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Secret Diary of a PM - Full online access to medical records

I sometimes wonder whether ideas and initiatives are ever thought through before those of us who work in general practice learn about policy changes and amendments to the GP contract.


Don’t get me wrong, I am all for change if it enhances the patient experience, but when initiatives are announced I find it is usually the primary care  provider that is left to work around all the issues. I am thinking in particular about the ongoing ‘access to medical records’ initiative and can see the finer points have been left for GP practices to work out.


A new contractual obligation for GP Practices

Practices are being told to offer patients online access to their full medical records retrospectively from April 2020, as stated in the new GP contract.

Practices will be expected to make progress during 2019/20 towards offering online medical records, a requirement that will become contractual from April 2020.
 
This means we will start providing new patients with ‘full online access to prospective data subject to existing safeguards for vulnerable groups and third party confidentiality and system functionality’, as outlined in the GP contract.


Preparing for the 2020 GP Contract deadline

According to guidance by the BMA, patients will be able to access their health data using ‘NHS login identity verification’, but will only be able to add their own information and access their full records retrospectively from April 2020.

We have been going through the mounds of detail and trying to get things in place well before the deadline day.  It is amazing how so many people can read a document and interpret it so differently.
 

Issues are already arising for GP Practices

It is also amazing the sort of issues that arise when you delve down into the specifics of the rules. Last week, a patient contacted us on Tuesday morning extremely upset and agitated as they had read in their medical records that a recent scan had revealed a fracture and nobody had contacted them. The patient insisted on being seen that morning - how many more people will use the system to demand urgent appointments?

We received the relevant letter about the scan on Friday and work-flowed it on Saturday, a doctor saw it on Monday and staff were asked to give them an appointment. The patient felt we were negligent in not contacting them on the day we received the letter and reasoning with them was difficult.
 

Working out the fine details of patient access

When people sign up for online access we get them to fill in a form that asks ‘how would you cope with seeing bad news’, for example when the surgery is shut or over a weekend. I know that cancer patients are advised as a matter of urgency over the phone, but what about other conditions?

How about a situation when a patient disputes the written consultation by the GP, how is that going to work - or are we going to have ambulance-chasing solicitors getting involved in such disputes?
 

Online access: more of a problem than a solution?

I know we have the right to refuse access but we need to have valid reason.  As a result, I wonder if this empowerment to patients is really all it is cracked up to be and could it do more harm than good.

As the saying goes, “a little knowledge is a dangerous thing”. I may be in the minority but personally I have no appetite to get online access, I see it as more of a problem than a solution.


FPM members have access to a suite of policies, forms and protocols relating to online access for patients in the FPM Policy Library. Take a look at this week's Policy Update blog for more details!


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