BMA FAQs on GP Connect ‘Update Record’
What exactly is GP Connect?
GP Connect (see https://digital.nhs.uk/services/gp-connect) is a piece of software that interfaces with GP systems (eg EMIS/TPP) that allows authorised health and social care workers in a variety of care settings to access information in patients' GP records. There is the provision to use this software to send documents and to write coded data to the GP record.
There are different parts to GP Connect and we are talking about the ‘Update Record’ part here.
What is GP Connect ‘Update Record’?
GP Connect Update Record is one part of GP Connect that allows a third party to send a structured record to the GP to be incorporated directly into the medical record. Observations, diagnoses and medicines can all be incorporated in coded form. Currently, only community pharmacies can use this facility, but there is nothing stopping it being rolled out to other providers, including the commercial health sector, as it would only require a policy change on the part of NHS England to make this happen. (There is ongoing work to allow commercial health providers to access records via GP Connect for direct care purposes.)
What is a data controller?
GPs are data controllers. A data controller determines the purposes and means of processing personal data. In other words, the data controller decides the how and why of a data processing operation.
Why are you asking us to turn off ‘Update Record’?
It is our understanding that NHS England asked EMIS and TPP to remove the ability for GPs to turn off ‘Update Record’ at the start of July 2024. We learnt they had been given three months’ notice to remove the option from the start of the programme. Though delayed, the programme began in earnest in April 2024 when the first use of ‘Update Record’ became possible for pharmacies who had suitable software. We think it is important to pause this just now and allow time to consider the implications of this new technology and ensure GP clinical systems clearly indicate the source of any coded information that enters the medical record. As GPs are responsible for the information provided through the NHS app (for those patients with online access) we need to be especially careful. The future workload implications of allowing many other providers to add consultations and prescriptions to the medical records are not yet understood. We may find there will be more requests for follow up and support from patients for work initiated by others outside the practice team. There will be medico-legal implications flowing from this.
Why were we advised to consider turning off ‘Update Record’ with such little notice?
The GPCE team had been in discussions with NHSE, EMIS and TPP for months around this specific issue. Discussions with EMIS/TPP have increased over the past month. Despite asking repeatedly for reassurance that the ‘toggle off’ switch would not be removed, we faced uncertainty from the data processors and silence from NHSE.
We decided to make this one of our collective actions in our GP Practice Survival Tool Kit.
NHSE’s own web pages spoke of a time-limited window before ‘Update Record’ would be forcibly turned on. (See https://web.archive.org/web/20240630215458/https://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-update-record where it states “You can choose to temporarily disable it for up to 3 months if your practice needs more time to prepare for the changes” and “At the end of the 3-month period, GP practices that still have Update Record disabled will be contacted by their system supplier and given a date when it will be automatically enabled in their practice.”) The 3-month time scale fitted with what we had already heard and that there was a deadline for removal. We had understood this deadline was to be “by July” and had advised colleagues about how to turn off ‘Update Record’ in guidance we issued. Late last week (Thu 27th June) we then heard this was to be ‘by the start of July’. Given the uncertainty, and the potential for confusion, we decided to ask colleagues to take up our existing guidance and follow it as soon as possible.
What information will be blocked from automatic upload to the GP record?
At the present time only pharmacies can make use of the ‘Update Record’ service. If turned off, they will be unable to send a structured record for direct incorporation into the medical record. Treatment summaries will default to coming in via NHSmail, as has been the case since Pharmacy First launched at the end of January 2024. The information content should be identical, though this will depend on what each pharmacy provider chooses to send.
What will happen if we turn this off – won’t we lose important patient info?
You will still receive the information, but it will be via email. Yes, this is more work, but no more work than at present, but we feel it is important to pause this and allow proper discussion and negotiation over the impacts of this process going forward.
Will it mean I can’t book appointments at my local diagnostic centre?
No – that is a separate piece of software and will still be able to occur.
Will it mean it stops 111 booking appointments with us?
No – 111 will still be able to book the slots on your screen. We are not stopping this happening.
Does it stop COVID vaccine info coming through?
No – that will still come through into your patients’ records as it does now.
Does it stop integration with other services, like Anima or other online consultation tools?
No – these providers do not use the GP Connect Update Record software.
What are you worried about at GPCE by wanting this paused?
We are concerned that GPs as data controllers would lose the future ability to turn off ‘Update Record’ if EMIS and TPP removed the on/off button. There is a concern that having not opted out NHSE will assume consent to progress onwards without suitable engagement of the profession, with the ‘Update Record’ being rolled out to other providers to write into our records leaving GPs with the responsibility to deal with a new diagnosis, and oversight and monitoring of new medication. Pausing now allows time for discussion over the way forward with this. We’re not saying ‘no’ to this technology, but ‘not yet’.
Do I need to inform EMIS/TPP about the action I have taken?
No you don't need to. We (GPCE) will be in touch with EMIS and TPP about the next steps and we will of course be in touch with NHSE and DHSC.
Is this a breach of contract if we do this?
Not at all – as data controller you are able to make the decision here and pause the upload of data to your records.
How do I turn off GP Connect 'Update Record’?
It is very easy to do this and we want to thank Dr Dustyn Saint from PCIT for producing these two simple guides below.
Is this part of the collective action you are asking us to do?
It is a form of collective action, but it is not a breach of contract. GPs acting together show that we can do the right thing for our patients and ensure safe care is provided, both now and for the future, given the constraints we work under.
You can find out more about our campaign to save general practice here.
Dr David Wrigley, Deputy Chair, BMA GPC England
Dr Mark Coley, Digital, IT & Data Policy Lead, BMA GPC England
1st July 2024