# The primary record of care For GP, community and hospital source records and the GP record's additional primary record of care (PRC) role, read [Records and their purposes](https://copper-tiger.pages.dev/foundations/records-and-purposes/index.md). This page develops the primary-record role for NHS–Defence continuity. The GP record provides the continuing primary-care history around which this proposal is organised. NHS England calls it the **primary record of care** and, in its digital-primary-care guidance, the **source record**. It includes care recorded by general practice and relevant information returned by other providers. These terms describe the GP record's role; they do not make it the only authoritative clinical record. [SRC-004](https://copper-tiger.pages.dev/sources/index.md#src-004) [SRC-005](https://copper-tiger.pages.dev/sources/index.md#src-005) ## Civilian history and military care The project aims to maintain patients' lifelong primary records of care in line with applicable NHS conventions and standards. This supports continuity and record transfer from and to NHS general practice when Defence care arrangements begin and end. The scope includes Armed Forces and civilian patients receiving Defence healthcare. It does not depend on military service or imply identical care entitlements. [SRC-219](https://copper-tiger.pages.dev/sources/index.md#src-219) [SRC-220](https://copper-tiger.pages.dev/sources/index.md#src-220) The continuing history includes relevant care received within and outside Defence. For an Armed Forces patient, this includes civilian history before, during and after service, alongside relevant care received during service. That journey is one example within the wider patient scope. Civilian history remains part of the continuing record, rather than a frozen pre-service record or a separate civilian-only history. [SRC-036](https://copper-tiger.pages.dev/sources/index.md#src-036) [SRC-219](https://copper-tiger.pages.dev/sources/index.md#src-219) Continuity requires more than preserving old entries. The receiving service needs usable information about current treatment, significant risks and follow-up, with its origin and date retained. The [information-flow model](https://copper-tiger.pages.dev/information-flows/index.md) sets out the proposed exchanges. Detailed specialist records remain available through separately governed access where needed. [SRC-001](https://copper-tiger.pages.dev/sources/index.md#src-001) [SRC-003](https://copper-tiger.pages.dev/sources/index.md#src-003) ## Continuity through a changing provider NHS England's Records Management Code describes a record that follows the patient between GP practices throughout life. Its registration guide refers to transferring the **full GP record** when a patient changes practice, normally electronically. The intended continuity is an accumulated history that the receiving practice can maintain. It is not a fresh history at every registration. [SRC-004](https://copper-tiger.pages.dev/sources/index.md#src-004) [SRC-006](https://copper-tiger.pages.dev/sources/index.md#src-006) **GP2GP** is one mechanism for this transfer. It exchanges electronic GP records between practices in England. It does not provide the same function as a shared care view or a summary record. Transfers can fail, and received records can require review and curation. Record continuity is therefore the objective; GP2GP is a particular supporting service. [SRC-007](https://copper-tiger.pages.dev/sources/index.md#src-007) ## Civilian care during military service NHS guidance describes temporary NHS GP registration for up to three months when a person cannot use DMS services. Their DMS GP remains their main registered GP. Temporary NHS GP and out-of-hours services pass treatment records to the military medical centre. Civilian care during service therefore also contributes to the continuing history. [SRC-037](https://copper-tiger.pages.dev/sources/index.md#src-037) This temporary arrangement differs from authorised Armed Forces dual registration. NHS England permits the latter for up to two years with written DMS authorisation. The person must reside or work within the practice area during the authorised period. A simple civilian-to-Defence-to-civilian journey does not cover every registration arrangement. [SRC-010](https://copper-tiger.pages.dev/sources/index.md#src-010) ## Primacy and specialist records GP-record primacy does not require every specialist consultation to be copied into general practice. The Records Management Code expects most other services to inform the GP through discharge notes or clinical correspondence. That supports a continuing primary record without making it identical to every contributing service's record. [SRC-004](https://copper-tiger.pages.dev/sources/index.md#src-004) In the proposed Defence model, specialist services retain their detailed source records. Applicable NHS conventions and standards govern which correspondence and clinically significant information contributes to the continuing PRC. This requires an applicable content and pathway standard, rather than a bespoke rule excluding all specialist detail. [SRC-004](https://copper-tiger.pages.dev/sources/index.md#src-004) [SRC-212](https://copper-tiger.pages.dev/sources/index.md#src-212) The proposed [Defence Shared Care Record (DShCR)](https://copper-tiger.pages.dev/architecture/index.md) would connect fuller information from multiple source systems in a primarily read-only view across services and over time. Authorised users could access complete contributing clinical source records through that view, subject to coverage, currency and permissions. [SRC-220](https://copper-tiger.pages.dev/sources/index.md#src-220) For example, an authorised Defence GP could consult a full mental-health assessment for clinical and occupational care, while the PRC receives appropriate correspondence. This illustrates proposed access and record roles, not current permission or a reason to omit information needed for continuing civilian care. Viewing does not itself add content to the PRC or transfer responsibility for follow-up. [SRC-212](https://copper-tiger.pages.dev/sources/index.md#src-212) The content of a return message depends on the clinical pathway. An assessment, treatment change or significant risk may require communication before an episode ends. The [information-flow model](https://copper-tiger.pages.dev/information-flows/index.md) explains these exchanges. Record primacy must not become a reason to omit information needed for safe care. [SRC-003](https://copper-tiger.pages.dev/sources/index.md#src-003) ## Extending continuity across Defence The target is a continuing primary-care history across changes in care arrangements, including NHS–Defence transitions for Armed Forces and civilian patients. It preserves relevant care within and outside Defence. It does not depend on continuous NHS GP registration or an unchanged record custodian. MOD controllership is a separate question from clinical authorship or responsibility for maintaining each part of the record; see [governance](https://copper-tiger.pages.dev/governance/index.md). [SRC-001](https://copper-tiger.pages.dev/sources/index.md#src-001) [SRC-012](https://copper-tiger.pages.dev/sources/index.md#src-012) [SRC-219](https://copper-tiger.pages.dev/sources/index.md#src-219) This is a target model, not a claim of completed integration. Existing commitments and historical announcements inform discovery but do not fix the future architecture. See the [programme definition](https://copper-tiger.pages.dev/programme-definition/index.md). [SRC-211](https://copper-tiger.pages.dev/sources/index.md#src-211) Continue with the [proposed architecture](https://copper-tiger.pages.dev/architecture/index.md) to see how the continuing GP record, specialist source records and the internal shared care record support this objective.