diff --git a/.github/workflows/preview-env.yml b/.github/workflows/preview-env.yml
index 4e3106a1..586dad1f 100644
--- a/.github/workflows/preview-env.yml
+++ b/.github/workflows/preview-env.yml
@@ -380,13 +380,14 @@ jobs:
       - name: Run integration tests against preview
         if: github.event.action != 'closed'
         env:
-          BASE_URL: ${{ steps.tf-output.outputs.preview_url }}
-          MTLS_CERT: /tmp/client1-cert.pem
-          MTLS_KEY: /tmp/client1-key.pem
-          STUB_SDS: "true"
-          STUB_PDS: "true"
-          STUB_PROVIDER: "true"
-        run: make test-integration
+          BASE_URL: "https://internal-dev.api.service.nhs.uk/clinical-data-gateway-api-poc"
+          PR_NUMBER: ${{ github.event.pull_request.number }}
+          PROXYGEN_KEY_ID: ${{ vars.PREVIEW_ENV_PROXYGEN_KEY_ID }}
+          PROXYGEN_CLIENT_ID: ${{ vars.PREVIEW_ENV_PROXYGEN_CLIENT_ID }}
+          PROXYGEN_KEY_SECRET: ${{ env._cds_gateway_dev_proxygen_proxygen_key_secret }}
+        run: |
+          touch .env.remote
+          make test-remote
 
       - name: Upload integration test results
         if: always()
diff --git a/gateway-api/poetry.lock b/gateway-api/poetry.lock
index 288db038..daf996b3 100644
--- a/gateway-api/poetry.lock
+++ b/gateway-api/poetry.lock
@@ -1,5 +1,17 @@
 # This file is automatically @generated by Poetry 2.2.1 and should not be changed by hand.
 
+[[package]]
+name = "annotated-types"
+version = "0.7.0"
+description = "Reusable constraint types to use with typing.Annotated"
+optional = false
+python-versions = ">=3.8"
+groups = ["dev"]
+files = [
+    {file = "annotated_types-0.7.0-py3-none-any.whl", hash = "sha256:1f02e8b43a8fbbc3f3e0d4f0f4bfc8131bcb4eebe8849b8e5c773f3a1c582a53"},
+    {file = "annotated_types-0.7.0.tar.gz", hash = "sha256:aff07c09a53a08bc8cfccb9c85b05f1aa9a2a6f23728d790723543408344ce89"},
+]
+
 [[package]]
 name = "anyio"
 version = "4.11.0"
@@ -51,6 +63,21 @@ files = [
     {file = "attrs-25.4.0.tar.gz", hash = "sha256:16d5969b87f0859ef33a48b35d55ac1be6e42ae49d5e853b597db70c35c57e11"},
 ]
 
+[[package]]
+name = "authlib"
+version = "1.6.9"
+description = "The ultimate Python library in building OAuth and OpenID Connect servers and clients."
+optional = false
+python-versions = ">=3.9"
+groups = ["dev"]
+files = [
+    {file = "authlib-1.6.9-py2.py3-none-any.whl", hash = "sha256:f08b4c14e08f0861dc18a32357b33fbcfd2ea86cfe3fe149484b4d764c4a0ac3"},
+    {file = "authlib-1.6.9.tar.gz", hash = "sha256:d8f2421e7e5980cc1ddb4e32d3f5fa659cfaf60d8eaf3281ebed192e4ab74f04"},
+]
+
+[package.dependencies]
+cryptography = "*"
+
 [[package]]
 name = "blinker"
 version = "1.9.0"
@@ -444,6 +471,78 @@ files = [
 [package.extras]
 toml = ["tomli ; python_full_version <= \"3.11.0a6\""]
 
+[[package]]
+name = "cryptography"
+version = "46.0.5"
+description = "cryptography is a package which provides cryptographic recipes and primitives to Python developers."
+optional = false
+python-versions = "!=3.9.0,!=3.9.1,>=3.8"
+groups = ["dev"]
+files = [
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+    {file = "cryptography-46.0.5-cp311-abi3-manylinux2014_aarch64.manylinux_2_17_aarch64.whl", hash = "sha256:c18ff11e86df2e28854939acde2d003f7984f721eba450b56a200ad90eeb0e6b"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux2014_x86_64.manylinux_2_17_x86_64.whl", hash = "sha256:4d7e3d356b8cd4ea5aff04f129d5f66ebdc7b6f8eae802b93739ed520c47c79b"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux_2_28_aarch64.whl", hash = "sha256:50bfb6925eff619c9c023b967d5b77a54e04256c4281b0e21336a130cd7fc263"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux_2_28_ppc64le.whl", hash = "sha256:803812e111e75d1aa73690d2facc295eaefd4439be1023fefc4995eaea2af90d"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux_2_28_x86_64.whl", hash = "sha256:3ee190460e2fbe447175cda91b88b84ae8322a104fc27766ad09428754a618ed"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux_2_31_armv7l.whl", hash = "sha256:f145bba11b878005c496e93e257c1e88f154d278d2638e6450d17e0f31e558d2"},
+    {file = "cryptography-46.0.5-cp311-abi3-manylinux_2_34_aarch64.whl", hash = "sha256:e9251e3be159d1020c4030bd2e5f84d6a43fe54b6c19c12f51cde9542a2817b2"},
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+    {file = "cryptography-46.0.5.tar.gz", hash = "sha256:abace499247268e3757271b2f1e244b36b06f8515cf27c4d49468fc9eb16e93d"},
+]
+
+[package.dependencies]
+cffi = {version = ">=2.0.0", markers = "python_full_version >= \"3.9.0\" and platform_python_implementation != \"PyPy\""}
+
+[package.extras]
+docs = ["sphinx (>=5.3.0)", "sphinx-inline-tabs", "sphinx-rtd-theme (>=3.0.0)"]
+docstest = ["pyenchant (>=3)", "readme-renderer (>=30.0)", "sphinxcontrib-spelling (>=7.3.1)"]
+nox = ["nox[uv] (>=2024.4.15)"]
+pep8test = ["check-sdist", "click (>=8.0.1)", "mypy (>=1.14)", "ruff (>=0.11.11)"]
+sdist = ["build (>=1.0.0)"]
+ssh = ["bcrypt (>=3.1.5)"]
+test = ["certifi (>=2024)", "cryptography-vectors (==46.0.5)", "pretend (>=0.7)", "pytest (>=7.4.0)", "pytest-benchmark (>=4.0)", "pytest-cov (>=2.10.1)", "pytest-xdist (>=3.5.0)"]
+test-randomorder = ["pytest-randomly"]
+
 [[package]]
 name = "flask"
 version = "3.1.3"
@@ -837,6 +936,155 @@ files = [
 [package.dependencies]
 six = "*"
 
+[[package]]
+name = "lxml"
+version = "5.4.0"
+description = "Powerful and Pythonic XML processing library combining libxml2/libxslt with the ElementTree API."
+optional = false
+python-versions = ">=3.6"
+groups = ["dev"]
+files = [
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+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-macosx_11_0_arm64.whl", hash = "sha256:266fb4cbf5e3cbd0b53669a6d1b039c45e3ce651fd5442eff4d07c2cc8d66808"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-manylinux_2_17_x86_64.manylinux2014_x86_64.whl", hash = "sha256:58133647260ea01e4d0500089a8c4f07bd7aa6ce109682b1426394988d8aaacc"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-manylinux_2_5_i686.manylinux1_i686.whl", hash = "sha256:287dad91cfb551c363dc62899a80e9e14da1f0e2b6ebde82c806612ca2a13ef1"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-musllinux_1_1_aarch64.whl", hash = "sha256:03b77d184b9eb40240ae9fd676ca364ce1085f203e1b1256f8ab9984dca80a84"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-musllinux_1_1_armv7l.whl", hash = "sha256:a668ce24de96165bb239160b3d854943128f4334822900534f2fe947930e5770"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-musllinux_1_1_x86_64.whl", hash = "sha256:f14f8f046c14563f8eb3f45f499cc658ab8d10072961e07225e507adb700e93f"},
+    {file = "pydantic_core-2.41.5-pp311-pypy311_pp73-win_amd64.whl", hash = "sha256:56121965f7a4dc965bff783d70b907ddf3d57f6eba29b6d2e5dabfaf07799c51"},
+    {file = "pydantic_core-2.41.5.tar.gz", hash = "sha256:08daa51ea16ad373ffd5e7606252cc32f07bc72b28284b6bc9c6df804816476e"},
+]
+
+[package.dependencies]
+typing-extensions = ">=4.14.1"
+
+[[package]]
+name = "pydantic-settings"
+version = "2.13.1"
+description = "Settings management using Pydantic"
+optional = false
+python-versions = ">=3.10"
+groups = ["dev"]
+files = [
+    {file = "pydantic_settings-2.13.1-py3-none-any.whl", hash = "sha256:d56fd801823dbeae7f0975e1f8c8e25c258eb75d278ea7abb5d9cebb01b56237"},
+    {file = "pydantic_settings-2.13.1.tar.gz", hash = "sha256:b4c11847b15237fb0171e1462bf540e294affb9b86db4d9aa5c01730bdbe4025"},
+]
+
+[package.dependencies]
+pydantic = ">=2.7.0"
+python-dotenv = ">=0.21.0"
+typing-inspection = ">=0.4.0"
+
+[package.extras]
+aws-secrets-manager = ["boto3 (>=1.35.0)", "boto3-stubs[secretsmanager]"]
+azure-key-vault = ["azure-identity (>=1.16.0)", "azure-keyvault-secrets (>=4.8.0)"]
+gcp-secret-manager = ["google-cloud-secret-manager (>=2.23.1)"]
+toml = ["tomli (>=2.0.1)"]
+yaml = ["pyyaml (>=6.0.1)"]
+
 [[package]]
 name = "pygments"
 version = "2.19.2"
@@ -1500,7 +1979,7 @@ version = "2.11.0"
 description = "JSON Web Token implementation in Python"
 optional = false
 python-versions = ">=3.9"
-groups = ["main"]
+groups = ["main", "dev"]
 files = [
     {file = "pyjwt-2.11.0-py3-none-any.whl", hash = "sha256:94a6bde30eb5c8e04fee991062b534071fd1439ef58d2adc9ccb823e7bcd0469"},
     {file = "pyjwt-2.11.0.tar.gz", hash = "sha256:35f95c1f0fbe5d5ba6e43f00271c275f7a1a4db1dab27bf708073b75318ea623"},
@@ -1512,6 +1991,21 @@ dev = ["coverage[toml] (==7.10.7)", "cryptography (>=3.4.0)", "pre-commit", "pyt
 docs = ["sphinx", "sphinx-rtd-theme", "zope.interface"]
 tests = ["coverage[toml] (==7.10.7)", "pytest (>=8.4.2,<9.0.0)"]
 
+[[package]]
+name = "pyotp"
+version = "2.9.0"
+description = "Python One Time Password Library"
+optional = false
+python-versions = ">=3.7"
+groups = ["dev"]
+files = [
+    {file = "pyotp-2.9.0-py3-none-any.whl", hash = "sha256:81c2e5865b8ac55e825b0358e496e1d9387c811e85bb40e71a3b29b288963612"},
+    {file = "pyotp-2.9.0.tar.gz", hash = "sha256:346b6642e0dbdde3b4ff5a930b664ca82abfa116356ed48cc42c7d6590d36f63"},
+]
+
+[package.extras]
+test = ["coverage", "mypy", "ruff", "wheel"]
+
 [[package]]
 name = "pyrate-limiter"
 version = "3.9.0"
@@ -1530,20 +2024,20 @@ docs = ["furo (>=2022.3.4,<2023.0.0)", "myst-parser (>=0.17)", "sphinx (>=4.3.0,
 
 [[package]]
 name = "pytest"
-version = "9.0.2"
+version = "8.4.2"
 description = "pytest: simple powerful testing with Python"
 optional = false
-python-versions = ">=3.10"
+python-versions = ">=3.9"
 groups = ["dev"]
 files = [
-    {file = "pytest-9.0.2-py3-none-any.whl", hash = "sha256:711ffd45bf766d5264d487b917733b453d917afd2b0ad65223959f59089f875b"},
-    {file = "pytest-9.0.2.tar.gz", hash = "sha256:75186651a92bd89611d1d9fc20f0b4345fd827c41ccd5c299a868a05d70edf11"},
+    {file = "pytest-8.4.2-py3-none-any.whl", hash = "sha256:872f880de3fc3a5bdc88a11b39c9710c3497a547cfa9320bc3c5e62fbf272e79"},
+    {file = "pytest-8.4.2.tar.gz", hash = "sha256:86c0d0b93306b961d58d62a4db4879f27fe25513d4b969df351abdddb3c30e01"},
 ]
 
 [package.dependencies]
 colorama = {version = ">=0.4", markers = "sys_platform == \"win32\""}
-iniconfig = ">=1.0.1"
-packaging = ">=22"
+iniconfig = ">=1"
+packaging = ">=20"
 pluggy = ">=1.5,<2"
 pygments = ">=2.7.2"
 
@@ -1648,6 +2142,35 @@ pytest = ">=6.2.5"
 [package.extras]
 dev = ["pre-commit", "pytest-asyncio", "tox"]
 
+[[package]]
+name = "pytest-nhsd-apim"
+version = "6.0.7"
+description = "Pytest plugin accessing NHSDigital's APIM proxies"
+optional = false
+python-versions = ">=3.10"
+groups = ["dev"]
+files = [
+    {file = "pytest_nhsd_apim-6.0.7-py3-none-any.whl", hash = "sha256:546683475a498c1ef49e9a2f4f195be4322edde16289ef0a847cd46343e55c1b"},
+    {file = "pytest_nhsd_apim-6.0.7.tar.gz", hash = "sha256:826f0434da78cf0eb59ea6cb5c3354b906916da741cc5002ede12594555a925e"},
+]
+
+[package.dependencies]
+Authlib = ">=1.6.6,<2.0.0"
+cryptography = ">=46.0.5"
+lxml = ">=5.3.1,<6.0.0"
+pycryptodome = ">=3.20.0,<4.0.0"
+pydantic = ">=2.9.2,<3.0.0"
+pydantic-settings = ">=2.2.1,<3.0.0"
+PyJWT = ">=2.8.0,<3.0.0"
+pyotp = ">=2.9.0,<3.0.0"
+pytest = ">=8.2.0,<9.0.0"
+requests = ">=2.32.0,<3.0.0"
+setuptools = ">=80.0.1,<81.0.0"
+toml = ">=0.10.2,<1.0.0"
+typing-extensions = ">=4.12.2,<5.0.0"
+urllib3 = ">=2.6.3,<3.0.0"
+wheel = ">=0.46.2,<0.47.0"
+
 [[package]]
 name = "pytest-subtests"
 version = "0.14.2"
@@ -2027,6 +2550,27 @@ dev = ["aiohttp (>=3.9.1,<4.0)", "coverage (>=6)", "coverage-enable-subprocess",
 docs = ["mkdocs-material", "mkdocstrings[python]"]
 tests = ["aiohttp (>=3.9.1,<4.0)", "coverage (>=6)", "fastapi (>=0.86.0)", "flask (>=2.1.1,<3.0)", "hypothesis-openapi (>=0.2,<1) ; python_version >= \"3.10\"", "pydantic (>=1.10.2)", "pytest-asyncio (>=1.0,<2.0)", "pytest-httpserver (>=1.0,<2.0)", "pytest-mock (>=3.7.0,<4.0)", "pytest-trio (>=0.8,<1.0)", "pytest-xdist (>=3,<4.0)", "strawberry-graphql[fastapi] (>=0.109.0)", "syrupy (>=4,<6.0)", "tomli-w (>=1.2.0)", "trustme (>=0.9.0,<1.0)"]
 
+[[package]]
+name = "setuptools"
+version = "80.10.2"
+description = "Easily download, build, install, upgrade, and uninstall Python packages"
+optional = false
+python-versions = ">=3.9"
+groups = ["dev"]
+files = [
+    {file = "setuptools-80.10.2-py3-none-any.whl", hash = "sha256:95b30ddfb717250edb492926c92b5221f7ef3fbcc2b07579bcd4a27da21d0173"},
+    {file = "setuptools-80.10.2.tar.gz", hash = "sha256:8b0e9d10c784bf7d262c4e5ec5d4ec94127ce206e8738f29a437945fbc219b70"},
+]
+
+[package.extras]
+check = ["pytest-checkdocs (>=2.4)", "pytest-ruff (>=0.2.1) ; sys_platform != \"cygwin\"", "ruff (>=0.8.0) ; sys_platform != \"cygwin\""]
+core = ["importlib_metadata (>=6) ; python_version < \"3.10\"", "jaraco.functools (>=4)", "jaraco.text (>=3.7)", "more_itertools", "more_itertools (>=8.8)", "packaging (>=24.2)", "platformdirs (>=4.2.2)", "tomli (>=2.0.1) ; python_version < \"3.11\"", "wheel (>=0.43.0)"]
+cover = ["pytest-cov"]
+doc = ["furo", "jaraco.packaging (>=9.3)", "jaraco.tidelift (>=1.4)", "pygments-github-lexers (==0.0.5)", "pyproject-hooks (!=1.1)", "rst.linker (>=1.9)", "sphinx (>=3.5)", "sphinx-favicon", "sphinx-inline-tabs", "sphinx-lint", "sphinx-notfound-page (>=1,<2)", "sphinx-reredirects", "sphinxcontrib-towncrier", "towncrier (<24.7)"]
+enabler = ["pytest-enabler (>=2.2)"]
+test = ["build[virtualenv] (>=1.0.3)", "filelock (>=3.4.0)", "ini2toml[lite] (>=0.14)", "jaraco.develop (>=7.21) ; python_version >= \"3.9\" and sys_platform != \"cygwin\"", "jaraco.envs (>=2.2)", "jaraco.path (>=3.7.2)", "jaraco.test (>=5.5)", "packaging (>=24.2)", "pip (>=19.1)", "pyproject-hooks (!=1.1)", "pytest (>=6,!=8.1.*)", "pytest-home (>=0.5)", "pytest-perf ; sys_platform != \"cygwin\"", "pytest-subprocess", "pytest-timeout", "pytest-xdist (>=3)", "tomli-w (>=1.0.0)", "virtualenv (>=13.0.0)", "wheel (>=0.44.0)"]
+type = ["importlib_metadata (>=7.0.2) ; python_version < \"3.10\"", "jaraco.develop (>=7.21) ; sys_platform != \"cygwin\"", "mypy (==1.14.*)", "pytest-mypy"]
+
 [[package]]
 name = "six"
 version = "1.17.0"
@@ -2113,6 +2657,18 @@ files = [
 doc = ["reno", "sphinx"]
 test = ["pytest", "tornado (>=4.5)", "typeguard"]
 
+[[package]]
+name = "toml"
+version = "0.10.2"
+description = "Python Library for Tom's Obvious, Minimal Language"
+optional = false
+python-versions = ">=2.6, !=3.0.*, !=3.1.*, !=3.2.*"
+groups = ["dev"]
+files = [
+    {file = "toml-0.10.2-py2.py3-none-any.whl", hash = "sha256:806143ae5bfb6a3c6e736a764057db0e6a0e05e338b5630894a5f779cabb4f9b"},
+    {file = "toml-0.10.2.tar.gz", hash = "sha256:b3bda1d108d5dd99f4a20d24d9c348e91c4db7ab1b749200bded2f839ccbe68f"},
+]
+
 [[package]]
 name = "types-click"
 version = "7.1.8"
@@ -2220,6 +2776,21 @@ files = [
     {file = "typing_extensions-4.15.0.tar.gz", hash = "sha256:0cea48d173cc12fa28ecabc3b837ea3cf6f38c6d1136f85cbaaf598984861466"},
 ]
 
+[[package]]
+name = "typing-inspection"
+version = "0.4.2"
+description = "Runtime typing introspection tools"
+optional = false
+python-versions = ">=3.9"
+groups = ["dev"]
+files = [
+    {file = "typing_inspection-0.4.2-py3-none-any.whl", hash = "sha256:4ed1cacbdc298c220f1bd249ed5287caa16f34d44ef4e9c3d0cbad5b521545e7"},
+    {file = "typing_inspection-0.4.2.tar.gz", hash = "sha256:ba561c48a67c5958007083d386c3295464928b01faa735ab8547c5692e87f464"},
+]
+
+[package.dependencies]
+typing-extensions = ">=4.12.0"
+
 [[package]]
 name = "tzdata"
 version = "2025.2"
@@ -2295,6 +2866,24 @@ markupsafe = ">=2.1.1"
 [package.extras]
 watchdog = ["watchdog (>=2.3)"]
 
+[[package]]
+name = "wheel"
+version = "0.46.3"
+description = "Command line tool for manipulating wheel files"
+optional = false
+python-versions = ">=3.9"
+groups = ["dev"]
+files = [
+    {file = "wheel-0.46.3-py3-none-any.whl", hash = "sha256:4b399d56c9d9338230118d705d9737a2a468ccca63d5e813e2a4fc7815d8bc4d"},
+    {file = "wheel-0.46.3.tar.gz", hash = "sha256:e3e79874b07d776c40bd6033f8ddf76a7dad46a7b8aa1b2787a83083519a1803"},
+]
+
+[package.dependencies]
+packaging = ">=24.0"
+
+[package.extras]
+test = ["pytest (>=6.0.0)", "setuptools (>=77)"]
+
 [[package]]
 name = "yarl"
 version = "1.22.0"
diff --git a/gateway-api/pyproject.toml b/gateway-api/pyproject.toml
index 5fadfdd8..0d76319a 100644
--- a/gateway-api/pyproject.toml
+++ b/gateway-api/pyproject.toml
@@ -57,7 +57,16 @@ dev = [
     "types-requests (>=2.32.4.20250913,<3.0.0.0)",
     "types-pyyaml (>=6.0.12.20250915,<7.0.0.0)",
     "pytest-mock (>=3.15.1,<4.0.0)",
+    "pytest-nhsd-apim (>=6.0.6,<7.0.0)",
 ]
 
 [tool.mypy]
 strict = true
+
+[tool.pytest.ini_options]
+bdd_features_base_dir = "tests/acceptance/features"
+markers = [
+    "remote_only: test only runs in remote environment (skipped when --env=local)",
+    "status_auth_headers",
+    "status_merged_auth_headers",
+]
diff --git a/gateway-api/tests/conftest.py b/gateway-api/tests/conftest.py
index 00783a77..2cee9823 100644
--- a/gateway-api/tests/conftest.py
+++ b/gateway-api/tests/conftest.py
@@ -2,7 +2,7 @@
 
 import os
 from datetime import timedelta
-from typing import cast
+from typing import Any, Protocol, cast
 
 import pytest
 import requests
@@ -10,23 +10,14 @@
 from fhir.parameters import Parameters
 
 # Load environment variables from .env file in the workspace root
-# find_dotenv searches upward from current directory for .env file
-load_dotenv(find_dotenv(usecwd=True))
+load_dotenv(find_dotenv())
 
 
-class Client:
-    """A simple HTTP client for testing purposes."""
+class Client(Protocol):
+    """Protocol defining the interface for HTTP clients."""
 
-    def __init__(self, base_url: str, timeout: timedelta = timedelta(seconds=1)):
-        self.base_url = base_url
-        self._timeout = timeout.total_seconds()
-
-        cert = None
-        cert_path = os.getenv("MTLS_CERT")
-        key_path = os.getenv("MTLS_KEY")
-        if cert_path and key_path:
-            cert = (cert_path, key_path)
-        self.cert = cert
+    base_url: str
+    cert: tuple[str, str] | None
 
     def send_to_get_structured_record_endpoint(
         self, payload: str, headers: dict[str, str] | None = None
@@ -34,14 +25,40 @@ def send_to_get_structured_record_endpoint(
         """
         Send a request to the get_structured_record endpoint with the given NHS number.
         """
+        ...
+
+    def send_health_check(self) -> requests.Response:
+        """
+        Send a health check request to the API.
+        """
+        ...
+
+
+class LocalClient:
+    """HTTP client that sends requests directly to the API (no proxy auth)."""
+
+    def __init__(
+        self,
+        base_url: str,
+        cert: tuple[str, str] | None = None,
+        timeout: timedelta = timedelta(seconds=1),
+    ):
+        self.base_url = base_url
+        self.cert = cert
+        self._timeout = timeout.total_seconds()
+
+    def send_to_get_structured_record_endpoint(
+        self, payload: str, headers: dict[str, str] | None = None
+    ) -> requests.Response:
         url = f"{self.base_url}/patient/$gpc.getstructuredrecord"
         default_headers = {
             "Content-Type": "application/fhir+json",
-            "Ods-from": "A12345",
+            "Ods-from": "CONSUMER",
             "Ssp-TraceID": "test-trace-id",
         }
         if headers:
             default_headers.update(headers)
+
         return requests.post(
             url=url,
             data=payload,
@@ -51,24 +68,62 @@ def send_to_get_structured_record_endpoint(
         )
 
     def send_health_check(self) -> requests.Response:
-        """
-        Send a health check request to the API.
-        Returns:
-            Response object from the request
-        """
         url = f"{self.base_url}/health"
         return requests.get(url=url, timeout=self._timeout, cert=self.cert)
 
 
+class RemoteClient:
+    """HTTP client for remote testing via the APIM proxy."""
+
+    def __init__(
+        self,
+        api_url: str,
+        auth_headers: dict[str, str],
+        cert: tuple[str, str] | None = None,
+        timeout: timedelta = timedelta(seconds=5),
+    ):
+        self.base_url = api_url
+        self.cert = cert
+        self._auth_headers = auth_headers
+        self._timeout = timeout.total_seconds()
+
+    def send_to_get_structured_record_endpoint(
+        self, payload: str, headers: dict[str, str] | None = None
+    ) -> requests.Response:
+        url = f"{self.base_url}/patient/$gpc.getstructuredrecord"
+
+        default_headers = self._auth_headers | {
+            "Content-Type": "application/fhir+json",
+            "Ods-from": "A12345",
+            "Ssp-TraceID": "test-trace-id",
+        }
+        if headers:
+            default_headers.update(headers)
+
+        return requests.post(
+            url=url,
+            data=payload,
+            headers=default_headers,
+            timeout=self._timeout,
+            cert=self.cert,
+        )
+
+    def send_health_check(self) -> requests.Response:
+        url = f"{self.base_url}/health"
+        return requests.get(
+            url=url, headers=self._auth_headers, timeout=self._timeout, cert=self.cert
+        )
+
+
 @pytest.fixture(scope="session")
 def mtls_cert() -> tuple[str, str] | None:
-    """
-    Provide mTLS certificate paths.
-    """
+    """Returns the mTLS certificate and key paths if provided in the environment."""
     cert_path = os.getenv("MTLS_CERT")
     key_path = os.getenv("MTLS_KEY")
+
     if cert_path and key_path:
         return (cert_path, key_path)
+
     return None
 
 
@@ -89,18 +144,46 @@ def simple_request_payload() -> Parameters:
 
 
 @pytest.fixture
-def happy_path_headers() -> dict[str, str]:
-    return {
-        "Content-Type": "application/fhir+json",
-        "Ods-from": "A12345",
-        "Ssp-TraceID": "test-trace-id",
-    }
+def get_headers(request: pytest.FixtureRequest) -> Any:
+    """Return merged auth headers for remote tests, or empty dict for local."""
+    env = request.config.getoption("--env")
+    if env == "remote":
+        apikey_headers = request.getfixturevalue("status_endpoint_auth_headers")
+        nhsd_headers = request.getfixturevalue("nhsd_apim_auth_headers")
+        headers = nhsd_headers | apikey_headers
+        return headers
 
+    return {}
 
-@pytest.fixture(scope="module")
-def client(base_url: str) -> Client:
-    """Create a test client for the application."""
-    return Client(base_url=base_url)
+
+@pytest.fixture
+def client(
+    request: pytest.FixtureRequest,
+    base_url: str,
+    mtls_cert: tuple[str, str] | None,
+) -> Client:
+    """Create the appropriate HTTP client."""
+    env = os.getenv("ENV") or request.config.getoption("--env")
+
+    if env == "local":
+        return LocalClient(base_url=base_url, cert=mtls_cert)
+    elif env == "remote":
+        proxy_url = request.getfixturevalue("nhsd_apim_proxy_url")
+
+        apikey_headers = request.getfixturevalue("status_endpoint_auth_headers")
+        token = os.getenv("APIGEE_ACCESS_TOKEN")
+
+        if token:
+            auth_headers = {"Authorization": f"Bearer {token}", **apikey_headers}
+        else:
+            nhsd_headers = request.getfixturevalue("nhsd_apim_auth_headers")
+            auth_headers = nhsd_headers | apikey_headers
+
+        return RemoteClient(
+            api_url=proxy_url, auth_headers=auth_headers, cert=mtls_cert
+        )
+    else:
+        raise ValueError(f"Unknown env: {env}")
 
 
 @pytest.fixture(scope="module")
@@ -123,3 +206,32 @@ def _fetch_env_variable[T](
     if not value:
         raise ValueError(f"{name} environment variable is not set.")
     return cast("T", value)
+
+
+def pytest_addoption(parser: pytest.Parser) -> None:
+    parser.addoption(
+        "--env",
+        action="store",
+        default="local",
+        help="Environment to run tests against",
+    )
+
+
+def pytest_collection_modifyitems(
+    config: pytest.Config, items: list[pytest.Item]
+) -> None:
+    env = os.getenv("ENV") or config.getoption("--env")
+
+    if env == "local":
+        skip_remote = pytest.mark.skip(reason="Test only runs in remote environment")
+        for item in items:
+            if item.get_closest_marker("remote_only"):
+                item.add_marker(skip_remote)
+
+    if env == "remote":
+        for item in items:
+            item.add_marker(
+                pytest.mark.nhsd_apim_authorization(
+                    access="application", level="level3"
+                )
+            )
diff --git a/gateway-api/tests/contract/test_provider_contract.py b/gateway-api/tests/contract/test_provider_contract.py
index e03e6f71..0a1715af 100644
--- a/gateway-api/tests/contract/test_provider_contract.py
+++ b/gateway-api/tests/contract/test_provider_contract.py
@@ -4,16 +4,21 @@
 satisfies the contracts defined by consumers.
 """
 
+from typing import Any
+
 from pact import Verifier
 
 
-def test_provider_honors_consumer_contract(mtls_proxy: str) -> None:
+def test_provider_honors_consumer_contract(mtls_proxy: str, get_headers: Any) -> None:
     verifier = Verifier(
         name="GatewayAPIProvider",
     )
 
     verifier.add_transport(url=mtls_proxy)
 
+    # So the Verifier can authenticate with the APIM proxy
+    verifier.add_custom_headers(get_headers)
+
     verifier.add_source(
         "tests/contract/pacts/GatewayAPIConsumer-GatewayAPIProvider.json"
     )
diff --git a/pytest.ini b/pytest.ini
deleted file mode 100644
index 2feddf4f..00000000
--- a/pytest.ini
+++ /dev/null
@@ -1,2 +0,0 @@
-[pytest]
-bdd_features_base_dir = gateway-api/tests/acceptance/features
diff --git a/scripts/get_apigee_token.sh b/scripts/get_apigee_token.sh
new file mode 100644
index 00000000..07dce409
--- /dev/null
+++ b/scripts/get_apigee_token.sh
@@ -0,0 +1,24 @@
+#!/usr/bin/env bash
+set -euo pipefail
+
+# Generates an APIGEE access token for remote test runs.
+# Prints only the token to stdout; all diagnostics go to stderr.
+#
+# Prerequisites:
+#   - proxygen CLI installed and configured (credentials in ~/.proxygen/credentials.yaml)
+#   - jq installed
+#   - Valid proxygen key (PROXYGEN_KEY_ID / PROXYGEN_CLIENT_ID env vars or config)
+#
+# The token is valid for ~24 hours and is a secret — do not log it.
+
+echo "Generating APIGEE access token via proxygen..." >&2
+
+TOKEN=$(proxygen pytest-nhsd-apim get-token | jq -r '.pytest_nhsd_apim_token')
+
+if [[ -z "${TOKEN}" || "${TOKEN}" == "null" ]]; then
+  echo "ERROR: Failed to obtain a valid token." >&2
+  exit 1
+fi
+
+echo "Token obtained successfully." >&2
+echo "${TOKEN}"
diff --git a/scripts/tests/run-test.sh b/scripts/tests/run-test.sh
index 8d1cefec..253a1817 100755
--- a/scripts/tests/run-test.sh
+++ b/scripts/tests/run-test.sh
@@ -35,20 +35,27 @@ mkdir -p test-artefacts
 
 echo "Running ${TEST_TYPE} tests..."
 
-# Set coverage path based on test type
 if [[ "$TEST_TYPE" = "unit" ]]; then
   COV_PATH="."
+
+  poetry run pytest ${TEST_PATH} -v \
+    --cov=${COV_PATH} \
+    --cov-report=html:test-artefacts/coverage-html \
+    --cov-report=term \
+    --junit-xml="test-artefacts/${TEST_TYPE}-tests.xml" \
+    --html="test-artefacts/${TEST_TYPE}-tests.html" --self-contained-html
 else
   COV_PATH="src/gateway_api"
+  TEST_ENV="${ENV:-local}"
+
+  poetry run pytest ${TEST_PATH} -v \
+    --env="${TEST_ENV}" \
+    --cov=${COV_PATH} \
+    --cov-report=html:test-artefacts/coverage-html \
+    --cov-report=term \
+    --junit-xml="test-artefacts/${TEST_TYPE}-tests.xml" \
+    --html="test-artefacts/${TEST_TYPE}-tests.html" --self-contained-html
 fi
 
-# Note: TEST_PATH is intentionally unquoted to allow glob expansion for unit tests
-poetry run pytest ${TEST_PATH} -v \
-  --cov=${COV_PATH} \
-  --cov-report=html:test-artefacts/coverage-html \
-  --cov-report=term \
-  --junit-xml="test-artefacts/${TEST_TYPE}-tests.xml" \
-  --html="test-artefacts/${TEST_TYPE}-tests.html" --self-contained-html
-
 # Save coverage data file for merging
 mv .coverage "test-artefacts/coverage.${TEST_TYPE}"
diff --git a/scripts/tests/test.mk b/scripts/tests/test.mk
index 192d5a22..8b6e9b17 100644
--- a/scripts/tests/test.mk
+++ b/scripts/tests/test.mk
@@ -98,3 +98,51 @@ ${VERBOSE}.SILENT: \
 	test-unit \
 	test-acceptance \
 	test-schema\
+
+# ---------------------------------------------------------------------------
+# Local vs remote environment helpers
+# ---------------------------------------------------------------------------
+# Usage:
+#   make test-local     - activate .env.local, run tests against local app
+#   make test-remote    - activate .env.remote, obtain an APIGEE token, run
+#                         tests against remote app and APIM proxy
+#
+#   .env.local          - local env config (ENV=local, BASE_URL, HOST)
+#   .env.remote         - remote env config (ENV=remote, BASE_URL, HOST, PR_NUMBER, PROXYGEN_API_NAME)
+#   .env                - active env, overwritten by env-local/env-remote
+#
+# The .env file is deterministically overwritten each time you switch
+# environments so the test runner always sees a consistent configuration.
+# ===========================================================================
+
+.PHONY: env-local env-remote test-local test-remote
+
+env-local:
+	@if [ ! -f .env.local ]; then \
+		echo "ERROR: .env.local not found. Needs creating." >&2; \
+		exit 1; \
+	fi
+	cp -f .env.local .env
+	@echo "Activated local environment: .env.local -> .env (ENV=local)"
+
+env-remote:
+	@if [ ! -f .env.remote ]; then \
+		echo "ERROR: .env.remote not found. Needs creating." >&2; \
+		exit 1; \
+	fi
+	cp -f .env.remote .env
+	@echo "Activated remote environment: .env.remote -> .env (ENV=remote)"
+
+# Run tests against local lambda
+test-local: env-local
+	@set -a && source .env && set +a && \
+		$(MAKE) test
+
+# Run tests against remote lambda, exporting APIGEE_ACCESS_TOKEN only
+test-remote: env-remote
+	@echo "Obtaining APIGEE access token..."
+	@set -a && source .env && set +a && \
+		APIGEE_ACCESS_TOKEN="$$(./scripts/get_apigee_token.sh)" && \
+		BASE_URL="$${BASE_URL}-pr-$${PR_NUMBER}" && \
+		export APIGEE_ACCESS_TOKEN BASE_URL && \
+		$(MAKE) test