Here are some updated searches GP practices may wish to run, if they are not yet live with prospective online medical record access for patients.
For those practices that are live, these searches will show an overview of what coding you have within your patient list.
Applying a 104 / 106 code AFTER you have gone live will have no effect unless:
– the patient moves practice and the 104 code if applied as a latest code will prevent automatic access
– the patient turns 16 and the 104 code if applied will prevent automatic access
Download these updated searches and review 104 and 106 codes. These searches also include additional searches to look for patients with safeguarding codes.
Download searches and review 104 and 106 codes
These EMIS searches have been designed to support practices with the ongoing confusing issues around prospective record access the NHS England have been changing without adequate support.
Click here to download the EMIS searches and import them in to your clinical system
These are the searches you will see:
ACTIONS
These patients have no code applied.
Includes all those newly registered.
Requires review of records – do any of these patients require a 104 code?
Do you have resources / process to review?
Would sending a SMS / email message to these patients be appropriate to inform access is being granted?
Consider coding all these patients with the 104 code until resources / process in place:
1364731000000104 (Enhanced review indicated before granting access to your own health record)
These are patients with existing access and under latest regulations will have their access withheld.
Consider coding these patients with:
1364751000000106 (Enhanced review not indicated before granting access to your own health record)
From the pilot sites, GP practices are advised to consider coding patients who may lack capacity.
Credit and thanks to Named GPs for Safeguarding BSW ICB (michelle.sharma@nhs.net) for creating these amazing searches!
These patients may lack capacity so under the guidance and clinical safety case, practices may want to code these patients with the 104 code:
1364731000000104 (Enhanced review indicated before granting access to your own health record)
These are patients with a code that indicates that they may lack capacity BUT have been given online access. Under latest regulations will have their access withheld on switch on date unless they are coded with a 106 code. Consider reviewing these patients and if suitable for online access to code these patients with:
1364751000000106 (Enhanced review not indicated before granting access to your own health record)
These are patients who are under the age of 16 and do not have a prospective code applied – do these patients require a 104 code due to any significant issue or code in their medical record that may make them unsuitable to view their medical record when they turn 16?
If so consider applying 1364731000000104 (Enhanced review indicated before granting access to your own health record)
Patients under the age of 16 who have current online access but no 104/ 106 review code – if they already have access does it need to be rescinded? Or if no code has been applied, then do they need to have a 104 code applied?
If these patients under the age of 16 do not currently have online access, then it may be appropriate to code the 104 code so that they do not get automated access once they turn 16.
For patients OVER 16 who may have a child protection code applied to their records, practices may want to consider applying a 104/106 code or rescinding access if it’s already been granted.
Patients OVER the age of 16 with historical codes on child protection may need review to rescind access if appropriate.
Implement Practice and Patient Processes
Suggested Practice Processes
- Ensure that practices have set EMAS manager to a particular date from which retrospective medical record access is available to all patients (default is 1/1/1900 for all records) – ONE OFF PROCESS
- The AccuRx Florey is set up at the practice – ONE OFF PROCESS
- Have a clear pathway for patients to request full (prospective + retrospective) access to their medical records through the NHS App that both patients and staff understand. Promotion of the NHS App is encouraged to be advertised via the practice website.
- The patient process as below is clear to all practice staff dealing with patient requests.
Suggested Patient Processes
- Patient requests online access
- Practice issues patient with access information via AccuRx Florey
- Patient completes and returns Florey that is saved in the patients notes
- Practice will further verify the identity of the patient if required
- A code “314191000000103” (Patient registration data verified) should be added to the medical record
- Patients are either:
– given full prospective access – if not already granted – as per the request on their application form at the point of verification (the practice would need to then review and allow retrospective access within a set time period (eg 2 weeks)
– informed that their request will be processed within a set time period (eg 2 weeks) - The practice will then review the records within a set time period (aiming for 2 weeks) and it is recommended that this is also an opportunity for clinicians to tidy up the medical record to ensure:
– The problem list is accurate with significant, active and minor problems accurately coded
– Medications are appropriate and repeat medications are correctly listed and linked
– Any data deemed confidential is marked as such