Lincolnshire LMC | Proxy Access to a Child's 'Online' Medical Record

Automatic Access for Parents, family members or Carers.

All mothers and most fathers have legal rights and responsibilities as a parent - known as ‘parental responsibility’. Someone with parental responsibility is responsible for, among other things, agreeing to the child’s medical treatment. A parent who does not live with the child still has a right to be kept updated about their well-being and progress. Circumstances surrounding who has parental responsibility may be complicated, therefore access should be granted on a case by case and, if necessary, with advice from a medical defence body.

As a parent, family member or carer, you may be able to access services for someone else using linked profiles. This is also sometimes called having proxy access.

It needs to be set up by a GP surgery where you and the other person are both registered.

You can then access the linked profile by using the online system provided by their Clinical System Supplier, the NHS App or by logging in through the NHS website.

RCGP Guidance

The RCGP recommends access based on three age milestones as below, but the practice has the final say as to how to implement proxy access.

Milestone 1: 11th birthday
Generally upto the age of 11, the usual position would be for the parents of the child to control access to their childs record and online services.

Milestone 2: Between the 11th and 16th birthdays
Decisions made at the first milestone can be re-considered and changed later. Each case must be considered individually for the best interests of the child. For example, parents with online access on behalf of children and young people with long term conditions that require regular monitoring and medication may have a good case for continued access after the 11th birthday but this must be balanced against the risks that may arise as the young person becomes competent to make their own decisions about their healthcare which will vary from person to person.

Milestone 3: 16th birthday
Once a young person turns 16, the previous competence assessment by default is no longer applicable as they are assumed to have capacity unless there is an indication to the contrary.
The parents access should usually be withdrawn when the child reaches their 16th birthday.

Sample Letter to Parent with Access prior to 11th Birthday

Dear Parent

INFORMATION FOR ONLINE PROXY ACCESS

We are writing as you currently have proxy access for your child, X, who is approaching their 11th birthday.

Once a child reaches the age of 11 years, they are entitled to either give or withhold consent for parents/legal guardians to be able to access their online records.

When a child reaches their 11th birthday the proxy access service ceases.

In the eyes of the law a child is a child until they reach their 18th birthday. For the purposes of medical treatment, the boundaries are different and in some circumstances a child younger than 16 years may access medical services without the knowledge of their parents.
In those cases the patient is entitled to retain their confidentiality. In light of this and in all cases online proxy access will be withdrawn once the patient reaches their 11th birthday. Text reminders of forthcoming appointments will also cease at that time as it is common for parents/legal guardians to list their mobile number on their child’s medical record.

This does not remove parental/legal guardian consent or involvement in their child’s medical health care.
As a parent/legal guardian, you may continue to act on behalf of your child, where this is in their best interest.

In some cases it may be appropriate for parents/legal guardians to continue to access their child’s record online, in cases such as those involving learning disabilities or complete repeat medications for example.

If you think you might have a justification to continue to access your child’s record, please contact the surgery to arrange a consultation/telephone call with your child’s usual GP to discuss with both yourself and the child concerned.

Yours sincerely