National Document Repository (NDR): Access and store digital patient documents

Lloyd George records are historical paper-based records for GP patients that were used across the United Kingdom before GP records were digitised. Many patients still have Lloyd George records that contain information that was recorded prior to digitisation. In this service, we refer to these paper records as 'scanned paper notes'.

Some practices have local solutions for scanning and digitising Lloyd George records. Others still have the original paper records. For further information see Digitisation of Lloyd George records. 

The National Document Repository (NDR) is a central place where digital patient documents can be accessed and stored by frontline services. Access and store digital patient documents is the first service available within the NDR.

In this service, the digital Lloyd George record is a place where a patient’s scanned paper documents, or other digital documents, can be stored.  

The digital Lloyd George record can contain:

• scanned paper notes 
• a digital printout of the electronic health record notes and attachments
• letters and documents that were received by a patient’s previous practice 

Access and store digital patient documents allows practices to: 

• download a report of the Lloyd George records stored in the service for their practice
• access, view, upload, and download documents
• review and action pending patient documents
• add files to a patient’s scanned paper notes
• reassign pages in a patient’s scanned paper notes to the correct patient
• view and restore previous versions of scanned paper notes
• restrict staff from accessing patient records

Primary Care Support England can view and download patient Lloyd George records. 

It allows practices and Primary Care Support England (PCSE) to access, view and download digital Lloyd George records. This service is free at the point of use there is no charge to practices for using it once their records have been scanned. The Patient Record Management (PRM) team are responsible for delivering this service. 

National Data Processing Deed 

Patient Lloyd George records are held in the NDR in accordance with The National Data Processing Deed. 

The National Data Processing enables NHS England to:   

• act as the data processor for all GP practices in England

• store the digitised Lloyd George records of patients registered at these GP practices  

This deed operates under the UK General Data Protection Regulation (GDPR) 2018.   

GP practices in England are automatically signed up to the National Data Processing Deed.  

Data Protection Impact Assessment 

NHS England has completed a Data Protection Impact Assessment (DPIA) in relation to the NDR and the Access and store digital patient documents service.  

You may wish to update your local DPIAs to reference this.  

For a copy of the DPIA, email [email protected] 

This service is for Primary Care Support England (PCSE) and practice staff, including clinicians and GP administrators. They can access digitised Lloyd George records stored in the NDR by signing in to the service with their NHS smartcard.   

It is strongly recommended for all GP practices in England to use this service.

Uses include:

• a clinician accessing a patient's digital Lloyd George record to support clinical decision making 
• a GP administrator accessing a patient's digital Lloyd George record to fulfil an access request
• an EHR fails to transfer to a new practice via GP2GP, so a GP administrator at the sending practice uploads it to the NDR, where it can be reviewed and accepted by the receiving practice
• a GP practice receives a letter or document for a patient who has left their practice, and uploads it to the NDR where it can be reviewed and accepted by the patient’s new practice

As this is a national NHS England service, all practices in England will have access to this digital service. The service reduces the need for third-party storage solutions and the need to send and receive paper records. It also acts as a digital fallback when other processes fail or cannot be used.

For more details, see Benefits of Lloyd George digitisation to patients and practices.

Read what GP practices say about using this service on our case studies page.

GP practice staff can sign in to the service and access the records of patients registered with their practice. Not all patients will have a digital Lloyd George record stored in the service.  

Practices and PCSE can sign into the service and download a report to see the list of Lloyd George records stored for their organisation.

For the initial roll out, the service works like this:

1. Transfer records

To transfer Lloyd George paper notes into the NDR, they must be digitised to the national scanning standard. This could be funded by the practice, the ICB or the Primary Care Network. 

Scanning suppliers work with practices to scan their Lloyd George paper notes and transfer them into the NDR via secure file transfer protocol (SFTP). 

You can find information about the scanning standard and approved scanning suppliers on the FutureNHS Digital Primary Care workspace (you will need a FutureNHS account to access these specifications):  

• Specification for digitisation of GP records  

• Scan on demand frameworks  

All suppliers listed have committed to scanning paper notes according to the national scanning standard. 

Practices can also scan and upload their Lloyd George paper notes directly into the service. See Uploading documents into the service section in help and guidance.

2. Access records

Practice staff, including clinicians and GP administrators, can: 

• sign in to the service's user interface, using their NHS smartcard or other CIS2 authentication method
• search for a patient using their NHS number 
• view the patient's Lloyd George record, if it is stored in the NDR
• upload documents to a patient’s Lloyd George record, including scanned paper notes, EHR notes and attachments, and other patient letters and documents
• add files to a patient’s scanned paper notes
• review patient documents that need approval before they can be stored in the service 
• download a report of the Lloyd George records stored in the service for their organisation
• reassign pages in a patient’s scanned paper notes to the correct patient
• view and restore previous versions of a patient’s scanned paper notes
• restrict staff members at their practice from accessing patient records

This service is in live. We are now rolling out the service nationally.

This is a bronze service, meaning it is available and supported during business hours 8am to 6pm Monday to Friday but not bank holidays.

There is a phased programme of roll out for this service.

We are in a pilot phase with Ministry of Defence and Ministry of Justice GP practices.

Upon completion, approved and authenticated users will be able to locate and access patient records.

The PRM team hold regular show and tells. These events are for GP practice staff, ICBs and other interested groups, to keep them updated on changes to the service and the progress of the roll out. If you would like to join a Show and Tell, please contact the PRM team on [email protected].