Use Case - Request Access

Request proxy access to act on behalf of a patient


User Story Summary (Clinical Overview) As a proxy,
I need to be able to request access to act on behalf of a patient I care for,
So that I can access services for them to support them with their care.

As a patient with capacity,
I need to be able to nominate a proxy to act on my behalf,
So that I can be supported in my care by a trusted individual.
Actors (Role) Proxies, Patients, Clinical professional / General practitioner
Frequency of Use Every time a proxy or patient requests proxy access.
Triggers A proxy or patient requests proxy access using a patient-facing service.
Pre-conditions
  • The proxy’s and patient’s identifiers (NHS numbers) are provided.
  • The proxy or patient’s identity is suitably verified and authenticated at the point when the request is made.
  • Where they are nominating a proxy, the patient’s consent is captured as part of the request.
Post-conditions
  • A request for access has been recorded.
  • Where a patient has capacity or is deemed competent, their consent has been solicited and recorded.
  • A decision to grant or refuse the establishment of the proxy relationship has been made and recorded by the clinical professional.
  • If authorized, an active proxy relationship has been established, the clinical professional has performed any necessary redactions to the patient record and local permissions for online access have been set up.
  • The proxy has been informed of their access being set up.
Main Course
  1. The proxy or patient makes a request for access using a patient-facing service. They receive confirmation of their request being received.
  2. The patient accepts a proxy access request within a patient-facing service if the request requires their consent to be approved. If this is not possible, the clinical professional will obtain the patient’s consent to inform their authorisation decision.
  3. The request for access is sent to the patient’s general practitioner for authorisation.
  4. The clinical professional views the request and determines whether the proxy relationship is safe and appropriate.
  5. If the relationship is authorised and records access is being granted, the clinical professional will review and redact the record accordingly.
  6. If the relationship is authorised, the clinical professional will set up local permissions for the proxy to access online services.
  7. The proxy is notified if the proxy access has been set up.
Alternate Course The proxy or patient does not meet the eligibility criteria for access. For example, they may be sensitive flagged (S-flagged) in PDS.
Exception
  • Proxy or patient 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.

Workflow

Request Access_JT