If you missed the October 2023 bulk enablement date
If you wish to now ‘go live’ we would advise you discuss this with your ICB’s primary care IT team and EMIS to schedule a new ‘bulk enablement’ date. EMIS confirmed at a BMA meeting on 4 October 2023 that they can accommodate this. We would also suggest you consider if those patients you have coded as ‘at risk’ from being able to automatically view their records require the addition of the ‘104’ code. Given you haven’t yet gone live, you could ask your patients if any decline consent to the programme, and wish to seek an opt-out, as not all will want access. You should also direct them to an information resource explaining how they may choose to opt in, should they change their mind. Those you consider ‘at risk’ and code as ‘104’ still need the opportunity to request access, and they need to be made aware of this. We have provided template messages you could send to such patients.
Deferring a bulk enablement you have already booked
You need to inform EMIS of your intentions in writing and/or apply bulk code ‘104’ to all your patients before the go-live date. This will not affect any patients who currently have access. You will also need to give patients an opportunity to opt out when you advise them of the programme. You should also direct them to an information resource explaining how they may choose to opt in, should they change their mind.
If you want to proceed with bulk enablement as planned
You should also contact those patients you have identified as ‘at risk’ and have added ‘104’ codes, in order to make them aware that they can still request access should they want it. As a practice you can decide how you do this, e.g. you may initially wish to maintain a list of ‘at risk’ patients requesting access and follow an opt-in model. We have provided template messages.
Deferring bulk enablement due to concerns found within your DPIA
We would advise you to communicate with your patients to ensure they are kept up to date with the programme and explain that your contract required you to provide prospective access to their full record on or before 31 October 2023 unless they had opted out. We would recommend you undertake a DPIA and inform your ICB if you have concerns, and we have provided a template letter you could use to send to your commissioner. We have also provided a template patient opt-in form you can use.
If you have batch-coded all of your patients with the ‘104’ code but now want to provide access and you have not yet ‘gone live’
After you have considered your DPIA, if you wish to proceed to provide access you need to add the ‘106’ code to each of those patients with a ‘104’ code whom you think can safely be given prospective access. Once the EMIS script runs at ‘go live’, patients with a ‘106’ code will be granted access if that ‘106’ code has been entered into the record more recently than a ‘104’ code. You will also need to give patients an opportunity to opt-out when you advise them of the programme. You should also direct them to an information resource explaining how they may choose to opt in, should they change their mind. Those with ‘104’ codes should still be made aware that they can request access.
If you have batch-coded all of your patients with the ‘104’ code but now want to provide access and you have already ‘gone live’
You will have to manually add individual access to anyone who has an online services account already as access settings can only be changed manually after ‘go live’ has occurred. For anyone without an online services account (which would suggest they haven’t yet created an NHS login and attempted a connection via the NHS app) you can add a ‘106’ code to the medical record and access will be provisioned automatically the first time they connect after creating a suitably authenticated NHS login.