National Proxy Service

WARNING

This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Use Case - Create a Relationship

Authorise a proxy to act on behalf of a patient

User Story Summary (Clinical Overview)	As a proxy, I need to be able to access services for a patient I care for, So that I can support them with their care. As a patient, I need to be able to share access to my services with someone I trust, So that I can be supported in my care. As a clinical professional, I need to be able to authorise proxy access, So that I can enable proxies to support patients in their care.
Actors (Role)	Proxy, Patient, Clinical Professional
Frequency of Use	Every time access is requested by a proxy or a patient. Every time a clinical professional decides that access may be beneficial as part of a regular care interaction.
Triggers	A proxy or patient makes a request for access using a patient-facing service. A clinical professional authorises access in their clinical system.
Pre-conditions	Proxy’s identifier (NHS number). Patient’s identifier (NHS number).
Post-conditions	The proxy is granted proxy access to a patient’s services. A message to the patient is sent if their consent is required to approve the request. In this case, their consent will be recorded as part of the request upon their approval and sent to the relevant clinical professional.
Main Course	A patient or proxy requests access through a digital application or in-person as part of a regular care interaction. The clinical professional creates a relationship, granting proxy access so that the proxy can act on behalf of a patient. Any pre-existing request for access is then updated and marked as ‘approved.’ The proxy and, where appropriate, patient get notified about the request being approved and/or access being granted.
Alternate Course	The proxy or patient do not meet the eligibility criteria for access. For example, they may not be at the same GP practice.
Exception	The clinical professional is not sufficiently verified or authenticated. The proxy or patient does not have a valid PDS record. Invalid or missing patient identifier. Invalid or missing proxy identifier.

View the patient(s) a proxy can act on behalf of

User Story Summary (Clinical Overview)	As a proxy, I need to know the patients I can act on behalf of, So that I can access health and care services for them to support them with their care. As a clinical professional, I need to know the patients that a proxy can act on behalf of and the relationship type, So that I can manage what they can do on behalf of patients.
Actors (Role)	Proxies, Clinical professionals
Frequency of Use	Every time a proxy views the patients they can act on behalf of. Every time a clinical professional views the patients a proxy can act on behalf of.
Triggers	A proxy views the patients they can act on behalf of within a patient-facing service. A clinical professional views the patient(s) a proxy can act on behalf of within their clinical system.
Pre-conditions	Proxy’s identifier (NHS number) Patient’s identifier (NHS number) – if querying for a specific patient
Post-conditions	The proxy can view the patients they can act on behalf of, the nature of their relationship to them, and the services they can access for each patient, in a patient-facing service. The clinical professional can see the patients the proxy can act on behalf of, the nature of their relationship to them, and the services they can access for each patient, in their clinical system.
Main Course	A verified proxy or clinical professional views patients that the proxy can act on behalf of within a patient-facing service or clinical system. The patient-facing service or clinical system displays the patient(s) that the proxy can act on behalf of, and the services the proxy can access for each patient.
Alternate Course	If the patient identifier entered has no existing proxy relationship, an error message is returned. If a patient identifier is entered, then if that patient is a proxy, the patient details will be returned. If the proxy has no patients they can act on behalf of, then the patient-facing service or clinical system will show that no relationships exist.
Exception	Proxy or clinical professional is not sufficiently verified or authenticated. Invalid or missing proxy identifier. Invalid or missing patient identifier.

back to top