Obtaining Medical Records Advice

[TheManWho85]

Hi

A few years ago I switched GPs and the new GP have not yet provided my medical records and I cannot access them under the patient access app.

I have emailed them many times and the things their admin have done have not produced anything yet and my last email was ignored. I spoke to the diabetes nurse at the GP and she said she would go straight to the admin people after my appointment to discuss it with them, but alas still nothing 6 months later. My Diabetes Care Team have also written to them to ask them to look into it about 6 months ago.

As I am now suffering complications, I want to be able to compare previous HBa1c results s as I know they weren't always amazing (around 7.5-8). The fact as a diabetic I have no idea what my HBa1c was prior to 2023 is just embarrassing.

Anyone got any advice, I was going to go down the freedom of information route but apparently this sort of request isn't covered under that? The NHS page just says you have to contact your GP..

 

[Rachox]

In your position I’d put in a complaint to the practice manager.

 

[KennyA]

Hi

This can be a tricky one. Technically your GP record is the property of the Secretary of State for Health, so the original practice has no justification for holding on to it. It's not an FOI issue.

You will need to make a complaint. Practice records are supposed to be transferred between practices in a timely manner in the best interests of patients: the BMA ( the doctors' trade union) publishes guidance to it members about this: this is the guidance from NHS England:

The current General Medical Services GP Contract requires GP practices to use a service known as GP2GP for transferring electronic health records (EHRs).

At present, a patient’s new and old practices need to be in England for GP2GP transfer. There is as yet no mechanism to send electronic records between the different countries of the United Kingdom. Where there is no GP2GP provision, electronic records are printed by the holding practice and sent as paper records to the receiving practice. There is currently no nation-wide service for this.

The PCSE process for individual patient migrations (or ‘deductions’) is currently triggered by the patient’s registration at a new practice. The electronic record is sent via GP2GP, if both practices are in England, and the follow-up manual process moves the remaining paper records, i.e. the Lloyd George envelope, to the new practice by following the guidance here. [this link isn't working - seems to be a fault on the NHS England website]

Record deduction needs to be done on a regular basis (suggested weekly) to ensure new practices have complete records quickly. This currently entails triggering the electronic transfer and packing and returning the paper records to PCSE. This will change as the programme to fully digitise patient records progresses.

What you need to establish is whether your old practice has sent your records to the new one. If it has, then the fault is with the new practice. If it hasn't, the fault is with your old one.

So - I'd ask your current practice if they've received your records. If they have, make a complaint to the current practice that you are not being allowed to access them. If they haven't received them, and this is because the old practice hasn't transferred them, you need to make a complaint to the old practice, and I'd advise copying the complaint to the new practice and to the Integrated Care Group(s) to which each of the practices belong. There is simply no justification for not transferring records.

They shouldn't have been deleted. The health departments give detailed advice about the minimum retention periods applicable to NHS records. The recommendations apply to both electronic and manual records, and the BMA advises private practitioners to follow the same rules. Hospital records should be kept for a minimum of eight years following the end of treatment, and GP records for 10 years, although certain types are kept longer.

Advice based on me being responsible for this policy around twenty years ago. I've quoted current documents above, though.

Best of luck.

 

[TheManWho85]

Hi

This can be a tricky one. Technically your GP record is the property of the Secretary of State for Health, so the original practice has no justification for holding on to it. It's not an FOI issue.

You will need to make a complaint. Practice records are supposed to be transferred between practices in a timely manner in the best interests of patients: the BMA ( the doctors' trade union) publishes guidance to it members about this: this is the guidance from NHS England:

The current General Medical Services GP Contract requires GP practices to use a service known as GP2GP for transferring electronic health records (EHRs).

At present, a patient’s new and old practices need to be in England for GP2GP transfer. There is as yet no mechanism to send electronic records between the different countries of the United Kingdom. Where there is no GP2GP provision, electronic records are printed by the holding practice and sent as paper records to the receiving practice. There is currently no nation-wide service for this.

The PCSE process for individual patient migrations (or ‘deductions’) is currently triggered by the patient’s registration at a new practice. The electronic record is sent via GP2GP, if both practices are in England, and the follow-up manual process moves the remaining paper records, i.e. the Lloyd George envelope, to the new practice by following the guidance here. [this link isn't working - seems to be a fault on the NHS England website]

Record deduction needs to be done on a regular basis (suggested weekly) to ensure new practices have complete records quickly. This currently entails triggering the electronic transfer and packing and returning the paper records to PCSE. This will change as the programme to fully digitise patient records progresses.

What you need to establish is whether your old practice has sent your records to the new one. If it has, then the fault is with the new practice. If it hasn't, the fault is with your old one.

So - I'd ask your current practice if they've received your records. If they have, make a complaint to the current practice that you are not being allowed to access them. If they haven't received them, and this is because the old practice hasn't transferred them, you need to make a complaint to the old practice, and I'd advise copying the complaint to the new practice and to the Integrated Care Group(s) to which each of the practices belong. There is simply no justification for not transferring records.

They shouldn't have been deleted. The health departments give detailed advice about the minimum retention periods applicable to NHS records. The recommendations apply to both electronic and manual records, and the BMA advises private practitioners to follow the same rules. Hospital records should be kept for a minimum of eight years following the end of treatment, and GP records for 10 years, although certain types are kept longer.

Advice based on me being responsible for this policy around twenty years ago. I've quoted current documents above, though.

Best of luck.

Many thanks for the advice, I emailed them again today and received the following response:

"I have put a request in to PCSE to see if they can find out where your notes are it normally takes a few weeks I will let you know when they arrive or what they say."

I'm not sure why they didn't do this the last two times I was in communication with them, but it seems there is some movement at least. As you say, my medical records should be floating around somewhere, however, if for some reason they're gone.. what are my legal rights?

If there has been some sort of issue with my previous surgery failing to send records to the PCSE appropriately, then my spidey sense would be tingling. That surgery misdiagnosed pretty much every medical issue I've ever had with gross malpractice every step of the way, bit of a coincidence if those records are now lost?

 

[AndBreathe]

Many thanks for the advice, I emailed them again today and received the following response:

"I have put a request in to PCSE to see if they can find out where your notes are it normally takes a few weeks I will let you know when they arrive or what they say."

I'm not sure why they didn't do this the last two times I was in communication with them, but it seems there is some movement at least. As you say, my medical records should be floating around somewhere, however, if for some reason they're gone.. what are my legal rights?

If there has been some sort of issue with my previous surgery failing to send records to the PCSE appropriately, then my spidey sense would be tingling. That surgery misdiagnosed pretty much every medical issue I've ever had with gross malpractice every step of the way, bit of a coincidence if those records are now lost?

Personally, I would write again, reinforcing your issue is now a complaint and ask then to outline their complaints process to you. That will make them at least have (their own) deadlines to meet, and allow you to manage your own expectations.

A couple of comments though. Firstly, if your records have disappeared, I'd ask to be informed where they were last known to be. If the old place says they sent them, I'd be asking for dates etc, and ideally a screen shot of their systems showing that.

In terms of legal rights, it's hard to have a right to something that doesn't exist. Sorry to be the pedant in the room.

Finally, a further couple of points; if your diabetes is handled by a hospital clinic, you may not find very fulsome information in your GP record. Often it will just be clinic letters. They may contain what you are looking for, but if they are anything like some of mine (not for diabetes), it can be hard to recognise myself.

And finally, once you have access to your records, it is often the case that the record will only be visible from the date of the request. Both myself and my partner have had to write a subsequent request to our GP to have access to our full records for the whole of our lives.

It's all such a pain, and it seems your experiencing more than your fair share of it. Fingers crossed for you.

 

[TheManWho85]

Personally, I would write again, reinforcing your issue is now a complaint and ask then to outline their complaints process to you. That will make them at least have (their own) deadlines to meet, and allow you to manage your own expectations.

A couple of comments though. Firstly, if your records have disappeared, I'd ask to be informed where they were last known to be. If the old place says they sent them, I'd be asking for dates etc, and ideally a screen shot of their systems showing that.

In terms of legal rights, it's hard to have a right to something that doesn't exist. Sorry to be the pedant in the room.

Finally, a further couple of points; if your diabetes is handled by a hospital clinic, you may not find very fulsome information in your GP record. Often it will just be clinic letters. They may contain what you are looking for, but if they are anything like some of mine (not for diabetes), it can be hard to recognise myself.

And finally, once you have access to your records, it is often the case that the record will only be visible from the date of the request. Both myself and my partner have had to write a subsequent request to our GP to have access to our full records for the whole of our lives.

It's all such a pain, and it seems your experiencing more than your fair share of it. Fingers crossed for you.

Many thanks, I will consider this

All I want is a history of my Hba1c results, it's not a lot to ask for! I've never had much luck with GPs, I could write a whole thread about how they've screwed me over the years. All my diabetes related info was dealt with my the GP, it's where I had all my tests and appointments, so they will have had it all.

What is strange though is that I was looking through the NHS app the other day instead of the Patient Access one just to check if there was anything there prior to 2021 (there wasn't), but I did find one thing prior, which was a prescription for eye drops when I had conjunctivitis.. this was back in 1992! How strange.

Also as you say, it's mostly letters sent from A to B, but there is some interesting information in there which I didn't realise. Such as back when I had background retinopathy a few years ago, I just had a letter saying 'you have background retinopathy', but the letter on file actually specified that it was in the right eye. Didn't realise there was extra information I wasn't aware of.

 

[AndBreathe]

Many thanks, I will consider this

All I want is a history of my Hba1c results, it's not a lot to ask for! I've never had much luck with GPs, I could write a whole thread about how they've screwed me over the years. All my diabetes related info was dealt with my the GP, it's where I had all my tests and appointments, so they will have had it all.

What is strange though is that I was looking through the NHS app the other day instead of the Patient Access one just to check if there was anything there prior to 2021 (there wasn't), but I did find one thing prior, which was a prescription for eye drops when I had conjunctivitis.. this was back in 1992! How strange.

Also as you say, it's mostly letters sent from A to B, but there is some interesting information in there which I didn't realise. Such as back when I had background retinopathy a few years ago, I just had a letter saying 'you have background retinopathy', but the letter on file actually specified that it was in the right eye. Didn't realise there was extra information I wasn't aware of.

Yes, the medications section is a bit interesting in the NHS app.

There do seem to be slight differences between NHS app and GP website/StstemOnline/Patient Access.

Unfortunately, GPs seem to be a very mixed bag, so hopefully your new bunch will be better than your historic experiences.

 

[KennyA]

Many thanks for the advice, I emailed them again today and received the following response:

"I have put a request in to PCSE to see if they can find out where your notes are it normally takes a few weeks I will let you know when they arrive or what they say."

I'm not sure why they didn't do this the last two times I was in communication with them, but it seems there is some movement at least. As you say, my medical records should be floating around somewhere, however, if for some reason they're gone.. what are my legal rights?

If there has been some sort of issue with my previous surgery failing to send records to the PCSE appropriately, then my spidey sense would be tingling. That surgery misdiagnosed pretty much every medical issue I've ever had with gross malpractice every step of the way, bit of a coincidence if those records are now lost?

Hi

does not sound good. Which practice did you email? I'd be including them both until it can be established who is at fault - and it could be both. I would have expected the new practice to be asking questions after years if records hadn't appeared. It could potentially be the old practice not transferring, and then the new practice not bothering to chase up. Both at fault in my book.

Use one to embarass the other, (neither will want to take the blame for the other's mistakes) and copy both of their Independent Care Groups in to embarass them further in front of their peers.

They should NOT have been deleted whatever the circumstances.

I think you are already in complaint territory and you might want to start that immediately, which could add a bit of urgency to their questions to PCSE.

 

[TheManWho85]

Hi

does not sound good. Which practice did you email? I'd be including them both until it can be established who is at fault - and it could be both. I would have expected the new practice to be asking questions after years if records hadn't appeared. It could potentially be the old practice not transferring, and then the new practice not bothering to chase up. Both at fault in my book.

Use one to embarass the other, (neither will want to take the blame for the other's mistakes) and copy both of their Independent Care Groups in to embarass them further in front of their peers.

They should NOT have been deleted whatever the circumstances.

I think you are already in complaint territory and you might want to start that immediately, which could add a bit of urgency to their questions to PCSE.

Looking back through my old emails, the last I heard from my previous surgery was a copy/paste of an email from the PCSE:

"We can confirm that these records were delivered to *new surgery* on 22/07/2021. If the practice has any queries then they will need to contact us directly."

I've gone back to the new surgery with this info, so yep, it would appear that the fault is theirs. Was initially annoyed at myself for forgetting this but then remembered I have already forwarded all this to them as at one point I was indeed copying in both surgeries.

Initially, the admin at the new surgery just kept sending me links to sign up for patient access, which I'd already been using for years.

 

[KennyA]

Looking back through my old emails, the last I heard from my previous surgery was a copy/paste of an email from the PCSE:

"We can confirm that these records were delivered to *new surgery* on 22/07/2021. If the practice has any queries then they will need to contact us directly."

I've gone back to the new surgery with this info, so yep, it would appear that the fault is theirs. Was initially annoyed at myself for forgetting this but then remembered I have already forwarded all this to them as at one point I was indeed copying in both surgeries.

Initially, the admin at the new surgery just kept sending me links to sign up for patient access, which I'd already been using for years.

I think that's "target acquired". They've had three years to process them.

best of luck.

 

[Lakeslover]

Just a thought but when I moved gps 5 years ago the practice told me I couldn’t use my old access and had to sign up again. I think they said the patient access login was in some way related to the surgery.

 

[AndBreathe]

Just a thought but when I moved gps 5 years ago the practice told me I couldn’t use my old access and had to sign up again. I think they said the patient access login was in some way related to the surgery.

I have recently changed GP, and it seemed all very pointless and frustrating in parts. I didn't have to sign up again, but the new surgery forced (in IT terms) a change of password. I just "changed" it to what it had been before.