Dr Kiren Collison, GP and Interim Medical Director for Primary Care, NHS England
Patients are playing a more active role in managing their health and care. The drive to improve patient empowerment has been gaining momentum in recent times and providing visibility of their health information is a part of this movement.
In just under 3 weeks’ time, nearly all patients aged 16 years and over, whose GP practices use TPP or EMIS systems, will see new (prospective) record entries on their GP record automatically via the NHS App. This is in line with the updated GP contract in 2019 and was set out in a letter to GP practices.
Without this access, patient understanding will continue to be heavily reliant on either their memory of previous interactions with staff or on contacting their GP practice for information. Although some people may continue to need non-digital routes, data suggests an increasing acceptance of, and reliance on, digital technologies within our practices and communities. For example, the NHS App now has over 28 million sign-ups and is being used by people an average of 2.7 million times a week.
Despite these benefits, there is no doubt that enabling patients to view their medical record online will involve a shift in how we, as primary, community and secondary care professionals, operate on a daily basis. It is therefore not surprising that many healthcare professionals may consider this to be a daunting prospect given the many demands already placed on the service.
From 1 November, changes will include the need to consider redacting certain information as well as being mindful of our use of medical terminology, something which is ingrained in so many of us. Prior to November, we will also need to assess whether it is, in a small number of cases, in the patient’s best interests to provide access.
Reassuringly, upon reading the Blueprint for accelerated patient access to general practice records, the experiences of GP practice staff from 16 early adopter sites tell a positive story and may help to allay some of the concerns about the changes.
After several months of giving their patients prospective access to their records, most sites reported that they did not see a noticeable increase in workload. In fact, some practices advised that they thought it had reduced their workload due to a lower volume of calls from patients requesting test results and a reduced administrative burden on staff resulting from fewer subject access requests (SARs).
Whilst one practice attributed a slight increase in workload, due to clinicians spending more time reviewing records for accuracy and any required redactions, they recognised this in a positive light, as it was anticipated to lead to improved data quality.
Direct feedback includes:
“We have next to no Subject Access requests as our patients already have access to their records.”
“Our receptionists can be doing other work instead of answering calls about test results.”
“Potentially one third of calls have now been prevented. The time spent on the phone is also a lot less.”
Another positive to emerge through patient feedback is reassurance around the ability to use their record to assist with an emergency admission or if something was to happen abroad. You can read more about the findings from the patient research in the report.
Although there is a tremendous amount of information to take in at present, I would encourage everyone to read and share this report. It offers practical tips and insight into the experiences of practices who now offer online access and will help you in managing the process as safely and effectively as possible.
I would also like to point you to, if you have not yet seen it, a GP practice readiness checklist, which is particularly helpful in continuing preparations for the access change.
Finally, given these changes, we are keen to hear your feedback over the next few months so we can continue to support you as needed. You can do so through your local LMC, regional teams or by emailing firstname.lastname@example.org