There has been complete silence on this issue and I have unconfirmed reports that there will be a further delay. I will repost when I find out more.
Original Post⬇️
It has been announced today that all Systems that support GP Practices within NHS England will move to AUTO SWITCH ON of patients prospective digital medical records from APRIL 2022.
This will apply initially to TPP and EMIS systems. Practices that use VISION have not finalised arrangements.
This is excellent news as application for enhanced access will not be required, confusion on how to configure systems and outright refusal by some GP Practices will be swept away. You will see your test results, consultation details etc after they have been checked by the GP. A time limit will be announced for checking results.
This is a step in the right direction for those of us who want to see our records and results. Historical record access will still need to be requested as described in the GP contract. However there are plans to make historical access requests via the NHS App in the future.
Unfortunately the live switch on was originally 1 December but GP objected to the short notice but nevertheless April is not too long to wait. We are getting there!
Written by
DJR1
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Thank you for that information DJR1. Hope they don’t get held up by the Easter eggs
Yes indeed people are dying because allergies, previous surgeries and complications recorded in medical records are not available throughout the NHS networks. My son was in a critical condition in an ED and there was no available information to save his life apart from the records we had stored on our phone. We are behind many countries in the Europe with our poor health service records and behind on the global strategy.
Individuals can opt out of sharing their health information on the NHS App and by submitting a Type 1 opt out to the GP. My view is that all my health information should be available to me and the recent change in the GMS contract gives me the opportunity to access all my health information. The errors contained within records are far more dangerous than the benefit of digital sharing.
Indeed for direct health care your records can be accessed without your permission by any clinicians involved in your care.
Yes, I'm aware of opting out and have done that at both levels.
I'm sorry to hear about your son's experience and hope he's ok now.
I wasn't referring to clinicians accessing data. The terms and conditions in the EMIS app state that your records can be shared without your permission. My question was whether digitising records would have an impact on selling our "pseudonymised" data on to anaytical firms. There's also the risk of data leaks.
I do understand your concerns and patient access and control of access to our data are important but separate issues. For the last 20 years or more GP practices have used computerised records instead of handwritten notes. There are four systems in use, EMIS Web, TPP, Microtest and VISION. All GP medical records on stored in one of these systems as there is no paper copy.
All your digital records will be on the EMIS system. The App designed for EMIS Web is PATIENT ACCESS. The App allows you access to link into the EMIS GP system to engage with their services. By deleting the App you do not change or remove your digital record on the EMIS Web server. It is the only source of your GP record and as patients we have no choice or control on what is on that system, we cannot remove our information from it.
By using an App which connects you to the system you have more control as you can see errors and track who has accessed your record.
When patients are refused digital access or choose not to use them remarkably, in reality they are the ONLY people who do not have access to their own information.
Security of information is huge which is why type 1 and 2 opt outs were available and the NHS App includes an opt out opportunity.
Campaigners like me have fought for access to enable care but also to correct errors. We also fight for control and security. The recent data sharing plans for GP records were postponed because of huge opposition. It is essential that citizens are asked for permission to view our individual records and we should be able to refuse access for any other reason including sharing for research. I am confident these steps will be put in place. I have a Type 1 opt out recorded on my records and I have used the NHS App opt out to control my information. However I use Patient Access, Evergreen and the NHS App to connect to the EMIS Web to read my records, track viewing, check vaccination history, make appointments etc There is a remote risk of data leak but the benefit of digital records is huge. The security layers currently in place are reassuring.
I hope that explanation gives you some reassurance.
I think we're approaching this from different sides. I'm not looking for your reassurance. I was asking for information on data sharing.
Please don't get me wrong; I can see the benefits of legitimate access to your own health records. I've been working in IT for over 20 years and sit on a committee that reviews data access, how the risk of breaches and leaks can be reduced (can they ever be fully avoided?), etc. Once your records are in the public domain, there's no getting them back. And it's not as though that hasn't happened before:
"NHS Digital recently identified a supplier defect in the processing of historical patient objections to the sharing of their confidential health data. An error occurred when 150,000 Type 2 objections set between March 2015 and June 2018 in GP practices running TPP’s system were not sent to NHS Digital. "
There are so many facets to data sharing and digitisation. I guess my answer was framed around my original post. The auto switch on above will not increase digitisation or wider access to the EMIS system. It will allow patients to access the information already held about them on that system and use services.
Looking at the wider context no systems are perfect, there are layers of controls in place however process errors happen as you describe. I guess with that in mind it is down to the risk/benefit of having your personal information available on digital platforms. I share your concerns and I too am very keen to protect my information.
Can I jump in and ask two questions please? I had access to my data using Patient Access from my gp surgery. I uncovered 2 massive errors. I was told that this info couldn't be corrected as it was put on by a previous surgery but an annotation was entered. Is this correct procedure?
Last year my surgery was closed and my records moved to another surgery, this surgery does not support Patient Access but keep pushing me (via text) to join NHS app. I havent yet and also haven't needed to see a gp just levo on repeat prescription.
Is the NHS app the system you are saying we will move to automatically in April?
With regards to correcting the errors, it is the case the records cant be altered. This is to prevent records being removed or changed to cover up a mistake or omission. The correct procedure is add an additional note.
My practice doesn’t support patient access either - I think it combined hospital held & GP practice records so would be useful.
Online access it still very useful. Most practices use the TTP or EMIS systems but we access our information through an app & NHS is one of the apps which can be used. There are many available each with different functionality and way to view records in a different way. eg 1 app might list all documents, another you have to search between two dates. One might list test results but another apps shows test results plotted on a graph.
I think the switch on makes basic access automatic, which may allow appointment to be booked or reordering prescriptions (depends on what practice allow) You then must request full access which then grants you access to notes and test results.
Thank you so much for your response. It all makes sense. I was more than happy to continue with PA and saw it is advertised on the web page of the new health practice I had been assigned to in June 2021. I called them to get the code and was told they didn't support it, didn't like it and I had to download the NHS app.
I've just checked and the PA info is still on there so I can only assume they use EMIS.
I did have full history previously and realised I had a diagnosis of Familial Hypocholesterolemia - absolutely untrue! I managed to track it back to a stroppy nurse at a previous practice that was annoyed that I was already doing everything on her tick list (vegetarian/regular runner/healthy weight).
My slightly raised cholesterol that time was directly related to my untreated thyroid problem. It was 6.0, nothing drastic, but her recommendation (signed off by a gp that had very little knowledge of thyroid) left me with this issue and further gp's continually trying to force statins on me and a forced visit to a cholesterol specialist! Because of this I was refused hrt when menopausal too.
I feel ready to give it another try now, just one question, if they are advertising they use PA on their Web page can they actually refuse me access?
They cannot refuse to let you use Patient Access. It is absolutely your choice. My GP Practice also tried to direct choice in the past by deleting all the App options on the registration form. This was addressed by NHS England and choice was offered to all patients. My husband also had a diagnosis of FH on his record. Our life insurance with a new mortgage application had an £80 per month extra premium due to risk. It took 2 years for the problem to be addressed by the GP and for the premium to be removed. The value of full access to GP records cannot be overstated. Good Luck with Patient Access.
Thank you! I felt like I was going mad at the time.
My then gp did a quick check on QRisk and said I needed to have BP meds/statins because my % was over the threshold, despite nothing changing with me. Apparently it went from 20% down to 10% thereby ensuring thousands of people put on statins. I did the QRisk myself at home and found out it was my postcode that put me over 10%. Any other postcode and I'm 7% with hypothyroidism and a bit overweight because of it You couldn't make it up.
I fought this for a couple of years, read The Great Cholesterol Con and found Health Unlocked and haven't looked back since!
The gp surgery that was closed furing lockdown was the best my gp was very helpful and I'm gutted I got moved. He was one of two partners in a small practice.
Thank you to everyone on here that shares their knowledge and experience.
Quick update re PA: managed to list my current practice to my PA account (that didn't work previously) this only gives me limited access (book 1 appt) then to take 2 x ID docs to surgery.
Let's see what happens - website still says no walk in. Will try tomorrow.
I went go my gp surgery today and asked for a linkage key to log in to PA. The receptionist tried to tell me that I would have to 'go all through starting up an account and I can't do that, my colleague will have to do that but isn't here right now'. Clearly to put me off.
I gave a big smile, told her no need as I have an account already and just need the linkage key, produced my ID and waited. She asked why I needed PA, was it for my medical history. I had the doc you sent me printed ready but I think she realised I wasn't backing down.
She took ID details and said her colleague (senior admin) will text me the code when my ID details had been processed.
Hoping to receive the text with the link by Friday if not I'll be back at reception asking for it.
Just received the attached text from gp surgery. No mention of PA just NHS app which is not what I requested. Just checked on PA and I'm still stuck on restricted access- just able to book one apot (which I don't need).
I can’t understand what they are doing or why your access is restricted as the Practice settings are not specific to the Apps. I think you are between two different members of staff and the message isn’t getting through.
I wonder if more specific advice would come from the Patient Access support team. They will follow up with the Practice to help with technical issues
If you are registered and have a PA account the App will allow access to the permissions set on the GP system settings.
If you have been given full record access on the system settings, you can use any App and it will automatically use the access settings that have been set by the Practice.
Alternatively ask to speak to the senior person who sets up access and ask for an explanation. I wonder if you have not completed a new registration form and specifically documented historical record access you have just been given basic access???? Largely practices for not understanding about Apps or system settings. They also do not understand that they cannot specify particular Apps as the NHS has contractual arrangements with approved partners and payment comes from use.
Thank you. I called the surgery, spoke to a stroppy male receptionist. He tried to tell me I HAD to use the NHS app. I replied that I wanted to continue using PA. He said they try to discourage people using PA. So I just repeated myself and he gave in.
He sent the linkage key via email but cut me off mid sentence and put the phone down.
I will look around for a better surgery but for now I am back on PA again.
I know, it really shouldn't be this difficult. I wonder why they are actively discouraging patients from using PA and trying to force NHS app? Especially when the PA system is advertised all over their website 🤷🏻♀️
I think they don’t really know how to use it or what functions it has. I guess it is easier to direct patients to the NHS App so everyone is the same and they can pass queries onto the NHS App team or direct the patient there. It’s not good enough
No problem, yes the Practice was following the correct procedure for errors. Medical records must not be altered retrospectively as it prevents fraudulent retrospective attempts to alter a patient history to cover up criminal activity such as Shipman or just simply changing the record to cover poor decisions making in other cases. Unfortunately this means an error cannot be removed only an annotation can be added explaining the error. This is very annoying but a good safeguard if you think about it. I have an erroneous ECG in my records, showing severe heart failure! I have no heart problems. I cannot get it removed only noted that it’s not mine. Each GP becomes the data controller when you move on and they are not responsible for the contents of the previous record so there is reluctance to share or annotate in some cases.
Now about getting access to your digital GP record.
There are four basic GP IT systems EMIS WEB, TPP, VISION, Microtest. Each of these use their own App. EMIS uses PatientAccess. TPP uses SystmOnline, VISION uses the Patient Services.
So if you have moved to a GP Practice which does not use EMIS you won’t be able to use PatientAccess.
If they do use EMIS you can use PA but note that some surgeries are exclusively promoting the NHS App as it’s been highly promoted by NHS England.
There are Apps like the NHS App and Evergreen Life which are called cross platform Apps and can be used with all the GP systems except possibly VISION?
In April NHS England is planning to override the EMIS WEB and TPP systems by automatically switching on prospective record access. Until now individual GP have chosen their own settings despite the requirements in their GP contract. This is unfair and the move is being made to introduce fair access.
That said if your new GP Practice uses Microtest or VISION, auto switch on will not happen as their software is still not capable of being switched on at a National level. The type of access will still be controlled by the GP.
If you use the NHS App you will not have auto switch on in April if the Practice uses Microtest or VISION as cross platform Apps depend on the settings on the GP system.
I hope that’s not confused things. I would try and find out what system the new Practice uses and which App is associated with that system. Then apply for full record access and state you want historical access in addition. Once that is set up you can apply online for the NHS App and your access settings will be pulled from the GP system.
I use the NHS App, Evergreen Life and Patient Access as they offer different things. You choose what is best for your needs, you could choose the Practice system App and/or the NHS App.
PS I am not assured the switch on will happen on April 1, there are continued objections from GP Practices. They have already forced a postponement form December last year.
Fab news I requested my medical records an they only went back as far as 1998 after my 2nd son was born , nothing in regards to my illnesses a etc before then an wanted 30 quid for full records so this is great news thank you🥰
Hi, I am in Health Unlocked because of health issues, but I've also worked on and off in Health IT for the last 20 years. After I got frustrated with the online content the NHS provides supporting patients to use digital tools, I created my own [hope it's OK posting the link here], which includes info about the NHS App and information sharing issues digitalhealthcoachuk.net/
Hello Sean,Thanks for the contact. I know of your work and you actually know me as Cancer Mum on Twitter! My interactions here are largely about getting people access to their digital GP medical records using both the requirements of the GMS contract and GDPR.
The number of people across NHS England being refused access despite mandatory requirements is quite shocking as you may know. The information about digital access, patient rights, Apps and functionality is almost non existent so thank you from me for posting your link which will be useful to many people.
This is indeed good news. I had reqqested full on line access as per the GP Contract but they wouldnt/couldnt it. Id also asked for full historical access. All I see is a one liner with the code. Id got full copies of my medical records and this was the reason for refusal. My surgery uses TTP System One. I tried using Evergreen and phoned the surgery as I couldnt connect via them either. The Receptionist said theyd never heard of Evergreen. I still dont have full on-line access!
I suppose they want everyone on the NHS app as its their 'baby' and they can track everyone easier that way. The other apps are independent of them.
If you live within NHS England ask your surgery for the registration form for full/enhanced access to your digital GP record. You will be asked for ID.
Choose an App that corresponds to the computer system your GP uses for example PatientAccess or if you prefer an App like the NHS App or Evergreen. Most surgeries are promoting the NHS App which works with any GP computer system
Complete the form and add in your words that you are also requesting access to your historical digital record in line with the GP contract.
You should receive a letter from the practice with the Practice ID and linkage keys to set up your App. You should then see your online account.
This might take some perseverance as often Practice Staff are not familiar with the process/Apps/registration forms etc
On the other hand if you just want a full copy of your records on paper, by Email, or CD you can submit a Subject Access Request asking for your copy.
I have written quite a few posts on this if you click on DJR1 they will come up.
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