Find out about the latest data sharing initiative, otherwise known as Accelerated Access to Records, or Citizen Access to Records
This page was updated on November 3, 2023
This is also known, by government, rather disingenuously, as Citizen Access to Records* and also known, rather confusingly, as Online Access to Records**.
As part of imposed contract changes on GPs, NHS England is forcing GPs to automatically grant access to patients’ medical records through the NHS app and other online portals from October 31, 2023.
Please note, this is separate from the existing processes already in place where patients can apply for online access to their records. In this existing process, individuals apply for access, we then take a look at the record, make sure nothing untoward is taking place with either the application or contents of the record, and access is then switched on for that individual patient. This has been happening for years with no major concerns - we have no problem with patients applying for online access in this way at all, and such applications are dealt with ad hoc as they arise, but in a controlled manner.
We don't have a problem with online access. In fact, over the years, we have actively encouraged online access as a practice, and about half of our patients already have an online account with some form of access, using such access, for instance, to order repeat prescriptions.
What is happening with the imposed changes, is that wholesale access to records must be automatically switched on for all patients. GPs and GP leaders are concerned about this.
The concern already expressed has largely been around the 'accelerated' bit of the process. We would argue that barely hidden agendas are also a concern. After previous abortive attempts at obtaining medical records data from GP surgeries (through the ironically named 'care.data' initiative and the confusingly named 'GPDPR' initiative), the government has now imposed a contract upon GPs where we have to switch on prospective access to records for all patients, regardless of their wishes.
The intentions are that once prospective access is fully in the bag, retrospective access will then be enforced, meaning the entire GP medical record, past, present and future becomes accessible externally, as was the original intention of the previous attempts at gaining access to medical record data.
One must therefore question the motives of government, when the GP contract is being used, quite inappropriately, to expedite a political process. So, despite well-voiced concerns about how the government has handled such initiatives in the past, it has now circumvented any consultation process with GPs and the public and instead has used the GP contract to push through its political agenda to try and get its greedy hands on your data.
Even ignoring the agenda behind this move, as GPs and the data controllers of your record, we have major problems with it:
You can read more about the risks in the section immediately below or skip to what we're doing about it.
As data controllers of your record, we have a duty to safeguard your data. This duty overrides any contractual duty as a GP.
In accordance with BMA guidance, we have conducted a risk assessment on the following areas (examples):
Are these risks overstated? Put simply, no. Other organisations and agencies, including the Information Commissioner's Office, have expressed concern:
After conducting our own risk assessment, we at Ivy Grove Surgery, like many other GP surgeries, have concluded that, in order to mitigate the risks, some of which are outlined above, it would be prudent to switch access on only for those patients who specifically request it (or have requested it in the past).
We have decided to take active steps to safeguard your data, and will only switch on access to records for those who ask us to, or for those who already have records access.
Basically, we're taking the 'accelerated' bit out of the equation; this gives us a chance to check your understanding and be sure that, not only access is what you specifically want, but also that access to your data is safe for you.
So, for those who have not already got online access, and for those who already have online access, but no access to records (for example, you use online access only to order repeat prescriptions), we will take steps to safeguard your data to prevent automatic switch on.
We will notify you by text and inform our Data Protection Officer, the ICB (health board) and the LMC (our local GP committee) of our response.
For those who already have online access, specifically including access to records, we are not going to do anything. Access will be granted automatically. But if you don't want this to happen, please see below.
As we have already taken steps to safeguard your data, you don't have to do anything. If you ever want access, just apply as you would normally, no problem.
What else you can do depends on your situation:
For example, you're not sure and need more time to think, or you don't want the current situation to change
As indicated in the notice box above, please don't worry if you end up doing nothing. By October 31, 2023, we will have taken steps to safeguard your data, as described in the above section 'What is Ivy Grove doing about it?'. At any point in the future, if you want access, or if your situation changes to any of the other scenarios below, simply let us know, not a problem.
For example, you are an abuse survivor and want to reduce the risk of your abuser getting their hands on your information, or you had online access to records and no longer want it
Please let us know and we will add a code to your notes to prevent records access .
If you are in this group you can also respond to the text questionnaire that we will send out to all patients and decline access and this will add the correct code to your medical record to remove access.
You can also decline access by completing the form below. Please note that for obvious reasons, we will not use the contact details you supply to get in touch with you or to confirm your decision.
And don't worry, if you ever change your mind, or your circumstances change, and you then decide you want access, simply apply for an online account (go to scenario 3 below).
For example, you don't have an online account at all, but would like to have records access
Apply for online access in the usual manner. Please follow the directions at our online service page to register for an online account.
We will review your application and following satisfactory review, we will add a code to your notes to allow records access .
Given this issue is now very topical, we anticipate increased interest in online access, and as each application and medical record must be reviewed before access is granted, please be aware that due to demand, there may be a significant delay in the processing of your application. Applications will be reviewed in order, therefore please be patient.
For example, you already have an online account but only use it for repeat prescriptions, but would like to have access to records as well
Please let us know, we will review your record and following satisfactory review, we will add a code to your notes to allow records access .
For example, you already have an online account but only use it for repeat prescriptions and are quite happy to stick with this with no additional access
You don't need to do anything as we will have already prevented access to records. If you change your mind and want records access, go to scenario 4 above.
For example, you already have online access, including to records, and are happy for things to stay as they are.
As indicated above, for this group, we weren't going to do anything anyway. And you don't need to do anything. You will have access. Simply sign up and self-certify via the NHS App.
For example, you may or may not already have an online account, but ultimately you're not concerned about where your data goes
Please let us know and we will add a code to your notes to allow records access .
Not surprisingly, for what is ultimately a political issue and not a clinical/medical issue, there is the usual promotional material, but there is actually little or no specific patient-facing or patient-facting material out there for people that would genuinely help them to gain an understanding of the issues and risks around this situation.
This is why we have made this more detailed information page to let you know some of the background to what is happening with your medical records.
The following resources come from NHS Digital itself, the government body responsible for digital technology, data and health service delivery in the NHS:
© Dr Michael Wong 2022