Doctors surgery of DS 11yo has removed my proxy access - normal?

[PieceOfString]

I have had a letter from ds doctors surgery advising me that my access to his medical records is removed and he must now self-manage his own access to his GP and all that entails (text reminders for repeat prescriptions etc.
I was surprised, ultimately personal independence is what we as parents are working towards of course, but I just was expecting it to be more gradual / at time of his own choosing / older age.
11 just seems to be young? Is this normal? Do other people find their 11yo are ready to take up managing their own repeat prescriptions etc? fwiw he doesn't have any serious conditions just asthma which he has a repeat for.
I was going to speak to the surgery to enquire if this is practice policy or a national thing but thought they might take umbrage and actually I'm wondering if it is my expectations which are out of line as I navigate this stuff for the first time?

@lgty

I remember when my DD was 11/12 years old (she's now in her mid 20's), our GP told her that she was allowed to contact the surgery and book an appointment without either my DH or my knowledge if there was anything troubling her. Also she didn't have to allow us into any of her consultations with the GP if she preferred not to and the GP wouldn't be allowed to tell us what was discussed without my DD permission.

Obviously nowadays with everything being accessible through the NHS/GP app the GP wouldn't be able to provide confidentiality for the youngster if parents still had access to their data.

If it's a blanket decision across the board that at a certain age the parents can't have continued access to youngsters medical data without their approval it protects the youngsters out there who have strict or even abusive parents who may not be happy with them going to see their GP about certain medical matters.

Ahhh x posts.

Yes that makes sense re access of data via nhs app.

I had to get proxy access to access my ds info in my app but he is over 16 and I'm registered as his carer with the GP

That does seem quite young. My dd16 has always preferred me to speak for her but in the last year or two there's been a shift in the staff usually asking to speak to her first in a similar way they do when you're calling a utility company on behalf of an elderly relative. It has seemed like a gradual easy change but for now they're still happy to speak to me with general queries or with her permission for the medical purposes

I have access to my adult sons and my husbands GP records , they wrote letters to authorise my access as our son is very deaf so cannot hear people on most phones and my husband just wants me to deal with anything medical , obviously I only use my access when it’s been okayed with them .

Oh wow this is bizarre. I was thinking it must be an error but clearly not.

My 11 year old wouldn’t have a clue. And doesn’t have a proper phone so couldn’t receive texts or emails 😂

Reminds me of the time when we called NHS 24 as DD was lightheaded (tonsillitis). The adviser asked to speak to her to go through the questions - she was 9, almost 10. They asked if there was any chance she could be pregnant

Tricky one, if this is to protect young people from parental abuse of their information on an app but simultaneously removes parental support for all management of health without the child (with parental support) reinstating that access which is the last thing some parents need to be worrying about. swings and roundabouts isn't it from a safeguarding pov

My 14yo wouldn't be able to do this. He has an epi-pen prescription and they can last for anything from 6 to 18 months. I find it hard enough keeping track of it myself.

I had this with my 12 year old (who's now 14). Utter nonsense- she was and still is far too young to deal with this on her own. There's no way even now at 14 she is mature enough to make appts and deal with prescriptions etc.

To satisfy them we handed in a letter that I wrote and she signed to say I could still handle her medical information.

What a load of rubbish.

@Looneytune253

That does seem quite young. My dd16 has always preferred me to speak for her but in the last year or two there's been a shift in the staff usually asking to speak to her first in a similar way they do when you're calling a utility company on behalf of an elderly relative. It has seemed like a gradual easy change but for now they're still happy to speak to me with general queries or with her permission for the medical purposes

That seems much more common sense to me!

just spoken to the practice and the person I spoke to said they didn't deal with proxy issues so couldn't advise on procedure to reinstate my involvement, but if those are the RCGP guidelines they have to do it, but when I said that I knew not all GP practices did this so it was within their power to not go with the guidelines she completely ignored that and just kept saying it was guidelines so they had no choice. Grrr don't you just love circular conversations where nothing you say is taken on board. Anyway, I wasn't trying to argue with her so I just ignored that and will call and speak to someone who has a clue tomorrow.

The daft thing was that in order to make that call, out of respect for ds's patient rights I had to discuss with him if that was what he wanted (surprise surprise he did) and in order to have that discussion I had to 'interpret' the bloody letter and explain the ramifications of it etc etc. so my involvement was required just to get him to understand what the heck they were even talking about!

@Sidge

That seems young. We offer it from 14.

Why?!

@GreyhoundG1rl because that’s the age at which our practice has decided to offer teens the opportunity to have their mobile number on their record as the primary contact, as well as managing their own health online account. It’s not compulsory but offered.

Given the Fraser Guidelines, it seems a suitable age to allow confidentiality in healthcare. Under 14s are still of course entitled to confidentiality and self management but as HCPs it becomes trickier.

So it seems to be down to how your practice decide to approach it. Wish I had one of the sensible 'offer it when they turn 14' sorts. Ho hum.

We had this but when DS turned 12. I received a message via the GP App saying he needs to contact them if he is willing for me to be involved with his care. I can't see DS wanting to call up so I wonder if I can write a letter and he sign it?

He has a couple of sensitive issues that he would fine extremely difficult to call and initiate a conversation about so it would be so useful, and his preference! if I could call and speak to the GP with him.

Parents still have to cosign everything for under 14s where I live (though under 14s can go to any doctor or dentist they're already registered with without their parents being involved the child can't go to a new practice or have any procedure requiring consent forms signing, such as even very minor surgery like removing a mole).

DD is one of the more responsible and self motivated teens I've known and started taking over booking her own appointments at 14, and completely manages her own orthodontic treatment, but even at nearly 16 her orthodontist suggests she have a parent come in occasionally and she sometimes checks our family calendar and adds me into her appointment to attend with her!

DS aged 14 needs me to remind him he can speak for himself! He goes to the doctor rarely as he's almost never ill, and was most taken aback last time we went that the staff now speak directly to him and not me - he is perfectly capable but apparently it hadn't occurred to him he'd have to explain himself! I guess I should have thought to pre warn him! I've also recently had to heavily nudge him into taking over communication with his own football team via WhatsApp group which both parents and kids are in - about 60% of the boys post on their own behalf and the parents of the other 40% post on their teen's behalf. DS was completely content for me to speak for him and I had to firmly insist he take over (I can still read the group and its just organisational stuff).

Removing parents from the loop by default before 14 is counterproductive, although should an under 14 even think of and manage to get themselves to the doctor's without a parent they should certainly be offered confidentiality then, although not necessarily treatment depending on the situation.

I can't manage my 11yo DCs records online for this reason. But I haven't had any problems managing his health otherwise... Repeat prescriptions, e-consult referrals, booking appointments etc. It's just the online records/bookings etc that I can't access which means if he needed to see them about something confidential he is covered.

Just remember very many young people lead lives different to that your child is living. The presumption is that engaged, involved parents who will support their child will care enough to help there child arrange proxy. Leaving those 11 year olds who need to to manage their own health care.

helpfulperson very few 11 year olds from abusive or (more so) neglectful homes are more able to manage their own healthcare than average peers though.

I've worked with that demographic and the child who achieves some kind of extra maturity through neglect is a myth - most neglected and emotionally abused children are less socially and emotionally mature than age peers even if they sometimes have a protective "shield" of outward street smarts type confidence (which is often / usually actually the opposite).

The intention might be good but at age 11-12 the children who need confidentiality aren't the ones who'd have the skills and resources to access the services they need kept confidential, sadly.

This is probably down to GDPR policy and whoever writing it having no common sense. Request an copy of this plan and request a form that allows your son give you his parents his consent to discuss his care, access all results and treatment plans, speak on his belhalf, make appointments on his behalf etc. You could also type a letter to that affect and get him to sign it.

My DD is 14 nearly 15 and I’ve heard nothing from our surgery at all, she’s not confident about dealing with medical things and I still book and deal with her medical issues.
She’s had some major issues this last couple of years and all the drs and surgeons involved have been happy for me to deal with everything.

Most 11 year olds would be completely incapable of even arranging the appointment! Most of the kids I teach in Y7 need their parents to do almost everything for them. It is very strange that everything regarding education goes through parents and yet children are regarded as being able to manage their own healthcare. It would seem more sensible to simply have confidentiality where requested. So if a child asks the doctor to maintain confidentiality about a specific issue then they do so. If the child makes no such request, care continues in the same way.

greyhound why what?

You cannot assume Gillick competency and I’m amazed that surgeries are doing so, without prior assessment. @Sidge your practice is opening itself up to a potential lawsuit if they don’t.

There are questions which you need a ask of a minor to determine competency - it can’t be assumed.

My practice do this.

Access for Children Under 11
For children aged 0 till their 11th birthday, record access will be given to their parent or legal guardian upon request. This is known as “proxy access”. The child will not be issued with a username and password. Record access will be granted through the parent or guardian’s SystmOne Online record. During registration the member of staff will mark the basis of granting access as “parental responsibility”. This access will automatically be revoked when the child turns exactly 11 years of age.

For patients aged between 11 - 15 years access to SystmOne Online services will not be considered due to General Data Protection Regulations (GDPR). SAHC has a duty of care to establish whether or not a child is capable of giving the necessary consent and this depends on the child’s maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment/request proposed, so the consent, if given, can be properly and fairly described as true consent.(Gillick v West Norfolk, 1984).

Proxy Access for patients aged 11 – 15
Xxxxxx surgery have decided to allow young people aged 11-15 years the right to consent to their parents/carer having access to their SystmOne Online record for “requesting medication” ONLY. This access will then be stopped on the patients 16th birthday, when they can request a SystmOne Online account themselves.

@underneaththeash I’m very aware of that thank you.

This is actually interesting re guidelines and 11.

My ds has had a few dental ally's and an MRI whilst 13-15 (pre covid!) that my dad took him to as I was working.

Each time I had to write a letter or collect permission forms from the dentist prior to sign.

It sounds like ds could do this himself under the rules?

That’s fucking stupid, surely a mistake?!

What is DS supposed to sit in the 40 minute queue when a doctor opens at 8am or tootle himself down to hospital with blood forms? 🤨

I would contact them and say you don’t consent for this? Surely that counts for something he’s still a child! If not make a complaint to the CQC.