Application for access to records via the NHS App

 
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Application for Online Access

Access to medical records via the NHS App, including proxy access

With the NHS App you can manage appointments, repeat prescriptions and see health records, including medications.

  • We can only process requests for patients and proxy applicants registered with us.
  • The surgery has a responsibility to look after your GP records.
  • You must also take care online and make sure your personal information is not seen by anyone who should not see it.
  • You can also use this form to apply for a linkage key, if required.

Missing Records?

If you think there is missing information on you NHS App record, complete a Subject Access Request.

Processing

All questions marked with a * are mandatory

I am: *

Proxy access to records of patients under 16

This process is designed to respect the developing confidentiality rights of young people while acknowledging the role parents play in their healthcare. It is based on the principles of Gillick competency and Fraser guidelines, and complies with UK GDPR, the Data Protection Act 2018, and guidance from NHS England and the Royal College of General Practitioners (RCGP).

Under 13 years

  • It is presumed that a person with documented parental responsibility will have full proxy access to their child's online services, including the medical record.
  • This access will be automatically restricted on the child's 13th birthday.

13 to 16 years

  • This is a transitional period. Proxy access is not granted by default.
  • The young person can then register for their own access.
  • Any request for new or continued access will be assessed on a case-by-case basis, considering the competency of the young person and their best interests.

Over 16 years

  • On a young person's 16th birthday, they are legally presumed to be competent.
  • All remaining parental proxy access will be automatically switched off.
  • Proxy access is possible for patients over 16 in exceptional circumstances

Guiding principals

  • Gillick Competency: The central consideration is whether the young person is 'Gillick competent' – that is, they have sufficient understanding and intelligence to enable them to understand fully what is proposed. A Gillick-competent young person has the legal right to consent to or refuse proxy access to their medical record. 
  • Safeguarding: The safety and well-being of the young person is paramount. The practice will refuse or withdraw proxy access if it is believed that granting it could place the young person at risk of physical or emotional harm, or if it could inhibit them from seeking confidential medical advice. 
Principles of proxy access for patients under 16: *
Permissions granted for proxy access may change as the patient ages: *
It maybe required for me to submit new applications for proxy access as the patient ages.: *
Access may not be granted by default: *
Processing
Details of the Patient
Please double check you've entered the correct email address
Details of the applicant(s)
 
Do you need to add a second applicant?: *
 

Should you need additional applicants, please submit another form once completing this one

If you are making an application on the behalf of somebody else we require evidence of your Authority

Please upload a copy your supporting documents

  • You can upload a document, photo or scan

We require evidence of your Authority or Birth Certificate

Please upload a copy your supporting documents

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Processing
Proof of Identity
NHS Logo

Identification

We are required to check the identity of all applicants

Acceptable forms of Photo ID

  • Photo Driving License
  • Passport

ID documents are not stored and will be securely destroyed in line with our data retention schedule.

Acceptable forms of Proof of Residence

  • Tenancy agreement
  • Mortgage statement
  • Bank statement
  • Utility bill (date within the past 3 months) 

Please upload a copy of 's ID and Proof of Address

  • You can upload a document, photo or scan
Please upload a copy of your ID and Proof of Address
  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Please upload a copy of 's ID and Proof of Address

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Please upload a copy of  's ID and Proof of Address

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Identity Validiation

  • As we have a responsibility for data protection it maybe that all identities need to be checked in person.
  • Should this be required we will contact you to discuss and arrange this.
A visit to the surgery might be required before access is granted: *
Processing
To be completed by the Patient

I, , give permission to my GP practice to give the following people proxy access via the NHS App

    

Rights to reverse any decision: *
Risks of allowing someone else to have access to my health records: *
Proxy declaration

 , as the lead applicant agree the following and sign.

Confidentiality: *
Security: *
Compromised Account: *
Accuracy of Records: *
Accuracy of Application: *
Fraud: *
Next Steps: *
Processing

Privacy Consent

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Providing NHS Services

Contact

Gloucester Road Medical Centre
1A Church Road
Horfield
Bristol
BS7 8SA

Telephone: 0117 949 7774

The Practice

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