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Access to Electronic Patient Records (EPRs) is a legal right for Patients and General Practice is now required to give all Patients aged 16 and over access to new entries to their record. These changes are to ensure Suppliers fully support General Practice in meeting this obligation by introducing the ability for GP Practices to set default access for newly enabled Patients and Patients when they turn 16 years old. Exclusion criteria has also been expanded to include additional SNOMED CT codes and some existing requirements have been refined due to these changes, and to ensure consistency with the wider Capabilities & Standards model.

See Online access to GP health records for further background.

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All Foundation Suppliers must be compliant against the changes by the Effective Date.

Summary of Change

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Patient Information Maintenance - GP: Epics E00171, E00172, E00174 updated

E00171 - manage View Record Citizen Service Aaccess for the Practice

As a Health or Care Professional

I want to be able to manage access to the View Record Citizen Service for the Practice

So that I can manage access to View Record Citizen Service

Acceptance criterion 1: enable access to the Summary Information Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to enable access to the Summary Information Record Level for the Practice

Then the Summary Information Record Access Level is enabled for the Practice

Acceptance criterion 2: disable access to the Summary Information Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to disable access to the Summary Information Record Access Level for the Practice

Then the Summary Information Record Access Level is disabled for the Practice

Acceptance criterion 3: enable access to the Detailed Coded Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to enable access to the Detailed Coded Record Access Level for the Practice

Then the Detailed Coded Record Access Level is enabled for the Practice

Acceptance criterion 4: disable access to the Detailed Coded Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to disable a Patient’s access to the Detailed Coded Record Access Level for the Practice

Then the Detailed Coded Record Access Level is disabled for the Practice

Acceptance criterion 5: enable access to the Document Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

And the Detailed Coded Recorded Access Level is enabled

When they the Health or Care Professional selects to enable access to the Document Access Level for the Practice

Then the Document Access Level is enabled for the Practice

Acceptance criterion 6: disable access to the Document Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to disable access to the Document Access Level for the Practice

Then the Document Access Level is disabled for the Practice

Acceptance criterion 7: enable access to the View Record Full Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to enable access to the View Full Record Access Level for the Practice

Then they can record a start date for data to be available from

And Then the View Record Full Record Access Level is enabled for the Practice

Acceptance criterion 8: disable access to View Record Full Record Access Level for the Practice

Given the Health or Care Professional is permitted to configure access to Citizen Services for the Practice

When they the Health or Care Professional selects to disable a Patient’s access to the a View Record Full Record Access Level for the Practice

Then the View Record Full Record Access Level is disabled for the Practice

E00172 - manage View Record Citizen Service Aaccess for a Patient

As a Health or Care Professional

I want to be able to manage access to the View Record Citizen Service for individual Patients

So that I can manage Patient access to View Record Citizen Service

Acceptance criterion 1: enable Patient access to the Summary Information Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to enable the Patient’s access to the Summary Information Record Level

Then the Summary Information Record Access Level is enabled for the Patient

Acceptance criterion 2: disable Patient access to the Summary Information Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to disable a Patient’s access to the Summary Information Record Access Level

Then the Summary Information Record Access Level is disabled for the Patient

Acceptance criterion 3: enable Patient access to the Detailed Coded Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to enable the Patient’s access to the Detailed Coded Record Access Level

Then the Detailed Coded Record Access Level is enabled for the Patient

Acceptance criterion 4: disable Patient access to the Detailed Coded Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to disable a Patient’s access to the Detailed Coded Record Access Level

Then the Detailed Coded Record Access Level is disabled for the Patient

Acceptance criterion 5: enable Patient access to the Document Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

And the Detailed Coded Recorded Access Level is enabled

When they the Health or Care Professional selects to enable the Patient’s access to the Document Access Level

Then the Document Access Level is enabled for the Patient

Acceptance criterion 6: disable Patient access to the Document Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to disable a Patient’s access to the Document Access Level

Then the Document Access Level is disabled for the Patient

Acceptance criterion 7: enable Patient access to the View Record Full Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to enable the Patient’s access to the View Full Record Access Level

Then they can record a start date for data to be available from

And Then the View Record Full Record Access Level is enabled for the Patient

Acceptance criterion 8: disable Patient access to the View Record Full Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When they the Health or Care Professional selects to disable a Patient’s access to a View Record Full Record Access Level

Then the View Record Full Record Access Level is disabled for the Patient

Acceptance criterion 9: enable Prospective Access to the Full Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When the Health or Care Professional selects to enable Prospective Access to the Full Record Access Level for a Patient

Then the Health or Care Professional records a start date for data to be available from

And the Prospective Access to the Full Record Access Level is enabled for the Patient

Acceptance criterion 10: disable Prospective Access to the Full Record Access Level for a Patient

Given the Health or Care Professional is permitted to configure access to Citizen Services

When the Health or Care Professional selects to disable Prospective Access to the Full Record Access Level for a Patient

Then the Prospective Access to the Full Record Access Level is disabled for the Patient

E00174 - configure access to elements of the Electronic Patient Record (EPR) in the View Record Citizen Service

As a Health or Care Professional

I want to record that elements of the Electronic Patient Record (EPR) are Restricted from View Record

So that elements recorded as Restricted from View Record are not displayed to Citizens via the View Record Citizen Service

Acceptance criterion 1: record existing elements of the Electronic Patient Record (EPR) as Restricted from View Record Citizen Service upon review

Given the Health or Care Professional is permitted to review the Electronic Patient Record (EPR)

When they the Health or Care Professional selects to record an existing element of the Electronic Patient Record (EPR) as Restricted from View Record

Then this element is recorded as Restricted from View Record

And it is not displayed in Citizen Services

Acceptance criterion 2: record elements of the Electronic Patient Record (EPR) as Restricted from View Record Citizen Service whilst entering information

Given the Health or Care Professional is permitted to enter information into the Electronic Patient Record (EPR)

When they the Health or Care Professional enters information into the Electronic Patient Record (EPR)

And the Health or Care Professional selects to record an element of this information as Restricted from View Record

Then this element is recorded as Restricted from View Record

And it is not displayed via the View Record Citizen Service

Acceptance criterion 3: indicate Restricted from View Record elements to Health or Care Professionals

Given the Health or Care Professional is permitted to view the Electronic Patient Record (EPR)

And there are elements of the Electronic Patient Record (EPR) that have been recorded as Restricted from View Record

When the Health or Care Professional selects to view the Electronic Patient Record (EPR)

Then the Health or Care Professional can view that these elements are Restricted from View Record

Acceptance criterion 4: update elements recorded as Restricted from View Record as available for View Record

Given the Health or Care Professional is permitted to view the Electronic Patient Record (EPR)

And there are elements of the Electronic Patient Record (EPR) that have been recorded as Restricted from View Record

When the Health or Care Professional selects to record an element as available for View Record

Then this element is recorded as available for the View Record Citizen Service

And it is displayed via the View Record Citizen Service

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Solutions MUST comply with the following when implementing this Epic:

Ability for Health or Care Professionals to record any type of element recorded in the Electronic

Patient

Record (EPR) as Restricted from View Record Citizen Service InfoE00174 - Supporting

Information

• Elements of the Electronic Patient Record (EPR) MAY include, but are not limited to:

  • An Electronic Patient Record (EPR) (as a whole)

  • Groups of elements of an Electronic Patient Record (EPR) e.g. an entire consultation, documents and all associated read coded information

  • Individual elements e.g. a code, a medication

• Examples of when a Health or Care Professional MAY need to record an element of the Electronic Patient Record (EPR) as Restricted from view include, but are not limited to:

  • When reviewing Pathology results

  • When reviewing Radiology results

  • When reviewing external documents

• Further information on the View Record Citizen Service can be found in the View Record - Citizen Capability and Citizen Services Implementation Guidance

Patient Information Maintenance - GP: MUST Epic added

E00XXX - configure defaults for Citizen Service Aaccess access for Patients As a Health or Care Professional I want to configure default access to Citizen Services for Patients So that configuring access to Citizen Services for Patients is more efficient and inline with current policy Acceptance criterion 1: enable the default as Prospective Access to Full Record Access Level for the View Record Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to enable the default as Prospective Access to Full Record Access Level for Patients Then the Health or Care Professional records a start date for data to be available from And Prospective Access to Full Record Access Level is enabled by default when a new Patient is enabled for access to Citizen Services And Prospective Access to Full Record Access Level is automatically enabled when a Patient who is already enabled for access to Citizen Services reaches their 16th birthday Acceptance criterion 2: enable the default as Full Record Access Level for the View Record Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to enable the default as Full Record Access Level for Patients Then the Full Record Access Level is enabled by default when a new Patient is enabled for access to Citizen Services Acceptance criterion 3: disable the default for View Record Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to disable the default for the View Record Citizen Service for Patients Then the default is disabled Acceptance criterion 4: enable the default for Appointments Management Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to enable the default for Appointments Management Citizen Service for Patients Then the Appointments Management Citizen Service is enabled by default when a new Patient is enabled for access to Citizen Services Acceptance criterion 5: disable the default for Appointments Management Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to disable the default for the Appointments Management Citizen Service for Patients Then the default is disabled Acceptance criterion 6: enable the default for Prescription Ordering Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default default access to Citizen Services for Patients When the Health or Care Professional selects to enable the default for Prescription Ordering Citizen Service for Patients Then the Prescription Ordering Citizen Service is enabled by default when a new Patient is enabled for access to Citizen Services Acceptance criterion 7: disable the default for Prescription Ordering Citizen Service for Patients Given the Health or Care Professional is permitted to configure the default access to Citizen Services for Patients When the Health or Care Professional selects to disable the default for the Prescription Ordering Citizen Service for Patients Then the default is disabled E00XXX - Additional Implementation Details Solutions MUST comply with the following when implementing this Epic: When Prospective Access to Full Record Access Level is enabled as the default for the View Record Citizen Service, for Patients newly enabled for online access (Practice enabled and via NHS Login) the Access Level is to default to Summary Information Record Access Level when the Patient is excluded for Prospective Access by one of the following criteria: Patient has one of the following SNOMED CT codes recorded in their Electronic Patient Record (EPR): ‘1364731000000104 - Enhanced review indicated before granting access to own health record (situation)’ without a later recording of ‘1364751000000106 - Enhanced review not indicated before granting access to own health record (situation)’ OR ‘1290311000000106 - Online access to own health record granted following enhanced health record review (finding)’ ‘1290301000000109 - Online access to own health record withheld following enhanced health record review (finding)’ without a later recording of ‘1290311000000106 - Online access to own health record granted following enhanced health record review (finding)’ '1290331000000103 - Online access to own health record declined by patient (situation)' without a later recording of ‘1290311000000106 - Online access to own health record granted following enhanced health record review (finding)’ Patient is under 16 years old When Prospective Access to Full Record Access Level is enabled as the default for the View Record Citizen Service, and the Patient is excluded for Prospective Access (see exclusion criteria above), on the Patient’s 16th Birthday the Access Level will: Automatically update to Summary Information Record Access Level for Patients with no previous access Remain the same for Patients with existing View Record Citizen Service access For Prospective Access to Full Record Access Level, if the start date for data to be available from is before the date the Patient Registration started for the Patient, then the start date for data to be available from is to be the same as their Patient Registration started date

Full Specification

The updated Patient Information Maintenance - GP Capability will be added at a later date. Proposed changes can be viewed in the Summary of Change above

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