Working with online record access - the challenges

Clinical safety

Patients who are subject to controlling coercion by an abuser are the most common group at risk from record access

Patients who register for the NHS App will automatically receive access to book and cancel appointments, order repeat prescriptions and record access.

If the patient is not able to keep these services secure, providing access  could allow abusers to monitor:

  • If the victim has revealed abuse
  • If the victim has accessed healthcare, especially issues like injuries, mental health, contraception or sexual health
  • Evidence in documents that other agencies have recognised abuse
  • Infer any of these from the absence of expected consultations or documents in the online record.

The Toolkit has guidance on how to recognise coercion and the safeguarding risks. This is relevant to every patient, not just those who currently have record access or who may currently have known safeguarding risks.  Any patient may obtain access, and safeguarding risks may fluctuate.