7.2 Age and development based reviews of access
There are two natural age-based milestones affecting proxy access.
When a patient reaches an age between 11 and 13, any granted proxy access should be reviewed. There is legally no cut off when a child may be considered Gillick competent in relation to proxy access, but it is good practice to implement standard review dates in line with a young person's evolving maturity and ability to consent to proxy access.
At 13 more digital services like the NHS App become available for young people to independently access, and so 13 should be used as a point to review the relevance of any ongoing proxy access. (This is due in many cases to the fact that 13 is the age at which a young person is considered to be able to give their own consent to data processing by information society services under the GDPR, where consent is the article 6 basis being relied on.)
Earlier or later age-based review dates may be set in line with a health and care organisation's local policy. For example, RCGP GP online services guidance for children and young people recommends age 11 as a review point for proxy access in general practice.
When a patient reaches age 16, they should be presumed to have capacity, as per the provisions of the Mental Capacity Act 2005. If they were previously deemed to not be Gillick competent in relation to proxy access, their capacity should be considered.
Clinical systems must therefore be programmed to suspend proxy access when a patient reaches age 16. Clinical systems should be programmed to suspend access for review at age 13 or earlier, configurable by the health and care organisation’s local policy.
Proxies and patients must be informed of this suspension ahead of time so that they have an opportunity to extend access if there is a need to.
Patients should also be informed of the opportunity for self-access where there are services that they are eligible for, so that they can be encouraged to utilise this as an alternative to proxy access. For example the NHS App is available at age 13, while other digital services can be offered to children younger than 13.
Clinical systems must support staff to easily reactivate proxy access that has become inactive on reaching an age milestone to support continuity of care.
Requests for extending proxy access must be considered in line with the requirements for proxy access defined in this standard.
Last edited: 6 May 2026 4:27 pm