Help / Patients

The patient record

From the search bar on Start, or the patient's name on any page.

Photo, under the patient's picture at the top of the card, takes a new picture with the device's camera or lets you choose one from the device. The picture is made smaller, replaces the patient's present one and shows on the card and beside their name in search at once, and the change is written on the patient's log. Where new-patient questions are switched on, a patient is also asked in the portal for their own photograph from their own device.

The date of an operation on the Surgery tile opens its operation note in a new tab; Booking form, beside it, opens the booking form. Where the browser blocks the new tab, the page opens in the same tab instead, with a link back to the patient.

Open pathways are listed beside the switch, in either view, and open the Pathways card, where Complete finishes one. Complete also appears beside an open step in the check before a portal invitation, and in the bar of the patient portal preview.

In Attachments, a folder with two or more photographs or videos has Share all at the top, which shares every one with the patient's portal at once.

New folder, at the top of Attachments, makes a folder on the patient's record that belongs to no appointment, for photographs and documents that are the patient's rather than a visit's. Press it, say what the folder is for when asked (or leave that empty for a general folder), and the folder's own page opens: Add takes files from your computer and Phone shows a code to scan so photographs go in straight from a phone. Back on the record, the folder is listed under Attachments with the patient's others, dated today, with its pictures under it, and making it is written on the patient's log. Photographs of a visit still go on from that appointment.

Sick note, beside New letter, under Letters,, is drawn only for a doctor or a nurse. Press it, give the first and last day the patient is unfit for work and a short reason, and press Create: a letter in your name is made on no appointment, to whom it may concern, with the sick-letter wording already in it. Read it, change what you like and tick Approved, which signs it. Nobody who is not a doctor or a nurse sees the button, and the same letter can be made from the patient's record.

The Timeline lists every email sent to the patient, by subject, with who sent it, and each appointment says how it went, for instance Departed or DNA. Emails picks out the emails alone.

The organisation beside the patient's number, on the Record line, is the organisation the patient belongs to. A Director or manager at both organisations can press it to move a patient made under the wrong one: choose where to, then Move. Their invoices and payments stay where they are, and the move is written on the patient's log.

The record opens on who the patient is and how to reach them. A pencil beside the name opens a box with Title, First name, Middle name and Surname, and the other names the patient is known by, which can be added or removed there; Save writes the name, and the patient's log keeps the old name beside the new one. Anybody who may correct the date of birth can do it, and the title and sex are left as they were. Under the name are three lines: DOB, the date of birth with the age beside it; Sex; and Record, the patient's number. Under the photograph is the organisation that holds the record, as its logo where it has one and its name where it has not; where you may move the patient to another organisation, a pencil beside it does that. A fact the record lacks says Not recorded. Where the patient is known by other names, such as a maiden and a married surname, a fourth line, Also, lists them. Add another name, in the Settings tile, takes a new one: type it and Save. The remove beside a name takes it off. Anybody who may correct the date of birth can do either, and each change is written on the patient's log. The pencil beside Sex opens a box with Male, Female, Non-Binary and Unknown; choosing one asks you to confirm, and the patient's log records what it was and what it now is. When two records are merged and their names differ, the merged record's name is kept here by itself. Under that is a switch between two views of everything else: Tiles and Timeline. The choice is remembered on the device you are using.

Pathways lists each pathway the patient is on, the stage reached, and every stage recorded with its date. Complete marks a pathway finished, for a patient who has been discharged, and their portal then stops showing the steps still to come; Reopen takes that back. Set stage corrects the stage recorded where it is wrong. Each change is written on the patient's log with your name. Start, under the list, starts a pathway with no appointment, so you can record what a patient is about to begin before their first appointment is booked: choose the pathway from the list and press Start, and it appears in the card ready for its stage to be set. A patient on no pathway shows None and the same Start. A pathway the patient has not finished cannot be started twice.

Under the patient's name, a red flag says when they have allergies or take a red flagged medicine. Press it and the list opens just below: each allergen with the reaction, or each flagged medicine with its dose and the warning that goes with it. Press it again to close it, and Health beside the list opens the whole Health section.

Tiles groups the record into bands: Health, Care, Records, Money and Contact. Each tile shows what is in that part before you open it, and some carry one badge for the thing that matters most there, such as an unchecked result, money outstanding or the next date. Pressing a tile opens that part in a panel from the right; Close, the Escape key, a tap outside it and the browser's Back button all shut it, and the page behind does not move.

Beside the switch, anything waiting is listed: results not checked, consent awaiting signature, portal decisions and money outstanding. Each one opens the part it is about, so it is a way in rather than a note.

Timeline is the same record as one list, newest first, with anything still to come in a block at the top. Each line gives the date, what kind of thing it was, what happened and who, and the name in it opens the part of the record it came from. The name on the right is always a person: the practitioner whose clinic an appointment was, and the surgeon on an operation, with the theatre or hospital in the words beside it. The pills above filter it to one kind, and Older shows the rest when there is more than the sixty most recent. Everything the record holds is in it: appointments, operations, admissions, letters, consent, information given, results, quotes, invoices, portal messages, filed emails and every log entry.

Settings is the cog beside the patient's name. It holds Add another name and Invitations, and Administration, for those who can see it, is opened from inside it.

Under Administration, Shared with organisations lists each organisation the patient is shared with, and beside each, who shared it and when. A share made before this was recorded says not recorded who. A share opens the patient's whole record to that organisation's staff, as before; Remove takes it away.

New appointment, at the top of the Appointments panel under Care, books the patient into an empty time in the diary without leaving the record, and is there when the patient has no appointments yet. Press it, choose a time from the empty ones at the organisations you work at, say what the appointment is for (the few most used purposes are buttons under the box, and typing in it suggests every pathway Fedelsoft holds, though what you type is saved exactly as you wrote it) and add a note for whoever sees them if you like, tick Email the patient a confirmation where the organisation sends them, and press Book. It makes the same booking as the schedule on Start, with the same checks: a time somebody has just taken, a second free consultation in the same period, or a practitioner who takes new patients by application is refused with the reason, and for the last you can confirm a matching application or enter an override code. The appointment is confirmed at once, the panel shows it when you press Book, and the booking is written on the patient's log. Where there are no empty times, the panel says so; clinics are built from Clinics on Start.

Care holds three lists: the patient's appointments, the treatments done at them and their operations. Seen by, on an appointment, is the practitioner whose clinic it is, not whoever entered the booking, and it is empty where no practitioner is named on the clinic. A treatment shows what was done, where on the body and who did it, newest first, with any notes written on it underneath, and its date opens the appointment it was done at, so a treatment can be read from the record without first working out which visit it belongs to. Each operation on the Surgery tile gives its date, the operation, where it is and the surgeon, who is the admitting consultant on its booking form. Where none is chosen, it is the plastic surgeon named on the operation itself or on its operating list, and where there is nobody either way, Surgeon says not recorded.

Add on the Surgery tile starts a new operation for the patient: a blank booking form, which makes no invoice. A quote goes onto it with Use this quote on the booking form. Where the patient already has an empty booking form with no date, Add uses that one instead of making a second. Add refuses, and says why, where the patient already has more than one operation with no date, already has two operations to come, dated or not, or already has one with the same procedures; the refusal offers to open the operation in the way. The new operation opens in its own tab, and appears on the waiting list of the organisation you are working in, where Add a case on an operating list finds it.

An operation with no date and no locked note can be removed from the Surgery tile by somebody with the administration privilege: press Remove beside it and confirm. It goes to the recycle bin, the way a cancelled case does, and the patient's log records who removed it. One on an operating list or with a locked note is refused; cancel it from its booking form. One with an invoice on it is refused too, unless the invoice has been voided, and the refusal puts an Open invoice button beside Remove for each invoice in the way, so you can void it there and come back. Operations in the recycle bin are not listed.

Where the patient has one operation on a list and another with no date, the one with no date is often the same surgery booked twice, and it also has Combine, which asks before it does anything and names the listed operation's date. Only confirm it if they are the same surgery. Its invoices, its tasks, including fees waiting to be paid, and a deposit marked paid all move to the listed operation, the one with no date goes to the recycle bin, and the patient's log says what moved. Nothing about the money itself changes. If the listed operation then carries two invoices, the page says so and puts an Open invoice button beside each, so the one billed twice can be voided. The booking form of a listed operation also says when the patient has another operation on no list, with Open patient to go and combine them.

A quote, an operation note, a consent document or a prescription opened from a patient's record now carries a way back to that record, so leaving one does not mean starting again from Start.

The Quotes tile lists every quote of this patient's, each with its date, whether it is open, accepted or declined, its total, what is on it and any Enhanced or Ultimate package it offers. Press a quote anywhere on its row to open it on its own page, where it is read, changed, sent or revised. New quote starts one for this patient without needing an appointment to hang it on. A quote made this way belongs to the patient; when it does turn out to belong to a visit, open the appointment and use Attach to put it on one.

Family, under Contact, lists the patient's family, friends, guardian and next of kin: each person's first name, surname, relationship, a Guardian tick and notes, with Remove on the row. Add opens a form for a new person: give at least a name, choose the relationship from the list (male and female relationships are listed separately), tick Guardian where they are one, and press Add. Each box on a row saves itself as you leave it; choosing Father ticks Guardian by itself. Remove asks to be pressed again before it takes anybody off. Every addition, change and removal is written on the patient's log with your name. A person who came with the patient to an appointment is the same list, so somebody added here can be picked as an attendee there.

Contact details are changed on the record and saved as you type. Where a patient has more than one set of contact details, each phone and email box shows the most recent set that has that detail, and the address boxes show the current address: the most recent set that has a postcode or a street, so a later set holding only an email does not hide it. The house name or number has its own box next to the street. To correct the date of birth, press the pencil beside the date of birth at the top of the record: the box opens on the date as it stands, Save asks you to confirm, and the patient's log records the date it was and the date it now is. If the new date makes the patient under 18 and that changes their Status, any Status flags they already had are kept, and the log says so. Anybody who can change the address and phone can do this. EVERY change to the record goes on the patient's log with your name, the time, and what it was before, so any of it can be traced afterwards.

Health reads as a ledger: one row for each of allergies, medicines, prescriptions, diagnoses, smoking and height and weight, with the name of each on the left and what is recorded beside it. Allergies is first and the only one on a red ground, because it is what people most often open the record for.

Nothing in it can be typed over until you choose to change it. Every allergy, medicine and diagnosis reads as plain text with a pencil at the right; press the pencil and that one entry opens its own boxes in place. What you type saves as you leave each box, so nothing waits on a button, and Done closes the entry back to text with the new wording in it. Remove is inside the opened entry and nowhere else, so nothing on the record can be taken off by a stray press. Stop sits beside it on a medicine and keeps it on the record marked stopped, which is what you want when somebody may go back on it.

Add, under Allergies and under Medications, is how a new one is recorded: press it and a short form appears under the list. An allergy takes the allergen, the reaction and a note. A medicine is found by typing its name: the drug list offers the medicines that match, with a red flag beside any that carries a warning, and pressing one takes it; a medicine that is not on the list is recorded as typed. It then takes its dose, route and frequency, the days it is for, any notes, the date it was dispensed, which starts at today, and its prescriber. The prescriber starts as you where you are a prescriber, and the list holds the prescribers at the patient’s organisation, each with their GMC number shown from their own record; Another prescriber takes the name and GMC number of somebody from outside. Each medicine shows its days and date after its dose, its notes and the prescriber beneath it, and the pencil opens its dose, route, frequency, days and notes to change. Add records the lot in one go and the entry on the patient’s log names what was recorded and who by. Medications offers Add even where the record says the patient takes nothing, and recording a medicine there leaves that answer alone, exactly as the old system does.

Add, under BMI, records a height and a weight on the record itself, so a new patient who has not yet had an appointment can have one. Type them as they were given: the height as 172, 1.72m or 5ft 8, the weight as kilograms or as 11st 4 or 154lb, and say whether they were measured or stated. The BMI is worked out as you type and again when you press Add, and the reading joins the chart and the list of readings with today's date, belonging to no appointment. A reading taken at an appointment is still recorded on that appointment.

The reaction, the route and the frequency are chosen from a list rather than typed, because Fedelsoft holds a fixed set of each; where a row carries one that is no longer offered, it is kept and marked. An allergen or medicine taken from the medicine list cannot be renamed here, because the name belongs to that list, though everything else about it can be changed. If a change is saved but its log entry is not, the line beside it says so rather than looking as though nothing happened.

Prescriptions, in the ledger, is itself the way to the patient’s prescription list, where a new one is started. Height and weight shows the latest reading on its own, or a chart once there are two.

A postcode is looked up as you leave the box and fills in the street, town and county from Fedelsoft's own address book, which is the practice's own history of every street it has ever recorded and is better than anything a public service will give you. A postcode the practice has never seen is checked against the national list instead, which can say whether it exists and which council area it is in but never the street.

Directors, managers and IT Support at your organisation see an Affordability line under the patient's name: a score from 1 to 10 for the postcode of their current address, with its band (Very high, High, Moderate or Low) and, underneath, the neighbourhood it was taken from. It describes the area, not the patient, and comes from the government's Indices of Deprivation for England, so an address in Scotland, Wales or Northern Ireland reads Not available for this postcode. It follows the address by itself: correct the postcode and the score is the new one's. Affordability profile, on the same line, opens the profile of all your organisation's patients. Nobody else sees the line at all.

The GP and surgery are on the patient card. Press change beside Surgery and type the GP's name or the surgery's name; choosing one from the list sets it on the record and goes on the patient's log. The list also holds every GP practice in the NHS list, marked NHS list: choosing one of those sets the surgery Fedelsoft already holds for that practice, or adds it if Fedelsoft has none, and, if Fedelsoft holds a surgery that might be the same, names those and does nothing; search and press the NHS practice a second time to add it as a new one. Where the surgery is in neither, press Add a surgery and type its name, address, town and postcode, then Check. Fedelsoft first lists the surgeries it already holds with a similar name or the same postcode, each with Use this, which sets that one instead. Only None of these, add it (Add it, where nothing is similar) adds the new surgery, sets it on the record and records it on the patient's log.

Referral source, under the GP on the patient card, lists every source recorded for the patient, with the person who referred them where one was named. Add opens a Referred by box and a list of sources: type the name first if somebody referred them, then choose the source, and it is saved as soon as it is chosen. The source is added to what is there, never replacing it, and goes on the patient's log.

At the foot of the record is the time it was read, and Refresh reads it again without losing your place.

Each letter on the Letters tile says whether it is approved or not approved, and separately whether it is editable or locked. Editable and locked are only about the text: a letter stays editable for two weeks after it was made or dated and for three days after it was last changed, then it is locked, whether or not it was approved. Approval is its own tick, so an unapproved letter can be locked and an approved one can still be editable. Approve, beside a letter that is not approved, ticks it without changing the text, and is there for the letter's signatory, or someone it is delegated to, on a locked letter as well as an editable one. A link to a letter opens the Letters tile with that letter unfolded.

In Settings, Invitations: tick Do not send the second-consultation invitation to leave this patient out of the email that invites a patient to book a second consultation. The tick is saved as you make it, written on the patient's log, and can be taken off again.

An approved letter on the Letters tile has Print, and Print for GP where it is to the patient and the record holds a GP. It opens as a document to print, addressed to the patient or the GP surgery, and the letter shows who printed it, for whom and when. New letter, on the Letters tile, starts a letter that belongs to the patient and to no appointment, signed by you, and it is written there and then (only somebody with a clinical role can start one, since a letter goes out in its writer's name): type it and it saves as you go, and tick Approved when it is ready. It is listed with the patient's other letters here and on every appointment, marked not on an appointment, and starting it is written on the patient's log. A letter on an appointment is still written on that appointment.

WhatsApp, in the Contact band, is the conversation with the patient's own mobile, shown only where the patient's organisation has a live WhatsApp number. It lists what was said, newest at the bottom, with who sent each message and whether it was sent, delivered or read, and Refresh reads it again. Where the patient has written within the last 24 hours, type a message and press Send. Otherwise choose one of the organisation's approved messages, fill in its values and press Send; if there is no record that the patient agreed to WhatsApp, say how they agreed first. A patient who has asked not to be messaged cannot be written to.

To do, in the Contact band, lists every task linked to the patient, newest first, finished ones included: what it is for, who it is for and who raised it, and whether it is open or done and when. A task you raised or that is yours opens on Start, among the completed ones if it is finished; anybody else's is listed so you can see it is in hand.

Admissions lists every admission at your organisation with its status and dates; the discharge summary is written on the admission and printed from there.

Financial lists the patient's quotes, invoices and expenses. An invoice opens on its own page, the same one Invoices under Money opens, where a payment is recorded under Payments and anything else about it is changed. Financial adds up what is still owed across the patient's invoices. An invoice that has been voided or marked not for payment is left out of that total, because nobody is waiting for the money. So is one that has been written off, which is counted separately as written off instead; the invoice keeps its own figure on its own line so you can still see what was written off. New invoice, under the invoices, makes an empty invoice for this patient at the organisation you are signed in at and opens it; add its lines there. It is not offered to somebody who sees only the anaesthetic fee.

Payment says how the patient pays. Add a payment method takes Self-pay, Insurance or NHS and makes it the default, which is what new invoices are billed by. Under an insurance method, type part of the insurer's name and pick it, then fill in the policy number and the authorisation code; under NHS, the approval code. Each is saved as you leave the box. Make default moves the default to another method. Card and bank numbers are never shown or taken here.

New email, on the Emails tile, writes to the patient at the email address on their record, which is shown and cannot be changed; where the record holds no address, the tile says so and offers nothing. Give it a subject and a message, and tick anything on the record to go with it: an approved letter to the patient goes as the letter document, and stored files and filed attachments go as they are. It opens with Dear and the patient's first name and ends with your email signature, and any PDF is locked with the patient's date of birth (DDMMYY). Send asks you to confirm the address, sends it once from the organisation's own address, and the email is then listed on the Emails tile and written on the patient's log. What you type is kept on this device until it is sent, so a reload does not lose it; Cancel throws it away. Consent documents and information sheets are sent as links with their own Email, under Consent and Information.

Each email on the Emails tile is listed by its subject, which opens it, with who it went to, when and who sent it, and whether it was sent. One that failed to send has Delete beside it, which asks Delete? on the same button and removes it on the second press, for when it has been sent again since and the failure is no longer worth keeping. An email that went cannot be deleted.

Emails filed on the patient are on the Emails tile too, under Filed on this record, above the emails sent from Fedelsoft. Each is listed by its subject with the dates of the messages inside it, the day it was filed and how many files came with it; press it to read the message and open anything attached. A forwarded chain is dated by the messages in it, so a patient's email of the ninth and the reply of the twelfth show those days even if you forwarded the chain on the twenty-fifth. The same email arriving twice is filed once. Start an email there opens a blank message with the filing address blind copied and the patient's code, FSP followed by their number, already in the subject; send it and the message and anything attached to it land on this record. You can also blind copy that address on a message you were already sending, as long as the code is in the subject.

Nothing has to be done to a filed email. Filed on the wrong record? under it is only for a message that landed on the wrong patient, for example from a mistyped code: Move puts it on the right patient, Unfile sends it back to the Emails page for somebody to place, and Remove is for good.

The filing address is 7xugvvgehxoirun1glcy@inbound.mailersend.net, the same one for every organisation. It is a long, random address that nobody could retype, so it is shown under Filed on this record with Copy address beside it, for pasting into a message you are already writing; Start an email fills it in for you. It is the same address tablets send drawings back to. If your organisation sets one of its own under Shared sketch address in Settings, that one replaces it for filing too, and Start an email always uses whichever is current.

A reply does not keep the blind copy. Either keep it in place each time you reply, or forward the finished conversation to the address once, which files the whole thing as one item. The code survives in a Re: subject, so a forwarded conversation still goes to the right record. Anything that cannot be matched to a patient with certainty waits on Emails for somebody to place rather than being filed against a guess, and an address that belongs to two patients matches neither. An email that has gone onto the wrong record is put right here: Move sends it to the right patient, Unfile puts it back on Emails, and Remove takes it off for good. Each one is written on both records' logs.

Investigations, on the patient's record, take the result where it arrives. Open an investigation and type the result in its box, which is saved as you leave it, or press Attach to put the report itself on it, a PDF, a picture or an office document up to 8 MB, whose name opens it and which Remove takes off again. The tag then moves on from awaiting result to result not checked, and Mark result checked appears. A result that already carries formatting is shown as it is and has no box, so nothing is flattened; attach the new report instead.