Enhanced Sharing

SystmOne is a clinical computer system which is used by doctors, nurses and their teams to record important information about their patients and the care they provide. It is designed to allow for safe and secure information sharing between health and social care organisations on a national scale for use in direct patient care.

SystmOne aims to join up healthcare based on a shared electronic medical record, improving access to clinical data and empowering you to take part in your care. SystmOne has been designed to enable you to have greater control over your record and which of your carers can see it.

Your electronic health record contains lots of information about you, including your medical history, the types of medication you take, any allergies you have and demographic information like your home address and next of kin.

In many cases, particularly for people with complex conditions, making this information visible to all of their carers plays a vital role in delivering the best care. Health and social care professionals can ensure a coordinated care response, taking into account all aspects of a person’s physical and mental health and where appropriate their social care needs.

Whilst some people have extensive knowledge of their conditions and care requirements, this is not true for everyone. Many patients are understandably not able to provide a full account of their care. The shared record means patients do not have to repeat their medical histories at every care setting, or make guesses about their previous care. A shared record ensures health or social care professionals always have the most accurate, up to date information. They can rely on their colleagues, sharing accurate and relevant data in a timely way, to provide you with safe and efficient care.

As the patient, you have complete control over whether your carers at one organisation can see details of the care you have received at other organisations.

To help your carers give you the most personalised care, you can choose whether to share your patient record with each service that cares for you. The choices available to you are:

1. Do you want data recorded at the organisation caring for you to be shared out? You can either consent or dissent to share out from each care setting you visit. You do not have to make the same choice for every organisation. Some organisations will set your record to share out to other organisations. In this situation, you should be informed about this and given the opportunity to opt out.
2. Do you want the organisation caring for you to view information recorded by your other carers? You can either consent or dissent to each organisation caring for you to allow them to view the information that you have chosen to share out. Again, you do not have to make the same choice for every organisation. Some organisations will set your record to be viewed. In this situation, you will be informed about this and given the opportunity to opt out.
3. There may be certain circumstances where the clinician at an organisation you present at needs to override your share settings in order to view your whole record, for example if you have previously dissented but have now changed your mind and decide that you do want the clinician to see your record, or if they have concerns about safeguarding. If this override is used, the clinician will be able to view all of your record regardless of any sharing consents you have recorded, including events you have requested to be private (see point 4 for details of this). As the patient, you can specify whether you want to prevent this override from happening.
4. You can specify entries in your record that you want to remain private. For example, if you have had a consultation about a particularly sensitive matter, you can ask for this section of the record to be marked as private. These entries can only be viewed by the organisation they were originally recorded at, even if you consent for another organisation to see your record. The only exception to this is if a consent override (see point 3) is used.

To change your sharing preferences you should speak to the service where you are receiving care. For each care provider on SystmOne, you have the right to either agree or disagree that they may view your SystmOne record.

You also have the ability to allow or prevent them from sharing the information, recorded at that organisation, to other SystmOne organisations.

As a patient, you have complete control over who can see your medical information. Even if you give permission on one occasion, you can change this at any time.

There are a variety of care services that use SystmOne, which could view your record should you present for care.

Your information is only visible once you have been registered for care and a permission to view your data has been recorded.

You can allow access to your medical record in the following care organisations:

• GP practices
• Community services such as district nurses, rehabilitation centres, telehealth and diabetes services
• Child Health services that undertake scheduling of treatments such as vaccinations
• Urgent care organisations such as Minor Injury Units and Out of Hours services
• Community hospitals
• Palliative care hospices
• Offender health – care providers within the health units
• NHS Mental health trusts
• NHS Hospital trusts
• Accident and Emergency departments
• Care Homes
• Pharmacy
• Social Care – registered and regulated professionals within social care organisations coordinating care (not social care providers)

Until you are registered at one of these care services, your record will not be shared to them.

Only SystmOne organisations where you have a direct care relationship can access your record.

Within every organisation using SystmOne there are controls that limit which staff members can register and access patient records. There are also controls that limit what elements of the record staff members can view. For example, a receptionist may only be able to view your administrative details and not your clinical information.

SystmOnline is a range of free of charge online services to allow patients to manage their care. This allows you to view and book appointments, manage medication requests and view your patient record, including an overview of allergies, medication, vaccinations and test results. Some GPs have not switched on all of these functions for all of their patients yet.

Your GP practice has to enable you to access SystmOnline. If you do not have a SystmOnline account, you can request login details from your GP practice. Once you have been given an account you can access SystmOnline as an online service or via the app. The SystmOnline app can be downloaded, free of charge, from the relevant app store for your device.

Learn more about SystmOnline

Via SystmOnline, you are able to view an online audit of every organisation that has accessed your GP record since 21/03/17. To gain access to this audit you will need a SystmOnline account and you may need to speak to your GP to enable the audit, as this will only be available if your GP practice offers this service.

Alternatively, you can also ask your GP practice. They will be able to tell you which other organisations are sharing in your record and can therefore access the information you have shared out. If you want further details as to which users within these organisations have accessed your record, you can contact the other organisations directly. 

There are a number of additional controls to prevent inappropriate access to your record. In order to access SystmOne records, organisations require access to the secure, encrypted NHS network. To gain access to this network all organisations must comply with the NHS set information security requirements and review this annually. SystmOne can only be accessed using either an NHS-issued logon card (which requires their identity to be verified to NHS identity check standards) or a unique username and password, given to them by the care provider where they work.

Even with all the above in place, your record will not be visible to any user until a permission to view your data has been recorded.

SystmOne provides a full audit trail of all activity performed on the SystmOne, including any time a user accesses a patient record and all the activity that they perform within any patient record. If you are concerned that someone has accessed your SystmOne record inappropriately, you should contact your care organisation.