GP Connect allows GP practices and authorised clinical staff, using role-based access control (RBAC), to share and view GP practice clinical information and data between IT systems, quickly and efficiently in real time, for the purpose of direct patient care.
‘Provider’ and ‘consumer’ organisations
GP practices are known as the ‘provider organisations’ as they hold the GP patient record. They will be both the providers and data controllers of the data shared via GP Connect: Access Record products. Current products and primary functions are detailed later in this article.
GP Connect products enable access to patient information by those people who are legally entitled to access, to share, view, or act on the information when they may not be able to access it any other way because they are using different IT systems or set-ups.
Those organisations that view the GP patient record via GP Connect are called ‘consumer organisations’. Examples of consumers include:
- social care
- GP hubs/primary care networks/integrated care systems (ICSs)
- ambulance trusts/services
- acute and emergency care service providers
- NHS 111 service providers
- care homes
- allied health care professionals (community)
- secondary care (hospitals) – elective care
- mental health trusts
NOTE | A single organisation can be both provider and consumer, such as an extended access hub.
A number of key policy drivers were behind the introduction of GP Connect in 2018:
- The Five Year Forward View
- Personalised Health and Care 2020
- General Practice Forward View
- Transforming Primary Care.
The aim of GP Connect was to support better, more joined-up, clinical care by opening information and data held within GP Practice IT systems.
The 2018/19 GP contract stipulated that NHS 111 should have the ability to book appointments for patients contacting them, directly into GP practices’ appointment schedules. GP Connect was the vehicle for this to happen.
Initial functionality targets were:
- 111 appointment availability, numbers of allocated slots to be made available were based on registered list size
- extended access provision for out of hours, including the ability for clinicians to view patient records at the extended access hub/urgent treatment centre (UTC)
- enable cross-system-appointment-booking, including the ability to send tasks and notifications across a local geography such as a federation or hub
GP Connect worked with GP clinical system suppliers (TPP, EMIS, Vision and Medicus), to develop application programming interfaces (APIs). These APIs make data from clinical systems available in a standard form so that it can be used across different systems and therefore made available to clinicians to use in direct patient care.
During the COVID-19 pandemic changes were made. GP Connect was enabled across all GP practices to share patient data nationally for direct care purposes and there was a change to policy to enable Summary Care Record Additional Information to be made available by default, unless the patient had previously told the NHS that they did not want their information to be shared. This beneficial change has been extended beyond the pandemic.
GP Connect primary functions
GP Connect has the following primary functions. As technology develops it is, however, expected that the list of functions will expand.
GP Connect: Access Record
Access Record: HTML
GP Connect: Access Record HTML enables a read-only view of the GP patient record across GP practices, NHS 111, hospital trusts, urgent care centres, acute care organisations and social care settings. This can be used during a consultation with a patient registered within another care setting. Depending on the consumer system implementation, this view can contain the following information:
- active problems and issues
- current medication issues
- current repeat medications
- current allergies and adverse reactions
- last three encounters
Consultation, encounters, including:
- planned encounters – such as pre-arranged appointments with a GP
- unplanned encounters – such as at an out of hours clinic and those unrecorded through appointment module(s)
- direct encounters – such as a face-to-face session with a GP
- indirect encounters – such as a GP reviewing and updating a patient record on receipt of test results
- any issue that is significant to a patient that impacts their health or wellbeing – includes disease, surgery, and social issues such as bereavement or unemployment
- medication – current medication issues including repeat dispensing and medication history – a list of drugs or other forms of medicines that are currently being, or have recently been, used to treat or prevent disease for the patient
- current repeat medication – a list of repeat drugs or other forms of medicines that are currently being used to treat or prevent disease for the patient – this may also include PRN, i.e. as and when required medication
- past medication – a history view of drugs or other forms of medicines that have been used to treat or prevent disease for the patient
- allergies and adverse reactions – description and date only
- referrals – request for transfer of care or requests to provide assessment/treatment or clinical advice on the care of a patient
- immunisation and vaccinations – may also contain vaccination-related information such as flu vaccine declined
- uncategorised- coded record entries not associated with a main clinical area of the record. These are split across three views:
- tasks such as scheduling and administering clinical care encounters, clinical communication with other care organisations, administering and monitoring of critical safety processes such as repeat medication administration and call/recall for care – not all clinical systems support administrative items
- items of information relating to the care, health, or wellbeing of the patient – examples of this type of information include screening information and past medical history
- a clinical observation recorded by health professionals during assessment or care of their patients – examples include blood pressure measurement, weight, height, or temperature measurement
Access Record: Structured
Access Record: Structured enables an NHS system to request (consume) a patient’s GP record in a structured and coded format that is machine-readable. This view currently includes the following, (seven of which are duplicated from Access Record: HTML – see above):
- Referrals (outbound)
- Uncategorised Items
- Making available any investigation results contained in GP systems that have been received from laboratories by EDIFACT message or the newer Pathology Messaging – FHIR These are integrations which use MESH technology to receive pathology test results in GP practices from pathology laboratories.
Pathology messages are received into a workflow by the GP system and remain there until they are filed into the patient record by a user of note. GP Connect will, however, return any additional diagnostic reports (regarding and in addition to the actual test result) regardless of whether they have been filed.
- Primarily a proposal for a clinical action to be undertaken at an indicative date in the future, which has not been completed or cancelled.
The diary entry is dated but unscheduled – that is, it is not an appointment (but may result in an appointment being created) and resources are not directly committed to it. It may be a reminder for a review, a follow up to a consultation/treatment/test, a recall or treatment to be provided according to a schedule. Diary entries may also be known as ‘recalls’ within some GP clinical systems.
The use of diary entries may vary significantly between practices and may not have any constraint in the scope for a selected action associated with the diary entry. Consumer systems displaying an originating date for the diary entry, i.e., when the need for follow up action was determined, should give the consultation date primacy.
Examples of actions which may be recorded as diary entries are:
- antipsychotic injections
- asthma review
- cytology smear
- Depo Provera administration
- diabetes review
- epilepsy review
- mental health review
- NHS health checks (every 5 years for ages between 40-74 without a pre-existing health condition)
- over-75 check
- seasonal influenza vaccination due
- repeat blood tests
- medication reviews
GP Connect: Send Document
GP Connect: Send Document enables a patient’s registered GP practice to receive an electronic document capturing the details of a care encounter following a patient being seen in another care setting.
The product uses NHS Digital’s MESH file transfer service to create a PDF document capturing the details of a care encounter in another care setting. The PDF is created within the sending organisation’s system, transferred across secure infrastructure, and delivered directly into the patient’s registered GP’s clinical system, with minimal user interaction.
This can replace similar information being sent via outdated methods such as printed letters, NHS mail, or faxes, which were phased out in 2020. It reduces administrative time and effort to send the consultation and update the patient record.
Information captured in an online consultation, where appropriate, can be automatically ingested and added to the patient record. This uses structured and SNOMED coded information and as a process standardises the patient information being sent to GP clinical systems.
GP Connect: Appointment Management
The GP Connect: Appointment Management function allows primary care organisations to share appointments with other care settings such as extended access hubs, NHS 111, GP out-of-hours service and Covid vaccination hubs, to support joined-up patient care and improve patient experience.
Governance and regulations
DPIAs should be updated to include the use of GP Connect capabilities. NHS Digital provides a paragraph for the end user organisation to uplift their DPIA to reference direct care APIs/GP connect if they wish.
NHS Digital acts as the data controller for the delivery of the GP Connect service, ensuring that messages passing through the NHS digital infrastructure are passed securely, safely and accurately to and from provider and consumer systems.
GP Connect uses the NHS Spine security proxy (SSP), a single security point for both authentication and authorisation for consumer systems, to record data relating to each access request including NHS numbers as well as system identification details. This data is used to manage the health or care system and service.
Suppliers are assessed for compliance with GP Connect specifications and a technical conformance certificate is issued when testing is complete, and the product is technically ready. The vehicle for this process is the Supplier Conformance Assessment List (SCAL).
More details of the consumer (user) assurance process can be found on GitHub.
As care pathways include patients being seen in more care settings, there will be an increasing need for patient-related updates to be received by GP practices.
The GP Connect messaging specification will be uplifted to enable a greater set of structured information to be captured via additional FHIR resources. This will support the sending of structured/SNOMED coded information to reduce administrative burden at GP practices, standardising and improving the patient information being sent back to the GP clinical system.
This development is expected to be released mid-2023. Check the national website for the latest information.
Related GPG content
- Personal demographic service (PDS)
- Shared care records
- Consent to record sharing
- Clinical messaging and test results
- Smartcards and access control (RBAC)
- Primary Care Networks (PCNs)
- Information governance and data protection
- Summary care records (SCR)
- Video consultation tools – to follow
- Clinical coding – SNOMED CT
Other helpful resources
- nhs.uk, Known issues with GP Connect
- EMIS, Training resources, help and support and more (log in required)
- NHS Digital, GP Connect case studies
- NHS Digital, GP Connect deployment and utilisation
- NHS Digital, GP Connect progress
- NHS Digital, Clinical risk management standards
- NHS Digital, GP Connect privacy notice
- NHS Digital, GP Connect specifications for developers