Application form to request access to a deceased patient’s health record
Strictly confidential once completed.
The Trust appreciates this is likely to be a distressing time for you and we wish to make the application process to see the health record as stress free as possible. With this in mind, please complete the relevant sections of this online form to assist us in completing your request as in as timely a manner as we are able.
Rights of Access
Requests for access to health records of patients who are deceased are dealt with through the Access to Health Records Act 1990 (AHRA).There are certain individuals who have rights of access to the health records of a deceased person. These are:
The patient’s personal representative
A personal representative is the executor or administrator of the deceased person’s estate. An example of where we are able to confirm that the applicant is a personal representative of the patient is when the applicant is, or has been, the Executor of the Will and they have sent us copies of documents as evidence of this relationship.
Any person who may have a claim arising out of the patient’s death
If the application is in respect of a claim arising from their death, access cannot be given to information which is obviously not relevant to the claim.
The law requires us to ask you for information to determine your right to access the health record. If you are applying to see a deceased relative’s record we will need to see one of the following:
- Grant of Probate
- Letter of Administration
- Last Will and Testament.
If you do not have any of these, we need proof of your entitlement to access the record, such as the deceased’s
- Birth Certificate
- Marriage Certificate
- Death Certificate.
Limitations to accessing the record or part of the record
The Trust follows a health records retention schedule whereby records are no longer held for patients who passed away more than eight years ago. We are required to check that any disclosure is subject to the recorded wishes of the deceased person.
We would consult with our health professionals to ensure there is nothing in the record which could harm a third person (such as information about the health of another person) if the record is to be released. If the health record, or part of the health record, is being withheld, we will advise you why, but we would not be able to give you specific details. If you have any queries, please do not hesitate to contact us – please see details at the end of this form.
If you have any queries or need help with completing your application please do not hesitate to contact us either by telephone or by email:
Direct dial: 01332 389131
Once completed you can either email your form attaching any relevant documents or post to us.
Access to a Health Record
IM&T and Records
Kingsway House East