A short explanation of the Primary Care Auto Switch-On and access to digital primary care records within NHS England.

[DJR1]

I have posted this on another thread in answer to a query but there so much confusion around access to our primary care records I thought a separate post might be helpful…….

There is huge confusion about access requests to patient records and the proposed auto switch on which I shall try to clarify as best I can. 

1. All GP Practices are independent businesses. They have a contract with the NHS called the General Medical Services Contract. (GMS Contract)

2.The patient demand for access to their primary care records has grown rapidly with the introduction of the NHS App . Large numbers of people who downloaded the App during the Covid pandemic have asked for full access to their medical records.

3. The GMS contract stated that all patients should be given access to their prospective (future records) from July 2019. However a large numbers of Practices refused to switch on this access for patients. The proposed auto switch on aimed to solve this issue to make sure that all patients had access to their future record. It was hoped that all patients within NHS England would have the same access and it would remove the postcode lottery.

4.As you know the auto switch on failed in December 2021, April 2022 and the 1 November 2022. The new date is 30 November 2022. There are many reasons for the delays, political, financial, safety, staff shortages etc. Although NHS England has stated the legal basis for the switch on I believe there is still significant opposition and a legal challenge may arise.

5. However that said, many GP Practices do support patient access to records. They provide full access on application to the full record both historic and prospective. Some patients already have this access and indeed the GMS contract 2020 states that historic access to the digital record must be given on request. 

6.Unfortunately some Practices still refuse to give historic access on application despite the contractual requirement and state reasons such as lack of redaction software, inadequate funding, inadequate training, poor use of staff time etc. This is an incredibly difficult situation and if your Practice takes this stance there seems little that can be done. This is distressing if you need historical information to share with others to manage your health and extremely disappointing if you lose this access when you move to a new GP Practice who refuse to allow it and you lose the access you were given with the previous GP.

7.Returning to the separate issue of auto switch on. This only supports switching on of future records from the specific date of switch on. If the switch on goes ahead and I have my doubts it will, patients will only see the full record with all documents, letters, test results and consultation details STARTING from the 30 November 2022. You will not see any historical information before that date. If your GP feels that your records will cause harm for whatever reason your access will be blocked.

 8.The auto switch on has confused patient record access and Practice staff have become confused about the whole subject. If you want your full historical digital records you are entitled to request them from your Practice. This is mandated within the current GMS contract. Many patients are still refused despite the mandation. This application is not related or dependent on the auto switch on. 

9.Some patients have lost full historic record access around the time of the auto switch on. This happened because Practices altered their global system settings to the proposed date of the switch on and it removed existing access. If you were affected by this you are advised by Patient Access to contact your surgery directly to restore your former settings. The Practice settings control visibility of all information on all Apps and the Practice system. If the Practice have set restrictions on their system this follows through to the NHS App and so on.

10.Finally if you want full access to your historical digital primary care record you must write clearly stating the Feb 6 2020 update stating patients must be given full digital access on request. The full information is quoted in my previous posts.

[humanbean]

Thank you for that.

I don't have any online access to any of my records.

If your GP feels that your records will cause harm for whatever reason your access will be blocked.

I suspect that a lot of GPs will block access because they are worried it will harm them.

A question...

Back in early 2014 I sent in a subject access request and got a copy of all my GP records on paper - or at least all of them that the surgery was prepared to give me.

Am I still allowed to do the same again and ask for copies of all records from 01/01/2014 onwards?

[humanbean in reply to humanbean]

Oh, I forgot to say that I don't have a smart phone (yes, I'm a Luddite), so I can't run the NHS App. I do run Patient Access on a desktop PC.

[DJR1 in reply to humanbean]

Yes you are certainly able to request all records by a Subject Access Request again. After an eight year gap it seems reasonable to me although Practices may use their own judgement as to whether it’s reasonable use of time to provide full or part access if there are a lot of records to check and redact. As a SAR is a legal request and you can request in a format of your choice, paper, email or CD. You do not have to fill in a specific form or mention the exact words SAR, you can request from any member of staff in written or verbal form.

I once submitted a request on social media as my Practice were being very specific about form filling, they had to accept my request.

[humanbean in reply to DJR1]

Thank you.

[bookish]

Thanks for that helpful information. Sorry to ask a slight aside, but do you know the best way to obtain historical hospital records? I too have no app or smart phone, have paper copies of all GP records since 2015 and odd bits earlier, but am missing some hospital testing c 2000-2003 and c 1985/6 which I'd like. Is writing directly to the hospital concerned my best option? Thanks for any advice.

[PurpleNails Administrator in reply to bookish]

Look on the hospital website as most have a contact email & address for data or health records coordinator.   

It might be listed as health records department / library.  

If not on website would try the hospital switchboard and ask it there’s a medical records department.  

Hospitals usually have their own application form (this is similar to subject access request- SAR) where you can request single, or entire record.    I have done both.  The single record was emailed back quite quickly.  The full record being a larger record was posted.  

ID and a witness signature is required which I was able to submit via email.    Photo copies via post can be used too.

[DJR1]

The demand for hospital notes is just as great as for primary care so most hospitals have a records department to deal with Subject Access Requests. If you have access to the internet the address to write to is usually on the hospital’s website under the patients services tab. There is unusually a form you can download and ID is required such as passport or photo driving licence.

However hospitals are only required to keep records for eight years after the last treatment episode. If you have returned to the hospital within that time the records will be there but if you have not attended for any reason the records may not have been kept. It is worth asking as hospitals do vary in their record processing.

GP records are kept until ten years after death so slightly different.

Useful guidance here

bma.org.uk/advice-and-suppo...

[bookish in reply to DJR1]

Thanks for that. Both hospitals have now been knocked down and I have no passport or driving licence and hadn't been near either place in years, so my chances are slim, but I will contact the replacement edifices just on the offchance! Cheers.

[LindaC in reply to DJR1]

Thank you for this! xox

[LindaC]

It seems that I have access to my MR but there seem certain categories...? I finally requested mine [something I didn't want to due to certain connotations that can be placed on this... I used to work in M Health!] and these go back to the years I've been with this particular surgery... 1993? I think. I requested these due to bizarre conduct towards me, within that surgery and beyond to the wider healthcare field [nope, not paranoid or any such... ] and found all manner of horror! These were tackled/challenged and with additions to and retractions made to consultants and 'apologies' made! Yeah, that really helps!? 🔍🖤🔥

My issue is that stored paper records of mine, prior to my Summer 2018 request, had been trawled through - going back 50 years, clearly to seek to 'hang something on me' [you'd get it if you had the full scenario]. Wholly irrelevant matters were then put up to my 2017 online records [where any consultant etc. could be directed to that information] and where a newer 'whip-snap' GP made it his business to 'discover' that I had an NVD' [Normal Vaginal Delivery] whilst married, albeit at 17 y/o - obviously with no involvement whatsoever with any 'services' of any type. Since it was NVD, then any future pregnancies 😂😍should not be of any concern! Crazy or what? Why is this conduct permissible?

Also, a personal/social issue [considering leaving the UK with a new partner and with my < under 10 y/o son, my father recently dx'd with MND and my not sleeping... taking aids for that] - this was from 40 yrs prior - and also put up on there for others to read, No counselling in those days and my being sooo unprejudiced, asked to see a psychiatrist... several 'chased me' saying nothing wrong = personal/social but one fabulous woman, to whom I suggested 'good old Freudian analysis', gave me an hour x 6 weeks and that was it - resolved. NEVER to revisit that scene again. No 'depression/anxiety-type meds' prescribed nothing. THAT incident was also put up in 2017 as some indicator of my...!? This is appalling but, on my making an informal 'For In-House Resolution' complaint - oh, this stuff doesn't touch the sides re medical 'neglect' - the Defense lawyers guided him though. Several apologies were made YET!?

THIS is how far some will go. What protection do we have against this obscene intrusion = where there is nothing on a 'need to know basis' and which has no bearing 40/50 years later!? Clearly, he was seeking to 'paint some picture of me'... like some little whipper-snapper 'gossip queen'! Knowing this does the rounds via ancillary staff at GP surgery? And available further afield.