Can I access a patient’s NHS record as part of a private GP consultation?

Why it matters

Working without the NHS record is one of the main safety risks in private general practice. Patients forget medicines, doses, allergies and past diagnoses, and they may not know what their NHS GP recorded. GMC guidance on prescribing, including its high-level principles for remote prescribing, highlights limited access to medical records as a particular risk where a service is not linked to the patient’s NHS GP.

The direct routes, and why they are closed

Tool	What it does	Who can use it
GP Connect Access Record	Lets authorised clinicians view a patient’s GP record from their own system	Organisations in the categories covered by NHS England’s national data sharing arrangement, such as GP practices, trusts, 111 and 999, pharmacies, optometrists and social care, using an assured system
Summary Care Record	Key information such as medicines and allergies	Staff with NHS login roles in organisations with approved access
Accurx Record View	A summary of the GP record, shared with the patient’s permission by a code	NHS professionals logging in with NHS.net or NHS.uk credentials

A purely private GP service is not one of the categories in the GP Connect data sharing arrangement and has no NHS login roles to use. Earlier versions of this article suggested some of these tools as options. At the time of review we could not confirm a route for purely private GP services, so do not plan around them.

One trap is worth naming. If you hold NHS credentials through your NHS job, they are for that NHS role. Using them to look up a private patient’s record would be outside the purpose they were issued for, even with the patient’s agreement. Keep NHS systems and private work separate.

The patient-led route that works

Patients can now see much more of their own record. Under changes to the GP contract, NHS England required practices to give patients with online accounts access to new entries in their record by 31 October 2023, unless the patient opts out or an exception applies. This is prospective access. It covers new entries, including free text, medicines, test results and letters such as clinic letters and discharge summaries. It does not automatically include older records. The v1 version of this article gave November 2022 as the start date. NHS England did plan to switch on access from 1 November 2022, but the rollout was paused after practices raised safety concerns, and it became a contractual requirement from 31 October 2023.

Patients can view this in the NHS App or other approved apps. In practice:

1. Ask the patient to log in before or during the consultation. For video consultations, they can share their screen.
2. Look at the medicines list, allergies, recent consultations and recent results and letters.
3. Record in your notes what you reviewed, the date, and that the patient showed it to you.
4. Remember what may be missing: older entries, anything the practice has withheld, and anything not yet filed.

This relies on the patient’s consent and cooperation, so it works best when you explain why it helps them.

Other routes

• A copy of the record. Patients can ask their NHS practice for a copy through a subject access request. The practice must normally respond within one month, so this suits planned care rather than same-day decisions.
• Asking the NHS GP. With the patient’s consent, you can ask the NHS practice for specific information, such as a medicines list or a recent result. Keep the request short and specific.
• Letters the patient holds. Clinic letters and discharge summaries are often in the patient’s email or app.

Prescribing without the full record

GMC prescribing guidance says you should only prescribe when you have adequate knowledge of the patient’s health and are satisfied the medicine serves their needs. If you cannot get the information you need, particularly for medicines with a risk of misuse or that need monitoring, do not prescribe. Explain why and offer an alternative, such as seeing their NHS GP.

Afterwards, close the loop. With consent, send a summary of what you prescribed to the NHS GP so the NHS record stays accurate. See sending notes to the NHS GP.

Scotland, Wales and Northern Ireland

The 2023 online access requirement applies to GP practices in England. Online record access, the apps patients use and the national record systems differ in Scotland, Wales and Northern Ireland, so ask the patient what they can see and do not assume it matches England.

For the other side of the NHS interface, see how private GPs should communicate with NHS GPs.