029. Patient Facing Services
Patient Facing Services are an increasingly important tool for a GP surgery. In COVID times the responsibility of verifying and registering patients for online services has thankfully been moved elsewhere, but Practices should still keep an eye on the use of Patient Facing Services.
This suite of searches performs several functions; to monitor overall uptake; to monitor activity of core online services such as prescription requests and appointments; to highlight young patients whose online accounts require urgent attention.
Patient Facing Services
The main folder contains just 3 searches for a quick overview of the Practice's online services uptake.
PFS-001 underpins many of the other searches, identifying all currently registered patient records which have an online services account associated with it. For a strategic review of online services adoption, think about looking at the Age/Sex tab and comparing it to the overall Practice population. Do more males or females have access? Is there an opportunity for targeted promotion in a particular age band? Bear in mind that regular online access use may be linked to patients who have repeat medication, so it would also be worth comparing the Age/Sex figures with a search like CQC-600 (On repeat medication)
Attached to PFS-101 is PFS-002) PFS client breakdown. This aggregate report will show the use of different online services platforms. The breakdown of numbers is likely to far exceed the number of patients counted in PFS-001. This is because the system counts those using Patient Access twice as it is mirrored in My Health Online. Consider that it is possible for patients to register with multiple platforms (eg: Patient Access and the NHS App), but also that multiple proxy users may not use the same platform.
PFS-003 details the level of access for all patients with a linked online access account. This is separated into core access (book appointments, request medication, view immunisations, amend demographics) and detailed access (lab results, documents, problems, consultations). This report is likely to be very large and we recommend exporting it to Excel to sort or apply filters. Each of the 4 detailed access sections also shows the earliest date a patient may see information, as well as whether free text viewing is enabled.
Remember that your organisation level Patient Facing Services configuration may override any dates shown in this report.
PFS-004 and PFS-005 list patient records which have an online account linked to them. PFS-003 will show where the patient themselves has access to their medical record, while PFS-004 will show proxy users. This proxy users report may be particularly useful due to displaying the name of the proxy users. Whilst the report cannot show the relationship between the patient and the proxy user, it may be possible in many cases to infer the relationship due to patient age (eg: parent) and/or matching surnames.
Managing Online Access for 12-16 year olds
Practices have a responsibility for monitoring the use of online services in young patients. When a patient turns 11 and again at 16, checks have to be carried out in order for any online users to continue to be able to use the account.
The reports provided highlight young patients who have a linked online services account. PFS-016 offers a detailed summary of all access for patients under the age of 16 (whether in their own name, or of a proxy).
- PFS-211 shows patients who have not yet turned 11 but will do so in the next 2 months (ie: 10 years 10 months) or they have had their 11th birthday within the last month.
- PFS-212 shows patients who have not yet turned 16 but will do so in the next 2 months (ie: 15 years 10 months) or they have had their 16th birthday within the last month.
PFS-220 creates a list of patients turning 16 (or have just had their birthday) who do not have a linked online services account but they could now be signposted to register for one.
Further information on managing proxy users for young patients is provided on EMIS Now:
Online Access Activity
These reports provide a selection of snapshots measuring activity of online prescription requests and online bookable appointments. These can be used to assess how much these services are being used, perhaps with a view of allocating resources to deal with busier times. Practices may wish to make copies of these reports to interrogate the data even further.
PFS-101 and 102 look at online prescription requests from the past 12 months up to and including the day the report is run. Each report breaks down the number of requests by month.
PFS-101 is a simple total, while PFS-102 can be used to look at whether any particular day of the week is busier than others (remember that the date of the request is shown, which could be up to 23:59 and would not be seen until the following morning).
PFS-111 and 112 look at appointment slots which have been booked online from the past 12 months. PFS-111 separates the data by slot type, while PFS-112 looks at which session holders (by both user type and name) have been booked.
PFS-113 looks at appointment outcomes; this will show a summary all of the online booked slots and their current slot status. Ideally all slots should show as Left (or Telephone complete or Visited) but some may also remain as Booked (the patient was not checked in and the slot did not get marked as DNA), or DNA.
PFS-114 details upcoming appointments booked online for the next 4 weeks / 28 days. PFS-114a provides a summary while PFS-114b offers a detailed review of each booked appointment, including the booked time to slot time in days (how far in advance the appointment was made).
Remember Population Reporting can only report on elements connected to a patient. There may be an operational benefit to regularly running a similar search in the Appointment Reporting module which looks at online bookable slots for the next 4 weeks as a check to confirm whether they should be bookable, embargoed, or how many have been booked so far.
PFS-115 lists all cancelled appointments. This can be a useful metric to review, but unfortunately cannot report on when or by whom the slot was cancelled. By referencing the report PFS-115b it is still possible to find the slot in the Appointment Book and view the slot history to determine this information.
Practices may wish to pay particular attention to the DNA appointments to review whether a particular type of slot is more likely to be left unattended. PFS-116 identifies all patients who have missed an appointment which they booked online. The report details all missed appointments for those patients from the past 12 months (including those booked by staff), and also shows the booked time to slot time in days. Remember to look at the wider context for each patient - did they actually attend but the slot wasn't checked in, was there a legitimate reason such as the patient was in hospital?
Online Record Access
This folder is provided to help Practices prepare for the switch on of prospective record access. For the latest information refer to NHS England guidance.
The searches provided help to summarise the scale of patients who may be affected.
PFS-301 lists the patients who would immediately notice prospective record access being enabled.
PFS-302 lists patients whose latest code is a 'blocking' code:
- Enhanced review indicated before granting access to own health record - this is a temporary block intended for use before somebody review's the patient's suitability for viewing their own record online
- Online access to own health record withheld following enhanced health record review - this is a more permanent block following a review into the patient's suitability
The blocking codes can be overridden using the following codes (respectively):
- Enhanced review not indicated before granting access to own health record
- Online access to own health record granted following enhanced health record review
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