Health Records - Online Access by Children
GMS/PMS Regulations and guidance do not make any reference to an age at which patients become eligible or entitled to view their own records independently.
However, it is generally accepted that:
- “Fraser/Gillick-competent” children are entitled to access their medical records (or authorise someone to do so on their behalf)
- Parents, or those who have parental responsibility for children who are not “Fraser Gillick-competent”, are entitled to access a child’s medical records in the child’s best interests.
Children mature at different rates. An individual assessment of a child’s competence may not always be practicable. Possible approaches for Record Access include:
- Begin with a policy of not allowing either parent or child access to a record if the child is below a certain age, say 16 years old
- Do not allow formal Record Access to any child’s record below a certain age, say 16 years old
- Have the system prompt the health professional when the child reaches 12, so the health professional can consider competency
- Have the Record Access system automatically disconnect parental access when the child reaches 12 years old. This would stimulate discussion within the family about whether parental access should continue.
Section 6.6 of the RCGP document Enabling Patients to Access Electronic Health Records: guidance for health professionals relates to children having access to their health records online.
Implementing online access to health records presents a significant administrative and training burden for practices and it is entirely reasonable for GP colleagues and Practice Managers to prioritise this process. It is not always practical to undertake an individual assessment of a child’s “Frazer-Gillick competence”. The process outlined in Section 6.6 of the RCGP document does allow a blanket approach based on certain age cut-offs, but could then be modified as confidence in the system, practice staff experiences, and also as an assessment of the likely demand [and workload] in relation to this issue can be made.
You should note this issue (online access) is separate to the access to written/computer medical records patients and those with parental responsibility already have under the Data Protection Act, and which you will be dealing with already within the practice and presumably have policies to manage.
Paragraphs 24 to 29 of the GMC Guidance 0-18 years : guidance for all doctors addresses the issues of allowing children online access to their health records and of assessing capacity to consent in young people.
NHS England has advised as follows:
Requests for access by those under 16 years of age – If requested, by the parent/guardian, access to a child’s online services, including access to records, can be granted up to the age of 11. Between the ages of 11 and 16 the parent/guardian can continue to have access with the child’s consent if the child is deemed competent by his/her GP. The child can also be granted access. It is a local practice decision whether online services are available to children in their own right under the age of 16. On reaching the age of 16, parental access ceases and rules governing access for adult patients apply.
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Updated on 23 October 2019