In addition to the legitimate relationship, in order to actually view a patient’s Summary Care Record the patient must give his or her consent. This can be done for an individual clinician or for a workgroup e.g. hospital department. The only times that a record can be accessed without this consent are:

• In an emergency and the best interest of the patient, e.g. patient unconscious on admission to Emergency Department and unable to consent.  This action should be undertaken in  the best judgment of the clinician and will generate an alert to allow monitoring by the organisation.
• By court order e.g. as part of a police investigation
• When it is in the public interest e.g. to help with investigation of communicable diseases
• When access is required by statute e.g. the Data Protection Act requirement to maintain accuracy of personal data.

The key thing to note about Permission to View is that as long as the patient has been asked for their permission (whether for an individual or or a group of staff) and have recorded this permission, then the SCR can be viewed to be used in the course of the patient’s treatment.

Principles for Implementing Permission to View for the Summary Care Record to support the diversity of care settings in the NHS (PDF,67Kb) is a key document in understanding the consent model.

Go the training section section of  this website for more information and examples on how permission to view appears in the Summary Care Record Application and other integrated systems through which SCRs can be viewed.

History of the Consent Model and Permission to View

Following extensive consultation with key stakeholders, the Summary Care Record Advisory Group (SCRAG) which represents the BMA and Royal Colleges, proposed the move to a Permission to View model in July 2008.   The Chair of the National Information Governance Board for Health and Social Care confirmed that the proposal is entirely in keeping with the NHS Care Record Guarantee for England and that, as well as being completely acceptable from a governance point of view, brings simplicity and clarity.

The decision to move to a Permission to View model (PowerPoint, 172Kb) was ratified by the NHS Care Records Board on September 17 2008.

We have listened to doctors and nurses who raised concerns about the complexity of the earlier model and are certain we now have a model which will work across a full range of care situations.

The focus of the revised consent model is on two questions asked of the patient:

1. Do you want a Summary Care Record?
2. Can I look at your Summary Care Record?

In January 2009 NHS CFH produced a document outlining the 'Principles for Implementing Permission to View for the Summary Care Record to support the diversity of care settings in the NHS' (PDF, 67kB).

The Permission to View (PTV) consent model was implementated at Bury and Rochdale Doctors on Call (BARDOC) in March 2009 where a similar document was produced, tailored to the local implementation needs  - 'Permission to View in use at Bury and Rochdale Doctors on Call (BARDOC)' (PDF, 120kB).