The digital firearms marker was rolled out to all general practices in England in May 2023 and NHS England is exploring the most effective way to report on its use. Information is currently not available in a format to be able to provide this detail. The memorandum of understanding was signed in 2019, and therefore predates the digital marker and we do not hold data from that time.

A digital version of the firearms marker has been rolled out to all general practices in England, and this was completed in May 2023.

When the police inform the general practitioner (GP) that the patient has been granted a firearms licence, the GP adds the appropriate clinical code to a patient’s medical record. The marker is used throughout the five-year validity of the firearm certificate and automatically highlights to the GP when patients recorded as firearms certificate holders or applicants are diagnosed with relevant medical conditions, such as depression or dementia.

The British Medical Association has produced guidance for GPs about firearm digital marker use and signed a memorandum of understanding in 2019 with the National Police Chiefs Council and the Home Office which encouraged GPs to place a firearms flag on patient records when requested.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

The Government wants people to be able to have access to their own records if they choose to do so. There is widespread international consensus about the benefits to patients and the effectiveness of the health system in providing digital on-demand access to personal health information.

For most, online record access is beneficial, but for a minority, having access could cause harm or distress. NHS England is taking an active approach to ensuring safe and secure patient record access, seeking to identify and provide additional protections to vulnerable people if they request access to their medical records online.

NHS England has engaged extensively with at-risk groups, professional bodies, patient groups, charities and safeguarding leads to support general practice and patients in preparing for this change safely and effectively. Communication packs have been provided to over 50 charities that support at-risk individuals. NHS Digital has published guidance in an online-only format for organisations, Supporting victims and survivors of domestic or sexual abuse, to support people when accessing their personal health information online.

Before viewing their record in the NHS App, users are advised what to do if they are being pressured to share their information. Patients can prevent access by disabling their National Health Service login with a simple online process or can ask their general practitioner (GP) for the details of specific consultations or treatment decisions to be redacted. When an individual first requests access, they cannot see information already recorded; they will only be able to access information recorded from that point onwards.

The expert safeguarding group has identified theoretical risks, which have fed into NHS England’s patient and GP communications packs and advice, messaging on the NHS App and NHS.uk and improvements made by GP IT system suppliers.

More than 23 million patients have viewed their records over nine million times, with no significant incidents relating to personal safety or security reported. Lower-level incidents, such as people finding out their diagnosis before being told by a clinician, have been reported, and some issues have been investigated and classed as low-risk and/or resolved.

NHS England continues to monitor this and would take action if an issue was identified or raised.

To ask His Majesty’s Government what measures they have put in place to mitigate the risk of people being coerced into showing their confidential medical records to third parties as records become universally available through the NHS app.

My Lords, the design goals for the NHS app should be to make it as easy and frictionless as possible for legitimate users to access the system, while making it as difficult and frictionful as possible for people trying to gain unauthorised access. But there is a natural tendency to focus on the first part of this equation as developers believe in the systems they build and find it hard to put themselves in the shoes of the cunning and resourceful attackers who will try to break them. Given this dynamic, can the Minister confirm that the NHS has a red team tasked with trying to identify all possible vectors of attack on the NHS app, and that the requisite resources will be put into mitigating any risks that they identify?

My Lords, with the abundance of health data available to the NHS, what future technologies are being developed to identify patterns and trends to improve patient outcomes and reduce the pressure on the NHS?

While it is obviously important to control confidentiality of patient data, it is vital to be able to use data for medical research. Much research, such as epidemiological research, the relationship between smoking and ill health—obesity, diabetes and all sorts of diseases—would not be known much about unless we were able to handle patient data. In the rush to control, let us make sure we can still do research with patient data.

My Lords, following the question from my noble friend Lord Allan about a red team, in the past not health data but personal financial data has been sold by subsidiaries or contractors of UK firms based abroad. I notice that we now have a deal with America on health data and GDPR. Is that true for other countries, such as India? Personal data, particularly medical data, would be seen as very valuable.

My Lords, could my noble friend update the House on where we are with sharing data—in particular, the outcomes of clinical trials—with our European partners?

My Lords, easy access to medical records on the NHS app is indeed positive and helpful to many, but of course there are parents whose abusive spouse or partner might use that sensitive clinical information to undermine legal cases of custody of dependants in the family courts. What discussions have taken place with the Ministry of Justice to assess both this risk and how to avert it?

My Lords, digital transformation of the NHS at pace is being held back by the number of vacancies for digital roles within the NHS, particularly when many people are going over to the private sector for higher pay. What could the Government do to deal with this, particularly regarding the inflexible Agenda for Change?

My Lords, as more people who are able to are switching between the National Health Service and private medical care for specific operations, is the Minister confident that relevant information is then transferred back to a single patient record? This will be very important if, for instance, somebody needs emergency care or is involved in an accident. Is the data all being kept in one place?

My Lords, following the question from the noble Baroness, Lady Bull, is the Minister confident, in all the talk about

advances in technology, that data-sharing within the NHS is fit for purpose? We frequently encounter an apparent disconnect between different departments in the NHS, or different levels of care, where information which should be available to everybody is palpably not or, if it is, it is not being taken any notice of.

My Lords, given the importance of medical research, for the development of advances in knowledge and for inward investment into this country in research, what consideration is being given to ensuring that patients in different disease groups can be asked whether they would consent to being informed about clinical studies that may be relevant to their condition? This is so that pre-consent to being approached is being built into the system, because we know that one of the big delays in recruitment into clinical studies is the process of case finding and consent, particularly for less common conditions and when patients are living in more rural and remote areas.

The Government want people to have access to their own records. For most, online record access is beneficial but for a minority, having access could cause harm or distress. In many cases, practices can identify these patients and ensure that safeguarding processes are in place. Furthermore, to access the NHS app, users must prove their identity through the NHS log-in and, before entering their record, are advised what to do if they are being pressurised to share their information.

No advice has been issued to GPs, but Patients are already able to order repeat prescriptions via the App, with 2.4 million prescriptions ordered in April 2023 alone. Patients unable to use the NHS App can continue to access services via telephone and through traditional face to face services.