The challenge
In July 2024, Normanby Medical Centre, Easton Primary Care Network (PCN), Tees Valley, appeared on the Prospective Record Access non-compliant dashboard that NHS England issued monthly. The practice was non-compliant for failure to provide Prospective Record Access to New NHS App users by default and providing access to less than 90% of patient online accounts, which are both Step 3 and Step 4, respectively, of Prospective Record Access compliancy, as measured by NHS England.
Our response
Primary Care Digital Support Hub (PCDSH) Project Manager, Alex Mills, met with Practice Manager Ruth Barker and Assistant Practice Manager Fern Williamson to discuss and review the practices current position with Prospective Record Access, in addition to the utilisation of digital tools (Online Services, NHS App and Websites).
The practice was provided with PCDSH clinical system guides for Prospective Record Access, as they needed to enable the service for new NHS App users within their clinical system. The practice was also provided with a bulk enablement guide that would apply record access to eligible patient online accounts, which would hopefully increase the record access for online account to above 90%.
Throughout discussions, the practice expressed a desire to increase the promotion and patient utilisation of the NHS App.
With this in mind, NECS provided the practice with an earlier iteration of the now published PCDSH NHS App implementation plan. This is a knowledge document that includes guidance on how to promote the NHS App, actions to carry with the aim off take away any decision making in practice, and a checklist that practices can save and mark off their progress.
The tasks:
- Complete the Prospective Record Access PCDSH clinical system enablement guide.
- Complete the Prospective Record Access PCDSH clinical system bulk enablement guide.
- Complete NHS App Implementation Plan and promote the App to patients.
Outcomes
As a result of completing the PCDSH Prospective Record Access guides, Normanby Medical Centre was removed from the NHSE Prospective Record Access non-compliant dashboard the following month, August 2024.
The practices Prospective Record Access compliancy was:
- Step 1 Clinical system enabled for Prospective Record Access – Yes.
- Step 2 Less than 10% of patients withheld access due to enhanced review (104 Code) – 5.45%.
- Step 3 Prospective Record Access enabled for New NHS App users by default – Yes.
- Step 4 Greater than 90% of patient online accounts provided with Prospective Record Access – 96.80%.
The practice is reminded to complete the bulk enablement guide to ensure new patient online accounts are updated with record access, to maintain their 90% target within step 3 of compliancy.
In collaboration with promoting the NHS App to their patient population by following the PCDSH NHS App Implementation Plan, the practice has seen an increase in detail coded record views via the App as result of bulk enabling Prospective Record Access.
The following results have been obtained via the National NHS App Dashboard provided by NHS England:
- Three month average prior to bulk enabling Prospective Record Access – 14,262pm.
- Three month average post bulk enabling Prospective Record Access – 25,818pm.
This has resulted in an 81% increase of a three month average in record views with the NHS App.
Fern Williamson, Assistant Practice Manager, has reported that since implementing Prospective Record Access and increasing awareness of the NHS App, the request for record access has reduced.
The practice has realised the following benefits for their workforce and patients:
- Improved patient experience as patients will be able to access their health record online at a time convenient to them.
- Improved practice efficiency by streamlining work processes to adapt access to patient records to include the digital electronic patient record.
In addition, the practice has also supported achieving a Primary Care Access Recovery Plan programme benefit by helping to reduce the number of practices who are not NHSE compliant with Prospective Records Access.
“The support PCDSH provided has been good, being very structured and organised. Meeting with PCDSH and viewing the Prospective Record Access diagram, which is available on the PCDSH Data Dashboard, was very helpful and without it, I don’t think we would have known there was an issue with compliancy.”