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For patients under 16 

Clinical professionals must assess the child or young person's Gillick competence in relation to proxy access to determine whether they are able to understand and consent to proxy access before granting it.  

For further guidance, see the BMA’s Children and Young People Ethics Toolkit.  

It is important that clinical professionals record the date competence was assessed and the outcomes of the assessment in the patient's record. 

For patients over 16 

For a patient who is aged 16 and over, clinical professionals should consider whether a capacity assessment is required, but may presume capacity to consent to proxy access unless they have evidence that the patient lacks capacity.  

A clinical professional must carry out an assessment of capacity to consent where a lack of capacity for the decision is suspected, but not evidenced. Refer to the MCA code of practice (Chapter 4). 

It is important that clinical professionals record the date capacity was assessed and the outcomes of the assessment in the patient's record, including any review needs.


Last edited: 6 May 2026 1:58 pm


Chapters

  1. DAPB3051 Identity Verification and Authentication Standard for Health and Care, Authorisation Use Case: Proxy
  2. Glossary
  3. Use of the terms "must" and "should" in this guidance
  4. 1.0 Overview
  5. 1.1 Purpose of this standard
  6. 1.2 Who this standard applies to
  7. 1.3 What this standard does not cover
  8. 1.4 Compatibility with other standards and guidelines
  9. 2.1 Types of proxy access: formal and informal proxy access
  10. 2.2 Types of proxy access: Records access by a clinical professional
  11. 3.0 Roles and responsibilities
  12. 4.0 Grant proxy access
  13. 4.1 Assess if access is appropriate
  14. 4.1.1 Establish whether access is necessary
  15. 4.1.2 Establish whether access is relevant
  16. 4.1.3 Establish whether access is safe
  17. 4.2 Establish a basis for access
  18. 4.3 Check evidence relevant to the basis for access
  19. 4.3.1 Verify the proxy and patient’s identity
  20. 4.3.2 Understand if the patient has the ability to consent
  21. 4.3.3 Obtain the patient’s informed consent to proxy access, if appropriate
  22. 4.3.4 Verify evidence of a basis for access if the patient cannot consent
  23. 4.4 Redact sensitive information based on what is being shared
  24. 4.5 Audit decisions about proxy access
  25. 4.6 Communicate the outcome of a decision to grant or deny proxy access
  26. 5.0 The scope of proxy access
  27. 6.0 System audit of proxy access
  28. 7.0 Managing proxy access
  29. 7.1 Ongoing reviews of proxy access
  30. 7.2 Age and development based reviews of access
  31. 7.3 Time-bound reviews of access
  32. 7.4 Wider events that materially affect proxy access
  33. Appendix A: Ways to evidence a basis for access if the patient is not capable of providing informed consent
  34. Appendix B: Driver diagram articulating the strategic aims of this information standard