AN NHS ACCOUNT

From the NHS
“Getting started with your NHS account” includes “Find out who can have an NHS account to use the NHS App or NHS website to access certain NHS services – and how to set up your account, log in and prove who you are to get full access.” Getting started with the NHS App – NHS App help and support – NHS

FURTHER INFORMATION ON THE ADVANTAGES OF AN NHS ACCOUNT

There is more information on your NHS account including many other functions beyond just online access to your test results under

• Your NHS Account

Advantages

NHS England suggest some of the advantages

• GP online services: the key benefits NHS England » GP online services: the key benefits
• Benefits of online access to records for GP practices and patients benefits-online-accss-recrds-gp.pdf
• Easy read leaflet
  What you need to know about your GP online record what-you-need-to-know-about-your-gp-online-record.pdf

Getting proxy access

From the NHS
How to get proxy access including for adults who cannot understand and agree to proxy access How to get proxy access – NHS

Practice form
You can inform the practice that you would like someone to have proxy access to your medical records by filling in the relevant practice form found under “Online access to your record”  (found under “Getting Help” in the main menu).

Switch profiles in the NHS account
As a parent, family member or carer, you may be able to manage services for another person by switching to their profile. This is also sometimes called having a linked profile or having proxy access.
Using linked profiles to access services for someone else – NHS App help and support – NHS

Patient Access explain the process through their portal
Proxy Proxy | Patient Access Support Portal

Authorising proxy access without a patient’s consent

Consent is normally required for proxy access, but the Royal College of General Practitioners explain when there may be
“legitimate reasons for the practice to authorise proxy access without the patient’s consent:

1. The patient has been assessed as lacking capacity to make a decision on granting proxy access, and has registered the applicant as a lasting power of attorney for health and welfare with the Office of the Public Guardian
2. The patient has been assessed as lacking capacity to make a decision on granting proxy access, and the applicant is acting as a Court Appointed Deputy on behalf of the patient
3. The patient has been assessed as lacking capacity to make a decision on granting proxy access, and in accordance with the Mental Capacity Act 2005 code of practice, the GP considers it in the patient’s best interests to grant the requested access to the applicant.
4. The patient has been assessed as lacking capacity to make a decision on granting proxy access but there is a record of the patient having made an advance decision that the individual seeking proxy access may act as their proxy for GP Online Services.
5. The patient is a child before their 11th birthday is not competent (for example a baby) to make a decision on granting proxy access.
6. If the applicant is a health professional who has a legitimate relationship with the patient for providing direct care to them, such as a nurse working in a nursing home.”

From the Royal College of General Practitioners
GP online services toolkit: Proxy access GP online services toolkit: Applications for proxy access | RCGP Learning

Reviewing proxy access – Adults

Change of mind
Where proxy access has been granted with the consent of the patient, the proxy access must be reviewed or withdrawn at the request of the patient.
Removing access Information for adults who want help with GP services – NHS

Reviewing proxy access –  Children and young people

For children the NHS suggests
“Children aged 11 or over are usually considered to have the capacity to consent, or refuse access, unless for example they have a medical condition or learning disability that affects their understanding. Parent and guardian access ends when a child is 16. If your child wants or needs you to help manage their GP services when they are 16 or over, your GP surgery can set it up again. Most GP surgeries also have an automatic cut-off age between 11 and 14, where online parent and guardian access is stopped to protect an older child’s confidentiality.”
Parent and guardian proxy access for children – NHS

From the NHS – information for children
Information for under-16s on parents and guardians accessing your doctor’s services Information for under-16s on parents and guardians accessing your doctor’s services – NHS

Lasting power of attorney

The value of planning for the future is demonstrated by a power of attorney. It can be helpful in the future to support proxy access.

Lasting power of attorney and proxy access is explained further by NHS England
pat-guid-give-another-person-access.pdf

The NHS provide a short summary about lasting power of attorney
Giving someone power of attorney – NHS

More detailed information can be found under:

• Lasting Power of Attorney

Further information

From the Royal College of General Practitioners
Patient registration for GP online services – Applications for proxy access GP online services toolkit: Applications for proxy access

Your health record

From the NHS
View your GP health record View your GP health record – NHS

Provides an overview of your medical record
Seeing your medical records Seeing your medical records | The Patients Association

your summary (emergency) care record

From NHS Digital
Summary Care Record Summary Care Record – NHS Digital

Abbreviations in your health record

To allow notes to fulfil their requirements alluded to in previous questions but at the same time to reduce the time required to make the notes you will find abbreviations used. The NHS website explains what some of the more common abbreviations used might mean, if you are looking at your notes.

From the NHS
Abbreviations commonly found in medical records Abbreviations commonly found in medical records – NHS App help and support – NHS

Some other commonly used abbreviations across the NHS

From NICE
Abbreviations and Symbols Abbreviations and Symbols | About | BNF | NICE

From the NHS Confederation
Acronym Buster Acronym Buster | NHS Confederation

Prescriptions and medicines

You can understand your medication better, see under

• Prescription and Medicine Management

Investigations (blood tests)

You can understand your investigations better, see under

• Investigations (including blood tests)

Purpose of your health record

As the Medical Defence Union suggest
“Clinical records fulfil several important functions.

• A reminder of what happened during a consultation, actions, steps taken and outcomes.
• Informing colleagues who may see the patient subsequently and supporting continuity of care.
• Providing evidence if the standard of your care is ever questioned.”
  “Effective record-keeping.” The MDU website. Retrieved 15th December 2022
  Effective record-keeping – The MDU

Requirements of your health record

The General Medical Council suggest
“You must make sure that formal records of your work (including patients’ records) are clear, accurate, contemporaneous  and legible.

There is a tension here with the level of detail given in the notes and the 10-minute consultation. Clinicians would prefer to spend time discussing their care with patients rather than filling in notes but there is a balance here to ensure the requirements are met.