, the change will be implemented as planned and all prospective data entered into records by 1 November will automatically become visible.
The practices who have instructed the suppliers to pause must develop and agree on plans to prepare for the change before their systems are automatically updated from 30 November 2022.
NHSE adds that “all practices can locally disable the functionality provided by the technical change and/or deny individual patient access, should they seem such action necessary” and sets out how this can be done. Practices can exclude individual patients or groups of at-risk patients by adding the appropriate SNOMED code to their records. Practices can also amend an individual patient’s configuration and hide individual elements from patient view.
In addition, guidance is provided on how to update organisational settings if practices wish to disable the record access functionality, and depending on the clinical system being used, practices can also disable access to components of the record that may be of concern.
“There is widespread international consensus about the benefits to patients and the effectiveness of the health system to provide digital on-demand access to personal health information,” NHSE’s statement reads. “Patients’ ability to directly access test results and referral correspondence saves workforce time fielding follow up enquiries. It can also support prevention and improving health outcomes, as patients can better manage their health and long-term conditions.”
It adds: “General practice retains full local rights, with a range of options to disable the new functionality and/or withhold patient access to some or all of their health information, to meet their obligations as data controllers and to ensure safe access. This means that there is no conflict between what GP IT suppliers are contractually required to do and practices’ compliance with their responsibilities under data protection laws.”
NHS Digital have updated their guidance to clarify this last point; it can be read here.
Dr David Wrigley, Deputy Chair of GPC England at the British Medical Association, said that the BMA was pleased to see that plans had been paused and noted that the BMA had voiced concerns that some practices might not be able to safely roll out the programme yet. He added: “Patient safety is at the heart of what we do, which is why any changes to the system – particularly default ones – should be carefully thought through.”
Dr Osman Bhatti recently attended a HTN Now event to discuss patient access to GP records in terms of what it means for practices, some of the challenges, and how practices can prepare. Watch or read Osman’s presentation here.
