GP online services toolkit

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. 

• Coercion (154 KB DOC) – Guidance on the impact of coercion to share record access with a third person or failure to maintain the privacy of online record access.
• Safeguarding and automatic record access (733 KB DOC) – Guidance on managing safeguarding risks and online record access.
• Safeguarding vulnerable groups (838 KB DOC) – Guidance on how specific groups of vulnerable groups of patients may not be able to manage online record access safely.
• Online GP records access for sectors (159 KB DOC) – Guidance on GP online services for other organisations.
• The RCGP has several resources in its adult safeguarding toolkit and child safeguarding toolkit on domestic violence that are relevant to the topic of coercion.
• NICE has succinct advice on recognising and responding to evidence of domestic violence or abuse and in their guidance on domestic violence and abuse: multi-agency working.
• Safelives provides many useful resources on coercion and domestic abuse, including resources for GPs and guidance on identifying domestic abuse.