Patients Know Best (PKB) has completed integration with the GP record for patients in England. It means the PKB record will automatically store for a patient a copy of the data the GP has released to that patient. This is achieved using the IM1 Patient Facing Services (PFS) API.

PKB is integrated with both Optum (EMIS) and TPP (SystmOne).

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Why use PKB for GP data?

We're committed to making GP data clear and accessible. Here are a few ways we doing that:

• Diagnoses: Finding diagnoses shouldn't feel like searching for a needle in a haystack. Often, these critical details are hidden within extensive consultation notes. To solve this, PKB has extracted and neatly presented diagnoses on our dedicated "Diagnoses" page, giving a clear, concise overview of key health conditions.

• Medication: Many platforms simply list a patients current medications, leaving medication history buried within lengthy consultation records. We've compiled all medication information, past and present, onto our dedicated "Medicines" page. This allows users to easily track a complete medication journey, providing a more comprehensive view of their health.

• Sharing: PKB puts patients in control, allowing patients to share their GP data with their healthcare professionals, family, or friends, as they see fit. The ability to share a PKB record provides a fuller picture of a patients health, enabling better informed decisions and helping healthcare professionals avoid issues caused by differing computer systems that don't always communicate effectively. Sharing in PKB can be especially beneficial to patients who see multiple specialists or receive care in different locations, out of area. Patients also have the ability to use our privacy labels which are a way for patients to label each data point in their record with one of four categories. Patients can decide who has access to each one of the categories, giving granular control over exactly who sees what.

• SNOMED CT Codes: GP data in PKB is tagged with SNOMED CT codes. These are standardised codes used throughout the NHS and internationally. This means the information is organised consistently, allowing for smoother sharing and analysis between healthcare providers.

In short, PKB helps patients to keep their GP data alongside their other health records in one secure place. We've made it easier to read and interpret GP information while also giving patients control to decide who sees their information and how much they see.

By connecting GP data to PKB, patients are taking a step towards better health management and improved communication with their care providers.

What GP data will PKB store for the patient?

PKB will store data the GP practice has already authorised for release to the patient. This is the same dataset the patient can see in the NHS App.

In Phase 1, users will start to be able to see demographic, appointment, medication, and diagnoses (conditions) data from their GP Practice. PKB will also store for the patient the GP observations (including measurements and test results), allergies & immunisations. These will be available via our FHIR APIs when the patient shares their PKB record.

In Phase 2, the patient will see more data from Phase 1 in the PKB user interface (UI) & we will be storing documents.

Phase 1: GP appointments, conditions and medications

Appointments	Diagnoses	Medicines

Appointments	Diagnoses	Medicines
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Phase 2: Patient can see full GP data

Allergies	Measurements	Test Results	Immunisations	Documents

Allergies	Measurements	Test Results	Immunisations	Documents
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What will the patient journey look like?

STEP 1	STEP 2	STEP 3	STEP 4	STEP 5

STEP 1	STEP 2	STEP 3	STEP 4	STEP 5
For the first time the patient must log in with NHS login to authorise	The patient enters their e-mail address, password and security code.	The patient confirms they would like a copy	Thereafter every time a patient logs in PKB pulls the latest record	Patient sees information  the GP has already authorised for release
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What does the patient need to do?

There is one-time one-step process for the patient. The patient has to log in with NHS login and choose ‘Get my GP data'. This prompt will show for patients whether logging in directly from PKB’s website or when using a jump off point to PKB from the NHS App.

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The NHS login is only necessary this one time to allow storing GP data. After that the patient can log in any way they prefer, including with the PKB login.

Does the patient need to obtain credentials from their GP Practice?

No. Using NHS login means neither the GP practice nor the patient needs to spend time on credentials.

When is GP data updated?

Whenever a patient logs in, PKB pulls the latest GP record. The patient can use PKB login or NHS login.

Why can’t a patient see GP data?

There are several reasons that could account for a patient not seeing their GP data in PKB:

1. Patient not used NHS login: The patient has not logged in with NHS login to trigger the initial data integration

2. Patient chose Not now: The patient chose ‘Not now' when prompted to get their GP data during the login process. The patient will be prompted with the 'Get your GP data’ screen again one month after selecting ‘Not now'

3. PKB completing data retrieval: Retrieving and showing GP data can take PKB a little while. It varies based on factors such as record size and demand at the time.

4. GP not switching on online services: Patients must have online services set up at their GP Practice. If a patient does not have an online services account, the patient should contact their GP Practice to request access to online services. See the sections below on How can a patient request access to online services and How does a GP practice enable online services for a patient.

5. GP does not have data: If a patient has recently registered at a GP Practice, there may not be GP data available in the patient's record yet.

6. GP not releasing data: The GP Practice has not permitted the release of the patient's online services data within their clinical system. Individual items can been restricted e.g. a single diagnosis (condition), a service can be restricted e.g. all diagnoses (conditions), or date range restrictions can be applied by the GP Practice to only allow release of data after a specified date. Patients are encouraged to contact their GP Practice directly to request access to their online services data. GP surgeries are required to give all patients in England online access to new information as it is added to their GP health record since 31st October 2023 (unless a patient has individually decided to opt out, or any exceptions apply).

How can a patient request access to online services?

GP practices usually require patients to attend the GP practice in person with at least one form of ID e.g. drivers license, passport or birth certificate to enable online services.

Some GP practices also allow patients to register for an online services account using NHS login. See more information here https://www.nhs.uk/nhs-services/gps/using-online-services/ .

How does a GP practice enable online services for a patient?

• EMIS: the EMIS GP Practice users online services guidePreview has training resources from EMIS, as well as step by step instructions created for EMIS GP Practice users by PKB.

• SystmOne: the SystmOne GP Practice users online services guidePreview has training resources from TPP SystmOne, as well as step by step instructions created for SystmOne GP Practice users by PKB.

How can a GP practice increase online services access for a patient?

• EMIS: the EMIS GP Practice users online services guidePreview has training resources from EMIS, as well as step by step instructions created for EMIS GP Practice users by PKB.

• SystmOne: the SystmOne GP Practice users online services guidePreview has training resources from TPP SystmOne, as well as step by step instructions created for SystmOne GP Practice users by PKB.

How can a GP practice reset online services for a patient?

• EMIS: the EMIS GP Practice users online services guidePreview has training resources from EMIS, as well as step by step instructions created for EMIS GP Practice users by PKB.

• SystmOne: the SystmOne GP Practice users online services guidePreview has training resources from TPP SystmOne, as well as step by step instructions created for SystmOne GP Practice users by PKB.

Why is a patient not able to see GP data for their linked accounts?

Patients can be granted proxy access to be able view and manage the online GP accounts of others e.g., children under 16.

PKB has not yet implemented proxy access functionality or linked accounts specifically for the GP data integration. This means that even if a patient has approved online access to a child’s (under 16) GP records though their GP’s online services account, the link will not extend to GP data within PKB at this time.

We are planning to develop this feature. Future updates will allow for the linking and pulling of proxy records.

GP Practice

Why are GP Practices receiving tasks about Online Services - Linked Applications?

SystmOne: When a patient links their online services account to a new application, SystmOne automatically generates a 'Online Services - Linked Application Successful' task for the GP practice. This task is informational, notifying the practice that a patient has successfully connected a new application such as Patients Know Best (PKB) to their online services account.

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GP Practice’s should follow their practice's standard procedures for managing these tasks, the same as they would for any other linked applications such as the NHS App. This might include actioning the task and automatically sending the patient a notification or deleting it. GP Practices can also bulk-action or bulk-delete these tasks in SystmOne with just a few clicks.

EMIS: EMIS does not generate a task when a new application is linked.

Notifications to patients

SystmOne:

1. When a patient links a new application to an online services account, the GP Practice receives a 'Online Services - Linked Application Successful' task. If the GP Practice actions this task, a notification is sent to the patient to notify them of the new link. Alternatively, GP Practices can delete this task and no notification will be sent to the patient.

2. SystmOne GP Practices can enable an organisation-wide preference to send email notifications to patients when their online accounts are accessed.

   1. If enabled, this notification setting will apply to every patient registered at the practice whenever they access their online account via any app e.g. PKB, NHS App, SystmOnline, Airmid etc.

   2. When a patient logs into Patients Know Best (PKB) to retrieve their data, the email notification advising them of this access may not be immediate. There can be a short delay while PKB processes the data request.

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EMIS: When a patient links a new application to an online services account, a message is automatically generated by EMIS Web and sent to the patient to notify them of the new link.

Data quality

Will there be duplicated GP data from multiple sources?

PKB receives data from multiple sources about each patient. In some regions this can include multiple copies of a patient’s GP record. We keep all this data in the record for each patient to ensure maximal coverage for all patients.

PKB only shows one copy of GP data to the patient. PKB prioritises EMIS IM1 bulk extract service data over the data from the EMIS IM1 PFS API integration. This is because the bulk extract service data is more accurate (with original codes); more frequent (updated daily); and more comprehensive (it goes beyond data manually released to the patient).

Why is a past medication showing as current?

PKB identifies whether a medication is current or past based on its status and/or end date. However, TPP’s SystmOne does not provide this information through the PFS API.

To address this, PKB applies specific rules to distinguish between past and present medications from SystmOne. In cases where we cannot determine the status, PKB will default to displaying the medication as current.

PKB has raised this issue with both TPP and NHS England.

Why is is a past diagnosis showing as current?

PKB identifies whether a diagnosis is current or past based on its status and/or end date. However, TPP’s SystmOne does not provide this information through the PFS API.

As a result, PKB will display all diagnoses from SystmOne as current for now. We are working on applying rules to distinguish between past and present diagnoses from SystmOne.

PKB has raised this issue with both TPP and NHS England for resolution.

How can a patient find out which patient record system their GP Practice uses?

A patient can ask their GP Practice what patient record system they’re using e.g. SystmOne or EMIS.

Why is my GP appointment named with a generic term like "Default," "Standard," or "Routine"?

The name for your GP appointment comes directly from your GP practice's system. It's the title they've given to that specific type of appointment slot.

GP practices have full control over how they name their appointment slots. While some may use very descriptive names (e.g., "On the day emergency," "Face-to-face consultation," "Telephone appointment"), others might use more generic terms like "Default," "Standard," or "Routine." This naming convention is entirely dependent on how your individual GP practice has configured their system.

If you believe a different or more specific name would be helpful or clearer for your appointments, please contact your GP practice directly to provide your feedback. They are the only ones who can modify the names of appointment slots within their system.

Information governance

Who gives permission to store GP data in PKB in PKB?

Each GP Practice is the Sole Data Controller for the GP-entered data they contribute. NHSE oversee the IM1 integration process and assure every use case and product for the use of the IM1 PFS API.

The data PKB is showing is GP-entered data that the GP Practice has released for the patient to see.

What are the privacy labels for GP data?

Appointments and medications automatically have the 'general health' privacy label. PKB maps diagnoses to privacy labels using SNOMED CT codes. For SNOMED CT codes with an existing privacy label mapping, this existing mapping will be used. For SNOMED CT codes that the PKB Product/clinical team has not yet mapped to a privacy label, PKB software defaults to 'Privacy label not set'. The PKB Product/clinical team regularly maps new SNOMED CT codes as they arrive.

Only patients or individuals with consent to see all four privacy labels can see unmapped diagnoses.

Patients can manually change this privacy label if they wish. To find more information on how to change a privacy label here.

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