National Record Locator (NRL) (draft)

The National Record Locator (NRL) helps health and care organisations find where patient information is held so it can be accessed by existing systems to support the direct care of a patient.

The service provides the National Record Locator - FHIR API, which allows systems to locate and access patient information shared by other healthcare organisations.

NRL maintains an index of pointers, which act as signposts to records held by other organisations. These pointers show where relevant records exist and help systems retrieve information directly from the organisation that created it.

A ‘record’ means patient information held by an organisation, such as letters or reports, PDFs, care plans or other clinical information recorded as part of a patient’s care.

NRL is for health and care organisations that need to locate patient information held by other organisations.

This includes:

• clinicians and care teams accessing information to support direct care
• NHS and social care organisations sharing information across organisational boundaries
• digital, transformation and information leaders responsible for information sharing services
• system suppliers integrating clinical systems with NRL

End users do not access NRL directly. They use it through existing clinical systems and applications.

Common uses of NRL include:

• ambulance staff viewing the end-of-life care plan for a patient who has had an accident away from home
• care home staff viewing the end-of-life plan for a patient from a previous care home
• a maternity nurse viewing a mental health crisis plan for a patient giving birth in order to assess susceptibility to postnatal depression

Here are some quotes from NRL users:

For more details, see Benefits of the National Record Locator.

NRL acts as a signpost (or pointer), helping systems find and request information from the organisation that holds it.

NRL does not have a user interface - health or social care workers must access it indirectly via point-of-care applications, such as:

• GP software
• electronic patient record (EPR) software in a hospital setting
• the National Care Records Service

Point-of-care applications access NRL via the NRL APIs.

Health and social care workers must be suitably authenticated and authorised to access NRL.

• How NRL works
  Process and system interactions

Types of record

The types of records in active use include:

• mental health crisis plans
• end of life plans
• emergency care plans

Other record types can be requested and will be reviewed for inclusion.

For a list of NRL provider and consumer organisations, the patient record types shared and their purpose for sharing, see the Controller Catalogue spreadsheet.

Information held against each 'pointer'

The 'pointer' includes:

• the patient's NHS number
• the name of care setting where the information is held and the type of document or information held
• a 'pointer' to the full record, held by the care provider
• the URL to request access to the record and/or contact details for the provider

Patient information is typically shared as unstructured information in PDF format.

Privacy and consent

Access to information is controlled and audited, and only authorised staff can view patient information for direct care.

Health and care staff do not access NRL directly. They use it through existing systems such as GP software, electronic patient record systems and the National Care Records Service.

NRL does not:

• store patient records
• replace clinical systems such as GP or hospital records
• provide direct access to information on its own

NRL is only used by health and social care workers to:

• let NRL know which patients they have information for
• access a patient’s information regardless of where they were treated in England

For example, an ambulance service called to an accident in London can access information about a patient who is visiting from Preston.

NRL is the only service approved for sharing 'pointers' to patient records. This is because it integrates patient record access across the NHS and social care, without dictating where those records are stored.

This service is live, and has been in active use since 2018.

Most consumers are currently using the National Care Records Service to access records.

Some consumers are using Regional Shared Care Record Applications to access records.

For an up-to-date list of NRL providers and consumers, see the Controller Catalogue spreadsheet.

NRL API v3

A new version of the NRL API - v3 is in development. The new version uses our API platform and will be easier to use. It is currently available for sandbox and integration testing. For more details, see NRL APIs.

The replacement NRL service is a gold service, meaning it is operational and supported 24 hours a day, 365 days a year.

For more details, see service levels.

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• NRL supplier and user forum
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