Sharing your information with someone who cares for you

We adhere to strict patient confidentiality policies so we will not discuss your medical records or provide information to anyone other than yourself. However, we do understand there may be times where you may need us to discuss your medical records and how best to mange your ongoing care with someone other than yourself. This could be a family member; someone you care for or a child. We have two ways in which this can be achieved. These are known as Consent to Share and Proxy Access.

Consent to share: allowing us to discuss your care with someone else

You may choose to allow our clinical teams to discuss your care with a nominated person or persons. You are in control of who you grant this access to and you can revoke this access at anytime by contacting us. Please note, granting ‘consent to share’ does not allow the nominated person/persons online access to your medical records within the NHS App or Patient Access (to do this you need proxy access).

If you would like to nominate a person(s) or your choice, you will need to either:

complete the online form below:

or

Provide a signed letter providing the details of the person(s) you consent to being able to discuss your medical records and care. This letter should include the following:

• Your Name, Address and Date of Birth
• Full name of the person(s) you are allowing us to discuss your care with
• Contact details of the person(s)
• Their relationship to you
• Be signed and dated by all parties.

• State that you give your consent for your relative/carer to have access to your medical records and personal details held by the practice and for members of the practice staff to discuss your health care with the above named person.
• Understand that this consent relates to all of my medical records. {Please note we do not have the facilities to be able to apply specific exclusions, or restrict parts of medical records}
• State that you understand this consent will remain active indefinitely and if you wish to remove or restrict carer/relatives access to your medical records, you should inform the practice in writing.

Please hand this letter to a receptionist at the surgery. We will then be able to action your request, updating your records to reflect your consent to share preferences.

Proxy Access: arranging for someone else to act on your behalf

As a parent, family member or carer, you may be able to access our services on behalf of someone else. We call this having ‘proxy access’. This is often used by parents, recognised carers or where Lasting Power of Attorney has been put in place.

To access someone else’s health and care records, you must:

• be acting on their behalf with their consent, or
• have legal authority to make decisions on their behalf (e.g. power of attorney or parent of a child under 11yrs)

Once proxy access is set up, you can access the other person’s profile in your own NHS account, using the NHS App or website.

The NHS website has more information about using linked profiles to access services for someone else.

Proxy access for children under 11 years

Before a child is aged 11, their parents usually control access to their health record and online GP services.

Proxy access for children under 11 – 16 years

When a child is aged between 11 and 16, parents may be allowed proxy access to their child’s online services, if we agree this is appropriate.

A parent or carer with proxy access will be able to manage certain elements of the young person’s record, such as making appointments and ordering medication, but they will not be able to see the young person’s past appointments or clinical records.

If you are aged 13 or over, you can access your own account using the NHS App.

If you’re aged between 11 and 16, and you have questions about who can access your health record or online services, contact us.

Proxy access for patients aged 16 years and over

When a child reaches the age of 16 years, proxy access for their parent/carer will automatically cease. Subsequent proxy access will need to be authorised by the patient via a new application with their consent.

Proxy access can be granted if the patient has been assessed as lacking capacity and granting access to a family member or recognised carer is deemed to be in their best interests.

 How to apply for proxy access

To requests proxy access, please complete the appropriate proxy access request form.

Request access for a child aged 0 – 10 years

Request access for a child aged 11 – 15 years

Request access for adults and young people aged 16+ years

Consent to Share: Allowing us to discuss your care with someone else

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This field is for validation purposes and should be left unchanged.

You may choose to allow our clinical teams to discuss your care with a nominated person or persons. You are in control of who you grant this access to and you can revoke this access at anytime by contacting us. Please note, granting ‘consent to share’ does not allow the nominated person/persons online access to your medical records within the NHS App or Patient Access (to do this you need proxy access). Your Details:

Title(Required)

Please select...MrMrsMsMasterMissMxDr

Name(Required)

First Last

"Known As" or "Calling Name" if different

Date of Birth(Required)

DayDay12345678910111213141516171819202122232425262728293031

MonthMonth123456789101112

YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

NHS Number if known

Address(Required)

Street Address Address Line 2 City Postcode

Additional access instructions for hard to find addresses e.g. "What3words Address"

Make it easy for emergency services to locate your house to the nearest 3m if needed. Great for difficult to find houses. e.g. https://what3words.com/limitless.requires.fear

Primary Phone Number(Required)

Usually Mobile number

Landline Telephone Number (optional)

Email(Required)

Secondary Phone Number

This will be recorded as a "work" number in the medical record and visible to other NHS organisations. Can be e.g. a parent or guardian to make them easily contacted if we can't reach your primary phone number

Consent(Required)

I confirm that:

The above are my contact details that I want the NHS to hold for me.
I give my consent for my relative/carer to have access to my medical records and personal details held by the practice and for members of the practice staff to discuss my health care with the above named person.
This consent relates to all of my medical records. {Please note we do not have the facilities to be able to apply specific exclusions, or restrict parts of medical records}
I understand that this consent will remain active indefinitely and if I wish to remove or restrict my carer/relatives access to my medical records, I should inform the practice in writing.

Signature(Required)

Date

DD slash MM slash YYYY

Name and contact details of person/people to whom you give consent to access your medical information

Name/Contact Details/Relationship to yourself. This information will be added to your record on the Family/relationship page. They will not be automatically contacted, e.g. about results, but if they contact the surgery, the above named people will be authorised to make appointments, request medication or receive results, on your behalf.

Consent(Required)

I confirm that:

I agree to treat any information that I receive in relation to the above named persons medical records with confidentiality. I agree not to disclose any information to a third party without full consent and any information I am provided with will be used in the patients’ best interest.

Signature(Required)

Security question: What colour is the sky...(Required)

You may only submit this form if you answer the question correctly, this is an anti-spam measure.

We aim to action all requests within 14 days, although often we manage this much sooner.  If there are any issues with this request, we will contact you directly.