General Practitioner’s Views on Digital Record Access-a study

[DJR1]

Following a thread, this week, on patient’s difficulties on accessing their GP digital records here is a link to a study from 2022. This explains some of the reasons behind the current difficulties achieving access and why some people have lost previous record access.

This paper found 56% of the GP’s responding to the study had objections.

The legal/safety concerns raised recently by the BMA and RCGP in response to the proposed automatic switch-on of medical record access has resulted in some Practices withdrawing access to historical access. There is a further planned switch on of prospective primary care records in October for the Practices who wrote to their system suppliers refusing auto-switch on.

Access to historical medical records will have to overcome significant barriers.

Patient Online Record Access in English Primary Care: Qualitative Survey Study of General Practitioners’ Views

jmir.org/2023/1/e43496/

[RedApple]

Thanks DJR1, this whole thing is such a mess!

[DJR1 in reply to RedApple]

Indeed, which is frustrating because the global evidence strongly supports access

[RedApple in reply to DJR1]

There are times when our once fantastic NHS feels like an absolute dinosaur. Dragging it's feet is a massive understatement.

[Zephyrbear in reply to RedApple]

I wonder why? I understand that GPs in the past have been able to get away with writing some very insulting comments in their notes and, perhaps, it may be that the editing process would be quite prohibitive in historical records…

[Hidden in reply to Zephyrbear]

GPs think we're too thick to have access to our records. That we will gain access and then they will be swamped by patients seeking reassurance over test results.

I think what's more likely is that we will be able to hold them accountable for shoddy work and they're crapping it.

[DJR1 in reply to Zephyrbear]

Yes subjective comments are a risk but also the number of errors found in our notes will be challenged and rightly so.

[2pence]

At my previous surgery I did get corrections to my digital records when granted access to them.

Having told the new surgery that the current confusion on switching on global prospective access did not mean that access rights currently in the GMS contract were negated, I am now told that they have asked advice from their data controller who says they are. Would their data controller be a staff member or independent?

I have also collected a print out of my full records to find that it is still coded with the exception of their interactions with me asking about an appointment and the emails regarding access to my records. Was I stupid to expect that a SAR request for my full records would result in actually being able to see my records?

[DJR1]

Oh dear, every GP Practice as an independent organisation that processes personal data must appoint a Data Controller. A member of staff is therefore the DC.

A SAR is a legal process that allows you to have a copy of ALL information a organisation holds on you with the exception of third party data which must be redacted. By refusing your request this GP Practice has breached the GDPR regulations. I suggest you contact them and say you are reporting them to the Information Commissioner's Office ICO. I would advise them to look at the definition of the term Subject Access Request. You do not need to use that exact term in your request for your information, any verbal, written or even request by social media is valid. You can expect to receive the information in a medium of your choice paper or electronic last time I checked. I would also contact your local Integrated Care Board, formally CCG and raise a complaint with them.

I do think however the warning of the ICO and if the member of staff you spoke to realises the legal requirement of an SAR you will find some rapid back tracking.

[2pence]

This is exactly what was sent to me "I have been in touch with our Data Protection Officer (DPO) he has stated that full access is not a GP contractual obligation.  When you transfer to another GP Surgery the access you had previously is ceased, upon registering at another practice you have the access that this practice is giving to its patients which for us as stated previously is for detailed coded record, when this changes we will give access to future data.  Regarding having your record put on a USB device, unfortunately our IT service has stated that we are unable to do this as we cannot connect any external hardware to our computers as this is removable data, it could also corrupt our systems" Thank you @DJR1 I will contact them again and point this out and also contact the ICO. they are only offering paper copies or emailing the file which is not secure.

[tattybogle in reply to 2pence]

When i did my SAR for all my 'previous' in 2020 , they put it all on a couple of CD's (with a password) so now can see it all on my laptop whenever i want to.

presumably there is no reason why they couldn't do that for yours , if you'd rather not have paper copies .

[2pence in reply to tattybogle]

From what she says they wouldn't do that either as their IT service says they must not connect any external hardware as it could corrupt their systems. They haven't offered a secure download as an option.

[tattybogle in reply to 2pence]

blank cd out of a new packet... how could that corrupt anything ?

[2pence]

I know or a brand new still wrapped usb stick as I don't have a cd drive on my laptop. If I could think of a reason to ask for a doctors appointment I would do that and see if I got anywhere with my choice of doctors over this. They have a letter from an audiology scientist saying that I must be given the choice of how I have interaction with them due to my hearing loss. It's a very useful letter and I was surprised to see it on the letter.

[tattybogle in reply to 2pence]

shame we can't swap .... i wanted paper copies (luddite lol).... but they gave me a cd

[DJR1 in reply to 2pence]

Apologies for a late response    2pence Easter has been busy. I see you have hearing issues which is a protected characteristic. You are entitled to reasonable adjustments to manage your healthcare. You can therefore request access to your full digital prospective and historical record on the grounds that your hearing makes understanding all conversations difficult and you therefore need a written summary of all consultations in primary care and secondary care. You have a letter from the audiologist stating your need which is fantastic!

You need to state you are applying for reasonable adjustment for a protected characteristic described in the Equalities Act 2010 and under the Accessible Information Standard which applies to the NHS. I would make it clear that you will pursue refusal as a breach of the Equalities Act. I would copy in your MP and your local Integrated Care Board.

I had to do similar for my son who has hearing and memory loss and full historic was switched on for him by the Practice. Please make sure you write/Email the Practice Manager and GP with your request and include a copy of the Audiologists’s letter . Keep a trail of correspondence.

Just a note about USB and CD- these items must be supplied by the provider of the information to avoid problems with unverified hardware. We get copies of scans every year from a hospital on a CD which they must provide. I am unsure of USB options but many people do not have the facility to accommodate a CD ( we don’t) so I don’t see why a USB should not be an option. We also receive the electronic records by secure email which is set up by the provider and password protected.

However as I have written above you have grounds for full access of your digital records under the Equalities Act and you have supporting medical evidence from your Audiologist.

I will find the link to the Accessible Information Standard and add it here.

Overview here

england.nhs.uk/wp-content/u...

More information here

england.nhs.uk/wp-content/u...

I use this regularly with NHS providers, they really should be aware of it but either don’t know about it or don’t apply it.

Do let us know how you get on.