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Medical Records Transfer Form Template for England and Wales

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Key Requirements PROMPT example:

Medical Records Transfer Form

"I need a Medical Records Transfer Form for transferring patient records from London Bridge Hospital to Guy's Hospital, including specific provisions for electronic health records and urgent access requirements, as the patient requires immediate specialist care."

Document background
The Medical Records Transfer Form is a crucial document used when patients change healthcare providers or require their medical records to be shared with other authorized parties. This form, designed for use in England and Wales, ensures compliance with data protection laws and healthcare regulations while maintaining patient confidentiality. It includes comprehensive patient information, details of both the transferring and receiving healthcare providers, explicit consent mechanisms, and specific transfer instructions. The form is essential for maintaining continuity of care and ensuring secure, authorized transfer of sensitive medical information.
Suggested Sections

1. Patient Information: Full name, date of birth, NHS number, current address and contact details of the patient

2. Current Healthcare Provider Details: Name, address, contact information and registration details of the current healthcare provider

3. Receiving Healthcare Provider Details: Name, address, contact information and registration details of the receiving healthcare provider

4. Records Description: Detailed description of medical records being transferred, including type, date range, and format

5. Consent Declaration: Patient's explicit consent for the transfer of records, including GDPR compliance statement

6. Transfer Method and Security: Specified method of secure transfer and data protection measures to be implemented

Optional Sections

1. Urgent Access Declaration: Additional section when immediate access to records is required for clinical reasons

2. Third Party Authorization: Details and authorization when someone other than the patient is requesting the transfer

3. Specific Exclusions: Section detailing any specific parts of the medical record to be excluded from the transfer

4. Special Instructions: Any specific handling instructions or requirements for sensitive information

Suggested Schedules

1. Schedule 1 - Identity Verification Documents: Copies of required identification documents for the patient or authorized representative

2. Schedule 2 - Proof of Authority: Documentation proving legal authority to request records (where applicable)

3. Schedule 3 - Record Index: Detailed inventory of all medical records being transferred

4. Schedule 4 - Data Protection Compliance: Checklist confirming compliance with GDPR and other relevant data protection requirements

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions




























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Relevant Industries
Relevant Teams
Relevant Roles
Industries

UK General Data Protection Regulation (UK GDPR): Primary data protection legislation covering principles of data processing, special category data protection requirements, data transfer requirements, and rights of data subjects in relation to medical records

Data Protection Act 2018: UK's implementation of data protection standards, including additional safeguards for health data and specific provisions for healthcare processing

Access to Health Records Act 1990: Legislation governing provisions regarding deceased patients' records and rights of access to health records

The Health and Social Care Act 2012: Establishes information governance requirements and NHS information sharing frameworks for medical records

Common Law Duty of Confidentiality: Legal principle covering patient confidentiality obligations and consent requirements for sharing medical information

Medical Act 1983: Sets out professional standards regarding medical records and record-keeping requirements

NHS Records Management Code of Practice: Guidelines establishing retention periods and storage and transfer requirements for medical records within the NHS

The Caldicott Principles: Framework of confidentiality and information sharing guidelines, including justification for data sharing in healthcare

Professional Guidelines: Includes General Medical Council (GMC) guidance and British Medical Association (BMA) guidelines for medical records management

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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