Key Information Summary Scotland: How to Get Your Advance Directive on the NHS System

Your Advance Directive Is Invisible Until It Is on the KIS

You can draft the most detailed, legally precise advance directive in Scotland — signed, witnessed, sanctity-of-life clause included — and it will make no difference in an emergency if the attending clinicians cannot find it.

In NHS Scotland, emergency doctors, the Scottish Ambulance Service (SAS), NHS 24, and out-of-hours clinics do not check paper documents carried by the patient. They access the electronic Key Information Summary (KIS) — a digital extension of the Emergency Care Summary (ECS) that contains critical medical details, care preferences, resuscitation decisions, and welfare attorney contact information.

If your advance directive is not on the KIS, it does not exist as far as emergency services are concerned.

What the KIS Contains

A KIS entry can include:

• Advance directive summary — the key treatment refusals and the clinical scenarios they apply to
• DNACPR/ReSPECT status — whether CPR should be attempted
• Welfare attorney details — name, phone number, and the OPG registration reference for any registered welfare POA
• Emergency care preferences — whether the patient should be admitted to hospital or kept comfortable at home
• Clinical alerts — flags that appear immediately when any clinician opens the patient's electronic record
• Contact preferences — who to call first in a crisis

The KIS is accessible across the whole of Scotland. It does not matter whether you are admitted to a hospital in Edinburgh when your GP practice is in Inverness — the digital record follows you.

How to Get Your Advance Directive onto the KIS

This is the step most people miss, and it cannot be done without your GP practice's involvement. Patients cannot upload documents to the KIS directly.

Step 1: Contact your GP practice. Book an appointment or write a letter explaining that you have a signed advance directive and need it added to your electronic patient record and KIS. Some practices will do this from a letter; others will want a face-to-face appointment.

Step 2: Deliver the document. Bring the signed original or a high-quality copy. The practice will scan it into your electronic patient record.

Step 3: Request a clinical alert. Ask specifically for a high-priority clinical alert to be attached to your record. This is a flag that appears immediately when any clinician — GP, hospital doctor, or out-of-hours service — opens your file. Without the alert, the scanned document sits in your record but clinicians may not see it unless they go looking.

Step 4: Ask for the KIS upload. The GP or practice nurse enters a summary of your treatment preferences, your welfare attorney's contact details, and any emergency care choices onto the KIS database. This is the critical step: the KIS is what the Scottish Ambulance Service and NHS 24 actually check.

Step 5: Confirm the upload. Ask the practice to confirm verbally or in writing that the KIS entry has been made. There is no patient-facing portal where you can check your own KIS, so you are relying on the practice to complete this step.

What If Your GP Practice Is Unresponsive?

Some GP practices are more familiar with KIS uploads than others. If your practice seems uncertain about the process, these points may help:

• The KIS is a standard NHS Scotland system managed by the Scottish Primary Care Information Management (SCIMP) group — it is not a new or optional feature
• Any GP practice in Scotland can create and edit KIS entries through their clinical system (EMIS or Vision)
• The BMA and NHS Scotland's anticipatory care planning guidance both recommend that advance directives and welfare attorney details be recorded on the KIS

If the practice still declines or delays, you can raise a formal request through the practice manager. You have a right to have accurate information included in your medical records.

Rural Scotland: Distance Does Not Change the Process

Families in the Highlands, Islands, and Scottish Borders sometimes worry that remote location makes advance care planning harder. The KIS actually reduces this problem — it is a centralised digital database accessible from any NHS Scotland facility, regardless of geography.

If you live remotely and cannot easily visit your GP practice:

• Telephone consultations can be used to discuss the advance directive and arrange the KIS upload — the practice can scan a posted copy
• Remote death registration is now permanent in Scotland, so related administrative steps can be completed without travel
• NHS Near Me (the Scottish video consultation system) may be available through your health board for advance care planning discussions

The key is ensuring your GP practice has a copy of the document and uploads it to the KIS. Once it is on the system, every NHS Scotland facility from Lerwick to Dumfries can access it.

Keep the KIS Entry Current

If you update your advance directive — after a new diagnosis, after a change in your treatment preferences, or as part of a regular review — notify your GP practice and ask them to update the KIS entry. The KIS is only as useful as its most recent content.

For the complete GP letter template, the KIS upload request checklist, and the welfare attorney notification instructions that ensure your advance directive reaches the NHS Scotland emergency care system, the Scotland Advance Directive Planning Kit covers the full clinical integration workflow.

See more Scotland guides →