National Record Locator (NRL)

The National Record Locator (NRL) allows health or social care workers to find and access patient information shared by other health and social care organisations across England, to support the direct care of a patient.

It works like this:

1. 'Provider' organisations share 'pointers' to their patient records with NRL.
2. 'Consumer' organisations search NRL for record 'pointers' - usually for a specific patient, using their NHS number.
3. The consumer uses the 'pointer' to get the patient record directly from the provider.

A record could be a document, such as a PDF, an application, such as the Greater Manchester Care Record, or raw data. 

NRL is only used by health and social care workers to:

• let NRL know which patients they have information for
• access a patient’s information regardless of where they were treated in England

For example, an ambulance service called to an accident in London can access information about a patient who is visiting from Preston.

NRL does not have a user interface - health or social care workers must access it indirectly via point-of-care applications, such as:

• GP software
• electronic patient record (EPR) software in a hospital setting
• the National Care Records Service

Point-of-care applications access NRL via the NRL APIs.

Health and social care workers must be suitably authenticated and authorised to access NRL.

For more details, see Benefits of the National Record Locator.

1. Provider and consumer organisations sign up to use the service. Their point-of-care software must be integrated with NRL (although NRL consumers have the option to use the National Care Records Service).
2. Provider organisations use their point-of-care software to share a list of the patient records they have. For each record, they share the patient's NHS number, some basic information about the record and a 'pointer' to the full record.
3. On an ongoing basis, they notify NRL of any changes.
4. When a patient interacts with a consumer organisation, the health or social care worker uses their point-of-care software to retrieve a list of all patient records from NRL. This is usually based on the patient's NHS number, but it is also possible to search in other ways, for example by care provider.
5. If the worker wants to view a particular record, their point-of-care software uses the 'pointer' to access the full record directly from the provider. A record could be a document, such as a PDF, an application, such as the Greater Manchester Care Record, or raw data.
6. In some cases, a record 'pointer' points to a PDF. To keep things secure, the software retrieves the record via our Spine Secure Proxy (SSP). They might also need to look up some care provider details in our Spine Directory Service. 
7. In some cases, a record 'pointer' isn't available. When this happens, the worker can instead view a web page with contact details for the care provider - using the URL included with the record pointer.
8. In some cases, a record 'pointer' points to an entire application, such as the Greater Manchester Care Record. This allows the end user to deep-link into that application, and view that service in the context of the patient. This feature is called 'in-context launch'.

All interactions between point-of-care applications and NRL are via the NRL APIs.

For both providers and consumers, operations are restricted to the document types agreed when they signed up.

For an example of how NRL works for a consumer, see the NRL demonstrator system.

Types of record

The types of records in active use include:

• mental health crisis plans
• end of life plans
• emergency care plans

Other record types can be requested and will be reviewed for inclusion.

For a list of NRL provider and consumer organisations, the patient record types shared and their purpose for sharing, see the Controller Catalogue spreadsheet.

Information held against each 'pointer'

The 'pointer' includes:

• the patient's NHS number
• the name of care setting where the information is held and the type of document or information held
• a 'pointer' to the full record, held by the care provider
• the URL to request access to the record and/or contact details for the provider

Patient information is typically shared as unstructured information in PDF format.

Common uses of NRL include:

• ambulance staff viewing the end-of-life care plan for a patient who has had an accident away from home
• care home staff viewing the end-of-life plan for a patient from a previous care home
• a maternity nurse viewing a mental health crisis plan for a patient giving birth in order to assess susceptibility to postnatal depression

Here are some quotes from NRL users:

NRL is the only service approved for sharing 'pointers' to patient records. This is because it integrates patient record access across the NHS and social care, without dictating where those records are stored.

This service is live, and has been in active use since 2018.

Most consumers are currently using the National Care Records Service to access records.

Some consumers are using Regional Shared Care Record Applications to access records.

For an up-to-date list of NRL providers and consumers, see the Controller Catalogue spreadsheet.

NRL API v3

A new version of the NRL API - v3 is in development. The new version uses our API platform and will be easier to use. It is currently available for sandbox and integration testing. For more details, see NRL APIs.

The replacement NRL service is a gold service, meaning it is operational and supported 24 hours a day, 365 days a year.

For more details, see service levels.