GP online services toolkit

GP Online Services is an efficient and effective method of providing patients with access to their current GP clinical record, which empowers patients to manage their health. It is particularly useful for patients with multiple long-term conditions, and their carers, because it enables them to take a more active role when, for example, preparing for consultations, reviewing care plans and hospital reports, and making informed decisions about what matters to them as part of a person-centred approach to care.

Practices in England have a contractual requirement to offer the prospective record. Patients who have a patient facing services account and app will have automatic access to their full prospective record (with the exception of administrative messages and emails about the patient).  Practices may offer online access to the full record, including past information to patients and trusted proxies. Practices must  ensure that the record is safe to share and that the patient is not subject to coercion to share their record unwillingly.

When patients move general practice, they will lose access to their record at their previous practice. They will usually gain automatic access to new record entries at the new practices but will not be able to see their previous practice’s record anymore.  If they want to have access to that data again, they will have to apply to gain access any record transferred from the old practice.  

In certain circumstances, if patients may not be able to protect the privacy of their online record, it may be safer to limit a patient’s online record access.  Ideally this decision should be done in collaboration with the patient.

The risk that patients may view harmful information or confidential third-party information online or may be coerced to share their record with others places a responsibility on practices to maintain high quality records, ready to be shared with the patient, and, when necessary, to consider withholding record access from the patient.  The practice is responsible for ensuring that any potentially harmful or confidential third party information in the patient’s record is not visible to the patient online.  Such information should be redacted.  This prevents it being visible through GP online services but does not affect the visibility of the information in the practice and when shared for direct patient care or used for decision support software and clinical audit.

• Infogram - Reception process for applications for practice online services (50 KB PDF) – seven steps to receive and complete an application for any GP online services
• RCGP Application form template (267 KB DOC) - a template for patients to use to apply for GP online services.  It includes a series of statements that the patient should agree to before access is agreed.
• Proxy access consent form (37 KB DOC) – a template for practices to use to record consent from patients for a trusted third-party to have proxy access to any of their GP online services
• Information governance (93 KB DOC) - brings all the guidance on information governance for the practice’s GP online services, including the data protection policies you may consider developing into one place.
• Patient Information themes for GP Online Services (88 KB DOC) - a list of suggestions for topics that you may wish to include in practice publications about your online services.
• Flowchart - new patient registration and auto access (171 KB PDF) – a guide to manage automatic record access for a new patient registering with the practice.

Subject Access Requests

The Information Commissioner’s Office (ICO) has agreed that practices may be able to comply with a subject access request (SAR) from a patient under data protection legislation by offering to provide a patient with online access to their full health records. This applies to requests on behalf of the patient from legal representatives and insurers. However, if the record is not fully digitised, paper copies may need to be provided on any data, including letters and reports, not available online.