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Mandating Proxy Access and enabling Proxy access for baby Patient Registrations

Mandating Proxy Access and enabling Proxy access for baby Patient Registrations

ID

RM256

Version

1.1.1

Type

Roadmap Item

Contracting Vehicle(s)

Title

Mandating Proxy Access and enabling Proxy access for baby Patient Registrations

Description

Establish a Proxy for a baby at GP Registration and mandate Proxy Access for all Patients

Date Added

Aug 27, 2025

Standards and Capabilities

Patient Information Maintenance - GP

Change Route

Managed Capacity - Other

Change Type

Uplift

Status

Closed

Publication Date

Oct 28, 2025

Effective Date

Mar 31, 2026

Incentives / Funding

Yes

Incentive / Funding Dates

Incentive Start Date: The date on which this Roadmap Item attains “Published” status.

Incentive End Date: Feb 20, 2026

Payment Rules

For the payment rules, please see RM267 Proxy visibility

Background

Current Proxy access is inconsistent and hazardous due to a lack of standardisation across Health or Care Organisations, negatively impacting Patients and Health or Care Professionals.

Additionally, existing Proxy access is limited by local implementation, preventing access to services across different GP Practices and wider NHS services. This is caused by a lack of shared Proxy information between Health or Care Organisations, leading to duplication and a poor experience for Patients and Carers.

A National Proxy Service will be established to enable portability, expand the services available to Proxies and enable national campaigns and messaging on digital channels.

This Roadmap Item enhances the GP Practice registration workflow by modifying the registration process to encourage Proxy registration at the point of Patient Registration at a GP Practice for baby Patient registrations. It also uplifts Proxy access Epics from MAY to MUST.

Outline Plan

The Proxy programme of work will follow a phased approach across the following Roadmap Items:

Phase 1: Enable Proxy requests into General Practice workflow:

  1. RM256 Mandating Proxy Access and enabling Proxy access for baby Patient Registrations (This Roadmap Item)

  2. RM263 Verified Candidate Relationships

Phase 2: Adoption of the Proxy Access Standard for digital health and care services:

  1. RM267 Proxy visibility

Phase 3: Integrate with the National Proxy Service to enable portability and expand the services available to Proxies:

  1. (Roadmap Item TBA) National Proxy Service: Enables integration with the National Proxy Service.

  2. (Roadmap Item TBA) Online Proxy Requests: Allows Patients and Proxies to submit Proxy access requests online.

Incentivised Pilot

This Roadmap Item is subject to an incentivised pilot rollout, targeting deployment across a minimum of 35 and a maximum of 70 designated GP Practice pilot sites (Or such other number as agreed between the Supplier and the Authority). The Authority supports the identification of Proxy pilot sites. These pilot sites will serve as a controlled environment to:

  1. Validate the functionality and effectiveness of the Roadmap Items.

  2. Test and refine associated communications materials and training approaches.

  3. Identify operational or technical adjustments needed prior to wider implementation.

To ensure equity and transparency the incentive will be structured to reflect delivery dependencies, which may vary across Suppliers. The Authority reserves the right to tailor incentive availability per Supplier to account for differing technical baselines, readiness levels, and integration complexities.

This incentive amount is applicable to Catalogue Solutions which are live in GP Practices in England at the time of publication of this Roadmap Item.

Post-Pilot Review and Iteration

Upon completion of the pilot phase:

  1. The Roadmap Item will be reviewed and, where necessary, updated to reflect findings and lessons learned.

  2. Any such updates will be jointly assessed by the Authority and participating Suppliers to determine whether changes constitute a material impact to the Roadmap Item’s Effective Date.

  3. If applicable, the Effective Date and deliverables may be adjusted accordingly, subject to mutual agreement.

National Rollout Coordination

Following successful validation through the pilot phase, the national rollout of the Roadmap Item will be coordinated by the Authority. This ensures that a consistent and effective training and communication programme is available to all End Users.

Summary of Change

Patient Information Maintenance - GP: MUST Epic added

E00749 - enabling Proxy access for baby Patient Registrations

As a Health or Care Professional

I want Proxy access to a Patient’s Citizen Services to be provided when registering a new Patient under the age of 1 year old at the GP Practice

So that Proxy access to a baby’s Citizen Services can be provided immediately upon the baby’s registration at the GP Practice

Acceptance criterion 1: enabling Proxy access for baby Patient Registrations

Given the Health or Care Professional is permitted to create Patient Registrations

When the Health or Care Professional selects to create a Patient Registration

And the Patient is aged under 1 year old

And the Patient does not have an existing Electronic Patient Record (EPR)

Then the Health or Care Professional can select to enable access to the Patient’s Citizen Services for a Proxy during the Patient Registration process

And access to the Patient’s Citizen Services for a Proxy is enabled

E00749 - Supporting Information

  • For information on managing Citizen Service Access for a Proxy, see manage Citizen Service Access for a Proxy

Patient Information Maintenance - GP: E00206 updated to MUST

E00206 - manage Citizen Service Access for a Proxy

As a Health or Care Professional

I want to manage Citizen Service Access for Proxies

So that Proxies have access to Citizen Services on behalf of Patients

Acceptance criterion 1: enable Proxy Citizen Service Access

Given the Health or Care Professional is permitted to enable Citizen Service Access

When the Health or Care Professional selects to enable Citizen Service Access for a Proxy

Then the Citizen Service Access is enabled for that Proxy

Acceptance criterion 2: disable Proxy Citizen Service Access

Given the Health or Care Professional is permitted to disable Citizen Service Access

When they select to disable Citizen Service Access for a Proxy

Then the Citizen Service Access is disabled for that Proxy

Acceptance criterion 3: create Proxy Verified User Accounts

Given the Health or Care Professional is permitted to create a Verified User Accounts

When they select to create a Verified User Account for a Proxy

Then the Verified User Account is created for that Proxy

Acceptance criterion 4: amend Proxy Verified User Accounts

Given the Health or Care Professional is permitted to amend Verified User Accounts

When they select to amend a Verified User Account for a Proxy

Then the Verified User Account is amended for that Proxy

Acceptance criterion 5: view Proxy Verified User Accounts

Given the Health or Care Professional is permitted to view Verified User Accounts

When they select to view a Verified User Account for a Proxy

Then the Verified User Account is displayed for that Proxy

Acceptance criterion 6: generate Verified User Accounts credentials

Given the Health or Care Professional is permitted to generate Verified User Account credentials for a Proxy

When the Health or Care Professional selects to generate Verified User Account credentials for a Proxy

Then the Practice ODS Code is generated

And the Verified User Accounts ID is generated

And the Verified User Accounts Linkage Key is generated

And a list of available Citizen Services is generated

And a list of Solutions providing a Citizen Service which integrate with the Patient Information Maintenance Solution is generated

And these credentials are shared with the Proxy

Acceptance criterion 7: link Proxy Verified User Accounts to Online Service Accounts

Given the Health or Care Professional has generated Verified User Account credentials for a Proxy

When the Proxy enters their Verified User Account credentials

Then the Online Service Account is linked to the Proxy’s Verified User Account

Acceptance criterion 8: associate Proxy Verified User Account to the Patient

Given the Health or Care Professional is permitted to manage Proxy Verified User Accounts

When the Health or Care Professional selects to associate the Proxy’s Verified User Account with a Patient

Then the Proxy’s Verified User Account is associated with the Patient

E00206 - Supporting Information

  • Further information on Citizen Services can be found in the Citizen Services Implementation Guidance

Patient Information Maintenance - GP: E00167 updated

E00167 - manage Identity Verifications for a Patient

As a Health or Care Professional

I want to manage Identity Verifications for Patients

So that Identity Verifications are managed Patients are accurately identified before being granted access to Citizen Services

Acceptance criterion 1: create Identity Verifications for a Patient

Given the Health or Care Professional is permitted to create Identity Verifications

When the Health or Care Professional selects to create an Identity Verification for a Patient

Then the Identity Verification is created for that Proxy Identity Evidence type is recorded

And who carried out the identity verification process is recorded

And the Identity Verification is created for that Patient

Acceptance criterion 2: amend Identity Verifications for a Patient

Given the Health or Care Professional is permitted to amend Identity Verifications

When the Health or Care Professional selects to amend an Identity Verification for a Patient

Then the Identity Verification is amended for that Patient

Acceptance criterion 3: view Identity Verifications for a Patient

Given the Health or Care Professional is permitted to view Identity Verifications

When the Health or Care Professional selects to view an Identity Verification for a Patient

Then the Identity Verification is displayed for that Patient

And the Identity Evidence type is displayed

And who carried out the identity verification process is displayed

E00167 - Supporting Information

  • For further information on Identity Verification please see DAPB3051 (previously DCB3051): Identity Verification and Authentication Standard for Digital Health and Care Services DCB3051 for Identity Verification and Authentication Standard for Digital Health and Care Services

  • Further information on Citizen Services can be found in the Citizen Services Implementation Guidance

Patient Information Maintenance - GP: E00207 updated to MUST

E00207 - manage Identity Verifications for a Proxy

As a Health or Care Professional

I want to manage Proxy Identity Verifications

So that Proxy Identity Verifications are managed Proxies are appropriately identified before being granted access to Citizen Services on behalf of Patients

Acceptance criterion 1: create Proxy Identity Verifications

Given the Health or Care Professional is permitted to create Proxy Identity Verifications

When they select to create an Identity Verification for a Proxy

Then the Identity Verification is created for that Proxy Identity Evidence type is recorded

And who carried out the identity verification process is recorded

And the Identity Verification is created for that Proxy

Acceptance criterion 2: amend Proxy Identity Verifications

Given the Health or Care Professional is permitted to amend Proxy Identity Verifications

When they select to amend an Identity Verification for a Proxy

Then the Identity Verification is amended for that Proxy

Acceptance criterion 3: view Proxy Identity Verifications

Given the Health or Care Professional is permitted to view Identity Verifications

When they select to view an Identity Verification for a Proxy

Then the Identity Verification is displayed for that Proxy

And the Identity Evidence type is displayed

And who carried out the identity verification process is displayed

E00207 - Supporting Information

  • For further information on Identity Verification please see DAPB3051 (previously DCB3051): Identity Verification and Authentication Standard for Digital Health and Care Services DCB3051 for Identity Verification and Authentication Standard for Digital Health and Care Services

  • Further information on Citizen Services can be found in the Citizen Services Implementation Guidance

Patient Information Maintenance - GP: E00209 updated to MUST

E00209 - manage Appointments Management Citizen Service Access for a Proxy

As a Health or Care Professional

I want to be able to manage Proxy access to Appointments Management Citizen Service

So that I can manage a Proxy’s access to Appointments Management Citizen Service

Acceptance criterion 1: enable Proxy access to the Appointments Management Citizen Service

Given the Health or Care Professional is permitted to configure Proxy access to Appointments Management Citizen Service

When they select to enable a Proxy’s access to the Appointments Management Citizen Service

Then access to the Appointments Management Citizen Service is enabled for the Proxy

Acceptance criterion 2: disable Proxy access to the Appointments Management Citizen Service

Given the Health or Care Professional is permitted to configure Proxy access to Appointments Management Citizen Service

When they select to disable a Proxy’s access to the Appointments Management Citizen Service

Then access to the Appointments Management Citizen Service is disabled for the Proxy

E00209 - Supporting Information

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

Patient Information Maintenance - GP: E00210 updated to MUST

E00210 - manage Prescription Ordering Citizen Service Access for a Proxy

As a Health or Care Professional

I want to be able to manage Proxy access to Prescription Ordering Citizen Service

So that I can manage a Proxy’s access to Prescription Ordering Citizen Service for Repeat Medication

Acceptance criterion 1: enable Proxy access to Prescription Ordering Citizen Service

Given the Health or Care Professional is permitted to configure Proxy access to Prescription Ordering Citizen Service

When they select to enable a Proxy’s access to the Prescription Ordering Citizen Service

Then access to the Prescription Ordering Citizen Service is enabled for the Proxy

Acceptance criterion 2: disable Proxy access to Prescription Ordering Citizen Service

Given the Health or Care Professional is permitted to configure Proxy access to Prescription Ordering Citizen Service

When they select to disable a Proxy’s access to the Prescription Ordering Citizen Service

Then access to the Prescription Ordering Citizen Service is disabled for the Proxy

E00210 - Supporting Information

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

Patient Information Maintenance - GP: E00212 updated to MUST

E00212 - manage View Record Citizen Service Access for a Proxy

As a Health or Care Professional

I want to be able to manage Proxy access to View Record Citizen Service

So that I can manage a Proxy’s access to View Record Citizen Service

Acceptance criterion 1: enable Proxy access to Summary Information Record Access Level

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

When they select to enable a Proxy’s access to Summary Information Record Level

Then Summary Information Record access Level is enabled for the Proxy

Acceptance criterion 2: enable Proxy access to Detailed Coded Record Access Level

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

When they select to enable a Proxy’s access to Detailed Coded Record Access Level

Then Detailed Coded Record Access Level is enabled for the Proxy

Acceptance criterion 3: enable Proxy access to Document Access Level

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

And Detailed Coded Recorded Access Level is enabled

When they select to enable a Proxy’s access to Document Access Level

Then Document Access Level is enabled for the Proxy

Acceptance criterion 4: enable Proxy access to View Record Full Record

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

When they select to enable a Proxy’s access to Full Record Level

And record a start date for data to be available from

Then View Record Full Record Access Level is enabled for the Proxy

Acceptance criterion 5: disable Proxy access to a Record Access Level

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

When they select to disable a Proxy’s access to a Record Access Level

Then that Record Access Level is disabled for the Proxy

E00212 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

  • The Access Level for a Proxy will not exceed the configured Access Level for the Practice

E00212 - Supporting Information

  • The start date determines the date from which the data made available goes back to, not whether the Service is offered/available by the Practice e.g. where the Full Record Access start date is set to 15th March 2015 and the Full Record Access is enabled (‘switched on’) by the Practice on the 1st April 2015

  • Further guidelines on Proxies can be found in the RGCP Patient Online Toolkit

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

Full Specification

Patient Information Maintenance - GP v10.0.0 Capability

Assurance Approach

  • Suppliers will be assessed against the MUST Epics as per the Capability Assessment process and this will be a high level assessment based on the Acceptance Criteria defined.

  • Suppliers will be asked to demonstrate their mitigations against any pre-identified risks through completion of the NHS England Solution Assurance Capability Risk Log submission.