National proxy service

The National proxy service (NPS) enables a trusted person, a proxy, to act on behalf of a patient online, to help them with their health and care.

Safe and appropriate proxy access improves patient care and extends the benefits of GP online services (NHS England) to those who are unable to use them themselves. 

Proxies can use the NHS App, or GP systems, to complete tasks for patients such as ordering repeat prescriptions, booking appointments or checking test results.

Patients or their proxies can apply using the Proxy application service (PAS), by choosing Manage health services for others in the NHS App, and selecting either Apply to access services for someone else or Give someone you trust access to your services. 

The Validated relationship service API (VRS API) helps verify identity and relationship information across IT systems.

Through 2027, a national data store of proxy relationships will be introduced, which can be used by providers across the NHS and social care, to enable proxy across different health and care settings. 

This service is for:

• patients who want someone they trust to perform health related tasks online for them, in a safe way that protects their privacy and choice
• carers who want to complete digital tasks for the person they care for quickly and efficiently
• parents who need to manage their children's health and care digitally to work around busy schedules
• GP practices who want to increase the percentage of transactions their patients do online, reducing phone calls and foot traffic
• GP practice staff who need an efficient digital method of receiving and processing applications and managing proxy access
• other health and care providers who will benefit from reliable information on proxy status so they can allow a proxy safe access to another patient’s services or information, in compliance with national standards
• NHS tech providers who can integrate with the National proxy service to enable safe digital access for those acting on behalf of other patients in compliance with national standards, using the VRS API

The National proxy service will provide a national data store of verified safe and appropriate proxy relationships. It will include:

• patient and proxy relationships
• who granted proxy access
• the legal basis for the access
• expiry and review dates
• an auditable record of changes to access

Other services will be able to integrate with NPS using the VRS API.

Existing proxy relationships stored locally in GP IT systems will be migrated to the national data store.

The National proxy service is an optional service, currently only available to GP practices taking part in our pilot. Other GP practices can continue to manage proxy access locally using their standard procedures, in line with the Identity Verification and Authentication Standard for Health and Care Digital, Data, Analytics and Technology Use.

From 2027, when the national proxy data store is available, it will become mandatory for GP practices in England to use the National proxy service to award any proxy access to their patients.

We will work with national services and other health and care providers and systems to onboard with NPS, once it has been fully implemented in primary care.

All proxy access providers will have to comply with the new proxy standard which is currently in consultation and will come into effect in 2026.

The Electronic prescription service (EPS) is integrating with NPS to provide proxies with tracking information on the prescriptions of the patients they care for, from more health and care settings. 

1. Patients apply for proxy access through Manage health services for others on the NHS App, or by filling in a paper form at their GP practice.
2. If the patient has applied using their NHS App, PAS uses the VRS API to check if there is a verified parental relationship in PDS, and sends the application information to the GP practice by email. Once the data store is built, it will also store the application data.
3. The GP practice then reviews the application to decide if proxy access is safe, necessary and relevant, and get patient consent if needed, before setting up any access in the GP IT system.
4. When it is set up, proxies can act on behalf of the person they care for, using their own NHS App.
5. In the future, GP IT integration will mean application information is received directly into the GP IT system for easier GP workflow. It will also send proxy relationship information from the GP IT system to the proxy data store, when proxy access is set up, changed or revoked.
6. Other health and care settings and national services will be able to integrate with NPS using the VRS API and NHS login, to help them decide if proxy access to their patient's information is appropriate, when requested, and to provide digital access to services for proxies.

This service is in Private Beta.

This service is still being piloted and is a bronze service. This means it is available and supported between 8am and 6pm, Monday to Friday excluding Bank Holidays.

During 2025 to 2027, the National proxy service will:

• ensure all parents have access to their child's health services and records
• integrate with EPS to provide the first proxy access to a national system
• improve the application and management of proxy for patients through Manage health services for others in the NHS App
• make it possible to be a proxy for a patient at a different GP practice
• build a national data store of proxy relationships, and migrate locally held proxy relationships
• integrate with GP IT to improve workflow for GP practices and centralised data management
• publish a new information standard for proxy, supporting a consistent process across the NHS

GP practices and Integrated care boards (ICBs)  interested in joining our pilot can find out more about the Proxy application service and how to get involved.

Developers interested in integrating with the National proxy service can find out more about the VRS API and onboarding.

Proxy application service, the patient-facing digital application currently in pilot in selected GP practices.

VRS API, used to check identity and eligibility information of proxies and patients, and enable integration with NPS.