Proxy access, nominated contacts and limits

Proxy access and nominated-contact arrangements clarify who can help a patient and what parts of the record they can use. Frontline staff must remember that these arrangements have specific limits and must match what is recorded.

Proxy access is specific

A proxy may be authorised to book appointments, order repeat prescriptions, view particular test results or access selected parts of the GP record, according to local setup and policy. Always check the recorded level of access rather than assuming it covers everything.

Patients can have multiple helpers with different permissions. A carer who manages prescriptions may not be entitled to information about sexual health, mental health, safeguarding entries or historic consultations.

Old permissions may need review

Permissions change. A patient may withdraw a relative's access, a young person may gain additional confidentiality rights, or safeguarding concerns may make previous access unsafe. Do not rely blindly on old notes if the present situation causes concern.

If a patient asks to change or remove a third party, follow the practice process promptly and record the request carefully, especially where there is pressure, coercion or family conflict.

When to pause

• The caller asks for more than their recorded access allows.
• The patient has withdrawn or changed consent.
• There are concerns about coercion, domestic abuse or unsafe access.
• A young person is approaching an age where confidentiality needs review.

Proxy access should make support safer; it must not become an informal route to unrestricted patient information.

Online and safeguarding risk