Use Case - Create a Relationship

Create an authorised proxy to act on behalf of a patient

User Story Summary (Clinical Overview) As a clinical professional,
I need to be able to set up proxy access,
So that I can enable proxies to support patients in their care.
Actors (Role) Proxy, Patient, Clinical professional
Frequency of Use Ad-hoc, forming part of a regular care interaction.
Triggers
  • A proxy or patient requests proxy access to be set up by the patient’s clinical professional.
  • The clinical professional determines that the patient would benefit from being better supported in their care as a result of enabling proxy access.
Pre-conditions
  • Patient is registered at a GP practice.
  • Patient has an NHS number.
  • Proxy has an NHS number.
Post-conditions
  • The proxy is granted proxy access to a patient’s services if the clinical professional deems it to be safe, necessary, and relevant.
  • Where a patient has capacity or is deemed competent, their consent has been solicited and recorded.
  • A decision to grant the establishment of the proxy relationship has been made and recorded by the clinical professional.
  • An active proxy relationship has been established, the clinical professional has performed any redactions necessary to the patient record, and local permissions for online access have been set up.
  • The proxy, and where appropriate, the patient are notified about proxy access being granted.
Main Course
  1. As part of a regular in-person care interaction, it is determined that a proxy relationship would benefit the patient. This may be determined by the GP or requested by the patient or a prospective proxy.
  2. The clinical professional performs any checks necessary to determine that – to the best of their knowledge – proxy access is safe and appropriate.
  3. In cases where the patient has capacity or is deemed competent, the clinical professional will seek (and record) consent from the patient.
  4. The clinical professional will create the relationship, granting proxy access so that the proxy can act on behalf of a patient.
  5. The clinical professional will set up local permissions for the proxy to access online services within their system and, in the case of granting records access, perform any redactions as necessary.
  6. The proxy and, where appropriate, the patient get notified about the request being approved, and/or access being granted.
Alternate Course The general practitioner decides that access would be inappropriate (e.g., not necessary, relevant, or safe for the patient). In this case, access will not be set up.
Exception The clinical professional is not sufficiently verified or authenticated.