GP online services toolkit

Providing GP online services

The first section of the Toolkit presents guidance on how to organise and provide GP online services and supporting resources that you might find helpful. 

Practices in England have been required by their contract to offer online services since 2015 and full prospective record access since 2019 and have well established policies and procedures in place.  The majority of people in England have access to their practice’s online services with over 50 million transactions a month.  

Nevertheless, this section may be useful to practices seeking to improve their management of online services or to practice team members who are new to GP Online.

Each supplier has interpreted the requirement to provide record access slightly differently.  This Toolkit does not replace your IT system supplier’s training materials in explaining exactly how to use your systems for GP online services.

Section: Providing GP online services 

Patient registration for GP online services

Patients may register for GP online services without applying to their practice.  Several patient facing services (PFS) apps and web portals work with NHS Login, which people can use to prove who they are safely and securely so they can be connected to their NHS records. This enables access to book and cancel appointments, request prescriptions, and access their full prospective record without needing to come into general practice.  In rare circumstances, patients may still need to apply to the practice to obtain login credentials so they can have their identify verified to use NHS Login, or to use an app or web portal that does not use NHS Login. They will also need to apply in order to access their historic record or consent to a trusted third-party having proxy access to their GP online services on their behalf.

This section describes how practices should manage applications for GP online services, including the steps to clinically assure the safety of historic records for online access, to verify the identity of applicants before they are given login credentials and ensure that applicants understand how to make best use of their services and how to maintain their privacy by keeping their record access secure before their access is switched on.   

• Websites and apps you can use with NHS Login, NHS.uk, – lists apps that patients can use with their NHS Login to access online NHS services.

Section: Patient registration for GP online services

GP online services in clinical care

Improving the care of patients with multimorbidity remains one of the most important challenges facing general practice.  It requires a consistent emphasis on collaborative care planning, solution-focused coaching, goal setting and action planning by health professionals taking into consideration the patient’s personal goals and priorities to enable patients to work in partnership with their health professionals. Patients need accessible and trusted information delivered through reliable sources and effective communication with their health professionals.  Online access to their health record is an essential part of this. 

Online services can also bring benefits for the practice.  It can save time when patients use it to book appointments, order repeat prescription and check recent test results and hospital reports.  “Did not attend” rates are lower with appointments booked online.  Communication is less prone to error and patients can use record access to prepare for consultations, saving time in the consultation and improving patients’ ability to make decisions about their care.  Patients can help to improve the accuracy of their record. 

Section: GP online services in clinical care

Working with online record access - the challenges

This section of the Toolkit discusses the impact of online record access on the work of everyone in the practice team who enters or files new information in patients’ records or discusses GP online services with patients.  This includes temporary staff, including locums and trainees.  It should be remembered that any patient may obtain record access at any time and safeguarding risks may fluctuate.  It covers  data quality, potentially harmful information and clinical safety. 

Section: Working with online record access - the challenges

A note on this iteration of the Toolkit

The GP Online Services Toolkit is intended to support and inform general practice teams who are offering online services for their patients, including transactional services and record access.  It updates the previous guidance provided by the RCGP, in collaboration with NHS England.  It does not cover online consultations.

Supporting information

• Patient online: The Road Map, RCGP, 2013 (1.9 MB PDF) – Report on workshops held to define the professional standards for the provision access by patients to online services (booking and cancelling of appointments, ordering of repeat prescriptions), online communication with the practice and online records.  

Acknowledgements 

We would like to thank the many people who have given their time to contribute to the material on this toolkit.  

Our thanks go to Dr Imran Khan and Dr Joy Shacklock for their work this year on automatic record access; Dr Nutan Patel, Joyce Pickering, Dr Geoff Schrecker and Dr John Lockley for their work on the previous iterations of the Toolkit.  Thanks to Dr Ralph Sullivan, RCGP Clinical Champion for Patient Online for leading the work from the beginning.  And lastly, we would like to acknowledge the invaluable support and input from colleagues at NHS England and many more organisations who have shared their knowledge and insight with us over the years.