Upload documents to a patient's Lloyd George record

You can upload documents to the service when they cannot be transferred electronically. If transferring to another practice,  the patient’s new practice will receive the document without the previous practice needing to print and transport it.  

You can upload scanned paper notes, electronic health record (EHR) notes and attachments, and other letters and documents for storage in this service.

Patients registered at your practice 

You can upload scanned paper notes for patients who are registered at your practice. 

Patients who are not registered at your practice  

You can upload documents for patients who are not registered with your practice, for example:

• if a GP2GP failure occurred when attempting to transfer a patients EHR to their new practice 
• letters and documents that have arrived for a patient after they have left your practice 
• scanned paper notes for a patient who is not registered at your practice 

You will not be able to view the documents in the service after upload.  

The uploaded documents will be listed on the receiving practices 'documents to review' page. The receiving practice will review it and decide whether to accept the document for storage in the service. See Review documents waiting for approval for storage in the service page. 

Orphaned and suspended patients 

Documents for patients who are orphaned or suspended can also be uploaded. They are held in the service until the patient registers with a new practice. The new practice can then access the patient’s record.  

Primary Care Support England (PCSE) can access the records of patients without an active registration.

Problems with uploading files 

If you have any problems uploading files, you will be taken to an error page. The error page will tell you if any of your files are:   

• damaged or unreadable  
• empty  
• have passwords   
• have viruses  

You will need to resolve any problems with files before continuing with the upload. Contact your IT support service for help.   

If you cannot fix the problem, do not upload any files for the patient. You must upload the full record you hold, or none.   

If you’re unable to upload all of the files in the patient’s record, you will need to keep and store the record in accordance with the Records Management Code of Practice.

Convert files to PDF  

You can only upload scanned paper notes and EHR notes in PDF format.   

If your file isn’t in PDF format, you’ll need to convert it. Most programs let you do this by choosing 'Export', 'Save as', or 'Print' and selecting the option to create a PDF.  

Remove passwords from files   

You will need to remove any passwords from files to upload them.   

If you know the password:   

Enter the password and open the file in Adobe.  

Navigate to the security settings and change to remove password protection.  

If you cannot do this in your version of Adobe, select print to PDF to save the file without a password. Check this new copy of the record to make sure it’s the correct size and quality.   

Contact your IT support service if you’re still unable to remove the password.  

If you do not know the password, you will need to find out what it is or ask for a copy which is not password protected.   

Files with viruses  

If one or more of your files has a virus, you will be told about this at the point of upload, after the files are scanned for viruses. The upload will be stopped. Contact your local IT support service immediately to notify them of the problem and get help to resolve it.   

Slow upload 

Your device may slow down or freeze other browser tabs while you upload files. To help prevent this close any browser tabs you do not need. If the problem continues, contact your local IT support service. 

Guidance on uploading each of these document types is below.

Scanned paper notes

Electronic health record (EHR) notes 

Electronic health record (EHR) attachments 

Letters and documents for patients who have left your practice

EHR notes 

These contain the patient’s personal details and all notes from their consultations and interactions with the practice or other healthcare providers. You may also call them the 'journal', 'practice notes' or a 'full EHR summary'.

They are downloaded as a single file from the clinical system. The file does not include attachments such as letters or other documents. You’ll be asked to upload those separately.  

Upload these notes if, for example, GP2GP fails.

Electronic health record (EHR) attachments

These are all the documents stored in the patient’s EHR with the EHR notes. For example, letters, laboratory results, scans and X-rays.

Upload these attachments if, for example, GP2GP fails.

You will need to download the EHR notes and attachments from the clinical system and other patient document management services. See the links below for guidance on how best to download from the clinical system for upload to this service:

Download from EMIS. 

Download from Medicus (this link will take you to an external site).

If you have documents for the patient stored in other document management systems, you will need to export or download them from there.

EHR notes

You can only upload the EHR notes in PDF format.  

If your file isn’t in PDF format, you’ll need to convert it. Most programs let you do this by choosing 'Export', 'Save as', or 'Print' and selecting the option to create a PDF.

You can only upload one file to the 'Choose EHR notes to upload' page.  

EHR attachments

You can upload EHR attachments in any format except .zip and .exe files. 

You can preview PDFs while uploading them, but other file types won’t display a preview. 

There is no maximum number or size of files you can upload. Your EHR attachments will be zipped on upload. 

Name your files

EHR notes and attachments are not renamed by our system on upload so you should name all the files in way which helps you to: 

• select all the files you need to upload for a patient  
• check you’re uploading files for the correct patient

When uploading EHR notes and attachments, choose the EHR notes to upload first, and then the EHR attachments to upload. 

You can choose to skip uploading EHR notes and go straight to adding attachments using the skip link at the bottom of the EHR notes upload page. You may do this if, for example, there has been a partial GP2GP failure and you only need to upload some attachments that failed to transfer. 

To upload EHR notes and attachments:

1.    Select the 'View and upload a patient record' button on the home page. 

2.    Enter the patient’s NHS number to navigate to their Lloyd George record. 

3.    Click the button 'Upload documents for this patient'. 

4.    Select the 'Electronic health record' button.

5.    Choose the EHR notes file to upload on the 'Choose EHR notes to upload'. page. This is a single PDF file. Then select continue.

After you’ve chosen the EHR notes file to upload (or have skipped this step), you can choose EHR attachments to upload. You can upload files in any format except .zip and .exe files but you will only be able to view PDF files during the upload process. 

If documents fail to upload 

If you have uploaded more than one document, occasionally some of these might fail to upload. This can happen if there is a problem with the service. If this happens you will see a screen telling you which files have not been uploaded. 

You’ll need to identify and make a note of the documents that did not upload. Check that each file opens correctly, and remove any passwords from files. Then go to the patient’s Lloyd George record to upload them again.

Make sure that you remove any digital copies of the files from your computer.   

Documents for a patient who is no longer registered at your practice will be listed in the receiving practice’s documents to review page. If another practice has uploaded a document for a patient who has registered at your practice, it will be listed on your documents to review page. 

See Review documents waiting for approval for storage in the service page for guidance on processing the documents in this list.

A practice can upload documents that have arrived at their practice for a patient who has left and registered at another one. These could include letters, test results and referrals.

File types, sizes and filenames accepted for upload

You can upload letters and documents in any format except .zip and .exe files. There is no maximum number or size of files you can upload. 

You will only be able to view PDF files during upload and when they are stored in the service.

Letters and documents are not renamed on upload so you should name the files in way which helps you to: 

• select all the files you need to upload for a patient  
• check you’re uploading files for the correct patient

How to upload documents

To upload a document: 

1. Select the 'View and upload a patient record' button on the home page. 
2. Enter the patient’s NHS number to navigate to their Lloyd George record. 
3. Click the button to 'Upload documents for this patient'. 
4. Select the 'Other documents' button.
5. Choose the documents you want to upload on the 'Choose documents to upload' page.

Once uploaded, each document will be listed individually in the receiving practice’s 'Documents to review' page. 

After you’ve uploaded a document

Make sure that you remove any digital copies of the files from your computer. 

Documents for a patient who is no longer registered at your practice will be listed in the receiving practice’s documents to review page. If another practice has uploaded a document for a patient who has registered at your practice, it will be listed on your documents to review page. 

See Review documents waiting for approval for storage in the service page for guidance on processing the documents in this list.

These are the patient’s historic paper notes which are stored in their Lloyd George envelope. You might have had them scanned by a scanning supplier and transferred into this service already during an earlier stage of this service’s rollout. 

You can scan and upload your patient’s paper notes directly to the service. 
Use this guidance in alongside the national scanning standard outlined in the service specification. 

Scan your paper notes

Your Lloyd George paper notes will need to be scanned at your practice before they can be uploaded. 

Before you scan your notes

Summarisation of records 

It is best practice that the paper Lloyd George record is summarised into the patient’s full electronic health record before records are scanned and digitised. Summarisation of records was a requirement of the General Medical Services contract in 2004. If however, records have not been summarised this should not be a barrier for records being digitised. 

It is best practice to inform your integrated care board (ICB) of plans to digitise records if they are not already involved in the project. 

Scan your paper notes 

Scan all pages contained within a Lloyd George record envelope and the envelope itself.  

We recommend scanning Lloyd George notes records as a single PDF document rather than splitting them into multiple sections.

Scan with Optical Character Recognition (OCR)

An Optical Character Recognition (OCR) layer enables text to become machine-readable so you can search for keywords within a record when it is stored digitally in the service. OCR enables you to find typed words within a document, but not handwritten notes.  

All scanned image files must comply with Optical Character Recognition standards, following the national scanning standard outlined in the service specification (NHS Futures login required). Check the OCR function on your scanner is enabled by turning on OCR in the settings. 

Scan quality 

All scanned images must meet a minimum of 300dpi following the national scanning standard outlined in the service specification (NHS Futures login required).

You can only upload scanned paper notes in PDF format. If your file isn’t in PDF format, you’ll need to convert it. Most programs let you do this by choosing 'Export', 'Save as', or 'Print' and selecting the option to create a PDF.

There is no maximum number or size of files you can upload. 

Name your files 

You don’t need to name your files according to the naming convention given in the Lloyd George digitisation guidance (NHS Futures log in required). The service will automatically name files following the file naming convention when they are uploaded.  

You should name your scanned files in way which helps you to: 

• select all the files you need to upload for a patient  
• put the files in the order you need them to appear in the final record 
• check you’re uploading files for the correct patient

Before you upload your files, make sure that: 

• they are in PDF format 
• they open correctly (meaning that the files are not damaged, empty or unreadable)  
• any passwords are removed

To upload your files:

1. Search for the patient using their NHS number. If you are shown any error messages when you enter an NHS number, you can find guidance on this in the search for a patient section.
2. Select the button to 'upload documents for this patient'.
3. Choose and upload your file(s).

Order your files 

Your uploaded files will be arranged in a default order by our system, so you may need to change this order. Do this by changing the order number in the drop-down boxes next to each file.  

There is a document viewer on this page so you can preview the order of the final document by scrolling through the files. Changes you make to the order of files will be reflected in the preview window so that you can check it's correct.

You can add files to scanned paper notes that are already stored in a patient’s Lloyd George record. You can do this if you find or receive additional pages of a patient’s scanned paper notes

To add files to existing scanned paper notes: 

1. Go the patient’s Lloyd George record and find their scanned paper notes in the documents list.
2. Click 'view’ to see the scanned paper notes. 
3. Select the button 'Add files'.
4. Choose your files.  
5. Put your files in the order you need them to appear after the existing notes.
6. Check and confirm the files are in the correct order and continue to upload the files.

After you have successfully uploaded scanned paper notes to a patient’s digital Lloyd George record, follow your usual process for managing a new patient record. 

You may want to add a note to each patient’s electronic health record to indicate that their Lloyd George record is stored in the National Document Repository. If you would also like to record this using a SNOMED code, you can use Lloyd George Record Folder 16521000000101. This SNOMED code is not unique to this service and might be used elsewhere.   

Where to find the scanned paper notes you’ve uploaded

Scanned paper notes uploaded for a patient registered with your practice will appear in the patient’s Lloyd George record page in the service. 

Scanned paper notes for a patient who is no longer registered at your practice will be listed in the receiving practice’s documents to review page. If another practice has uploaded documents for a patient who has registered at your practice, it will be listed on your documents to review page. 

See Review documents waiting for approval for storage in the service page for guidance on processing the documents in this list.

Delete files and destroy paper records 

After you’ve successfully uploaded files into the service, you must delete any digital copies from your computer in line with General Data Protection Regulations. 

You can also destroy your paper records. More information on record destruction can be found on page 24 of the NHS Futures article Digitisation of Lloyd George records (NHS Futures log in required).

Store scanned paper notes in the service

Scanned paper notes can stay stored in the service, you do not need to remove them unless they have reached the end of their retention period. See Remove scanned paper notes. 

Scanned paper notes uploaded for a patient registered with your practice will appear in the patient’s Lloyd George record page. 

Scanned paper notes for a patient who is no longer registered at your practice will be listed in the receiving practice’s documents to review page. If another practice has uploaded documents for a patient who has registered at your practice, it will be listed on your documents to review page. 

See Review documents waiting for approval for storage in the service page for guidance on processing the documents in this list.