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Before a child develops the capacity to make informed choices about their healthcare, including using GP Online Services safely, the usual position would be for someone with parental responsibility for the child to control access to GP Online Services. They may have proxy access as a trusted third-party where it is in the child’s best interests.
Approaching 11 years of age:
Up until a child’s 11th birthday, the parents or guardians of the child will usually control access to their child’s record and GP Online Services. Access to the record will be switched off automatically when the child reaches the age of 11. This avoids the possibility of:
- Sudden withdrawal of proxy access by the practice, alerting the parents to the possibility that the child or young person has been to the practice about something that they wish to remain private, an example may be family planning advice.
- The young person being deterred from coming to the practice for help.
Parents/Guardians may continue to be allowed proxy access to their child’s online services, after careful discussion with the GP, if it is felt to be in the child’s best interests and consent from the child can be obtained.
Between 11 and 16 years of age:
While each case must be considered individually with the interests of the child being paramount, and decisions made at this time can be re-considered and changed later. For example, parents with access on behalf of a child or young people with a long term condition that requires regular monitoring and medication. It would be appropriate for continued access after the 11th birthday, with child/young person’s consent, but this must be balanced against the challenges that may arise as the young person becomes competent to make their own decisions about their healthcare.
The young person may decide, once they are competent to act autonomously, to take sole control of their medical record. This will be assessed by the child’s GP and documented within the medical record.
Parental rights yield to the child’s right to make their own decisions when they reach a sufficient understanding and maturity and are seen to be capable of making up their own mind on matters requiring decisions.
At this the competent young person may decide to:
- Stop their parents’ proxy access to their online services, where the parents still have access after the 11th birthday.
- Allow their parents to have access to their online services, or to allow limited proxy access to specific services, perhaps restricting proxy access to only book appointments or request repeat prescriptions.
- Request access to their online services where nobody currently has access.
- Switch off all online access, including parental proxy access, until such time as the young person chooses to request access.
Approaching 16 years of age:
Once a young person turns 16, the previous competence assessment is no longer applicable as they are assumed to have capacity unless there is an indication to the contrary.
Where parents or guardians still have access to their child’s online services when the child reaches their 16th birthday, the proxy access will be reviewed. The parent or guardians’ access can be retained if:
- the young person is not competent to make a decision about access at this age, for example if they have a severe learning disability, and it would be in the child’s best interests for the parents to retain access, they may do so.
- the young person consents for their parents to continue to have proxy access.
At this time a personal GP Online Services account of their own would also be offered to the 16-year-old, following the usual protocols for identity verification, to reflect their new autonomy.
Where a young person has already been given access to their GP Online Services, after their 11th birthday and before their 16th birthday, and their parents or guardian do not have access, we will not make any changes unless the young person wishes to do so.
Information for the Parent/Guardian:
It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your record has been accessed by someone that you have not agreed should see it, then you should change your password immediately. If you are unable to do this, you must contact the practice so that they can reset the password for you or disable to account.
If you print out any information from your record it is your responsibility to keep this secure. If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all.
During the working day it is sometimes necessary for practice staff to input into your child’s record, for example, to attach a document that has been received, or update your information. Therefore, you will notice admin/reception staff names alongside some of your medical information – this is quite normal.
The definition of a full medical record is all the information that is held in a patient’s record; this includes letters, documents, and any free text which has been added by practice staff, usually the GP. The coded record is all the information that is in the record in coded form, such as diagnoses, signs, and symptoms (such as coughing, headache etc.) but excludes letters, documents, and free text.
Before you apply for online access to your record, there are some other things to consider. Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.
- Forgotten history: There may be something you have forgotten about in your record that you might find upsetting.
- Abnormal results or bad news: If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed, and you cannot contact them.
- Misunderstood information
Finally, your child’s medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within the medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation.