Protecting Your Confidentiality - Privacy Notice
How We Use Your Information
Improvements in information technology are also making it possible for us to share data with other healthcare organisations for the purpose of providing you, your family and your community with better care. For example it is possible for healthcare professionals in other services to access your record with your permission when the practice is closed. This is explained further in the Local Information Sharing section below.
Under the powers of the Health and Social Care Act 2015, NHS Digital can request personal confidential data from GP Practices without seeking patient consent for a number of specific purposes, which are set out in law. These purposes are explained below.
You can choose to withdraw your consent to your personal data being shared for these purposes. When we are about to participate in a new data-sharing project we will display prominent notices in the Practice and on our website at least four weeks before the scheme is due to start. Instructions will be provided to explain what you have to do to ‘opt-out’ of the new scheme. Please be aware that it may not be possible to opt out of one scheme and not others, so you may have to opt out of all the schemes if you do not wish your data to be shared.
You can object to your personal information being shared with other healthcare providers but should be aware that this may, in some instances, affect your care as important information about your health might not be available to healthcare staff in other organisations. If this limits the treatment that you can receive then the practice staff will explain this to you at the time you object.
To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS.
What else might information be used for?
Child Health Information
We wish to make sure that your child has the opportunity to have immunisations and health checks when they are due. We share information about childhood immunisations, the 6-8 week new baby check and breast-feeding status with NHS Berkshire Health Foundation Trust health visitors and school nurses, and with NHS South Central and West Commissioning Support Unit, who provide the Child Health Information Service in Berkshire on behalf of NHS England.
Information may be used for clinical audit to monitor the quality of the service provided. Some of this information may be held centrally and used for statistical purposes e.g. the National Diabetes Audit. Where we do this we take strict measures to ensure that individual patients cannot be identified and the information is anonymised.
Department for Work and Pensions
Our practice is legally required to provide anonymised data on patients who have been issued with a fit note under the Fit for Work scheme. The purpose is to provide the Department for Work and Pensions with information from fit notes to improve the monitoring of public health and commissioning and quality of health services.
Medical Student Placement
Our practice is involved in the training of medical students. As part of this programme medical students will work in the practice and may be involved in your care. If staff would like a student to be present they will always ask for your permission before the start of the consultation. The treatment or care you receive will not be affected if you refuse to have a student present during your appointment.
It is usual for GPs to discuss patient case histories as part of their continuing medical education or for the purpose of training GPs and/or medical students. In these situations the identity of the patient concerned will not be revealed.
National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.
Individual Funding Request
An ‘Individual Funding Request’ is an application made with your consent, but on your behalf by a clinician, to fund healthcare which falls outside the range of services and treatments which are routinely commissioned. These requests are considered by an Individual Funding Request Panel which considers evidence of clinical and cost effectiveness, as well as equity for the whole population. A detailed response, including the criteria considered in arriving at the decision, will be provided to the patient or carer and their clinician.
Invoice validation is an important process. It involves using your NHS number to check for authorisation from the clinical commissioning group that is responsible for paying for treatment received by all Buckinghamshire residents. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for invoice validation purposes. We can also use your NHS number to check whether your care has been funded through specialist commissioning, which NHS England will pay for. The process makes sure that the organisations providing your care are paid correctly.
UK Cabinet Office
The use of data by the UK Cabinet Office for data matching is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under the Data Protection Act 1998.
The Audit Commission Act 1998 defines data matching as the comparison of sets of data to determine how far they match. The purpose of data matching is to identify inconsistencies that may indicate fraud.
Data matching by the Cabinet Office is subject to a Code of Practice. View further information on the Cabinet Office’s legal powers and the reasons why it matches particular information.
Supporting Locally Commissioned Services and Quality Premiums
Clinical commissioning groups support GP practices by auditing anonymised data to monitor locally commissioned services, measure prevalence and support data quality. The data does not include identifiable information and is used to support patient care and ensure providers are correctly paid for the services they provide.
Supporting Medicines Management
Clinical commissioning groups support local GP practices with prescribing queries which generally don’t require identifiable information. Clinical commissioning group pharmacists work with your practice to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is safe and cost-effective. Where specialist support is required e.g. to order a drug that comes in solid form, in gas or liquid, the clinical commissioning group medicines management team will order this on behalf of the practice to support your care.
To ensure that adult and children’s safeguarding matters are managed appropriately, access to identifiable information will be shared in some limited circumstances where it’s legally required for the safety of the individuals concerned.
Risk Stratification (planning future health and social care services)
Risk stratification is a process for identifying and managing patients who are most likely to need hospital or other healthcare services in the future. Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health and not just the treatment of sickness. Unidentifiable, anonymised information about patients is collected from a number of NHS organisations and then analysed by software managed by NHS South, Central and West Commissioning Support Unit to create a risk score. This risk score is then given back to your GP practice who will assess future healthcare needs. This should improve care for everyone by helping practices to work more proactively by planning healthcare in advance. Patient data is securely managed throughout the whole process to ensure that identities are kept confidential.
Risk stratification is commissioned by the NHS Clinical Commissioning Group (CCG) in this area. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes. Further information on risk stratification is available from: https://www.england.nhs.uk/ourwork/tsd/ig/risk-stratification/
If you do not wish information about you to be included in the risk stratification programme, please let us know. We can add a code to your records that will stop your information from being used for this purpose. Please be aware that this may limit the ability of healthcare professionals to identify if you have or are at risk of developing certain serious health conditions.
Sometimes your information may be requested to be used for research purposes – the practice will always seek your consent before releasing information for this purpose.
Summary Care Record (SCR)
The NHS in England uses a national electronic record called the Summary Care Record (SCR) to improve the safety and quality of your care. It only contains basic information from your GP record and is not the full patient record. Your SCR provides authorised healthcare staff with faster, secure access to essential information about you in an emergency or when you need unplanned care, where such information would otherwise be unavailable.
The core information of the Summary Care Record comprises your allergies, adverse reactions and medications. An SCR with additional information can also include reason for medication, vaccinations, significant diagnoses / problems, significant procedures, anticipatory care information and end of life care information. Additional information can only be added to your SCR with your agreement.
Please be aware that if you choose to opt-out of the Summary Care Record (SCR), NHS healthcare staff caring for you outside of this practice may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency. Your record will not be shared with the Summary Care Record (SCR) programme. Your information will continue to be shared as previously in connection with your care, by letter, email, fax or phone.
If you wish to opt-out of having Summary Care Record (SCR) please return a completed opt-out form to the practice.
Local information sharing - Buckinghamshire’s My Care Record
Your patient record (My Care Record) is held securely and confidentially on this practice’s electronic system. If you require attention from a health or social care professional, such as an Emergency Department, Minor Illness and Injury Unit, 111, Out Of Hours location, or specialised local health and social care team, those treating you are better able to give appropriate care if information from your GP patient record is available to them. This information can be locally shared electronically via My Care Record.
In all cases, your information is only used by authorised health and social care professionals in organisation involved in providing or supporting your direct care. Your permission will be asked before the information is accessed, other than in exceptional circumstances (e.g. emergencies) if the health care professional is unable to ask you and this is deemed to be in your best interests, the reason for access will then be logged. Records and their access are audited by nominated privacy officers, on a regular basis to ensure compliance.
If you wish to opt-out of My Care Record please return a completed opt-out form to the practice.
Local information sharing – Specialist service teams
This Practice works with specialist health and social care service teams such as the diabetes and Locality Integrated Teams, to provide safe and joined up services in Buckinghamshire. The shared My Care Record provides authorised health and social care staff with access to relevant information, which helps them to make informed, timely decisions about your care and treatment and for new information to be instantly updated in your record. Access is strictly controlled by your practice.
If you do not wish your data to be shared with the specialist service teams please let us know so we can code your record appropriately.
Local information sharing - Extended Hours
As a result of the recently published Refreshing NHS Plans for 2018/19, which requires all CCGs to provide improved access to general practice, Buckinghamshire GP practices are now offering routine appointments, from at least one of the practices within their locality, between 8am and 8pm, five days a week and 9am – 1pm at weekends. The appointments offered can be face-to-face consultation, a telephone consultation and in some areas a video consultation. To ensure that the consulting clinician, which may be located at a GP practice that you are not registered with, is able to carry out the consultation safely and effectively the clinician will have remote access to your GP electronic record. If you do not wish to share your GP record with other clinicians outside of your GP practices an improved access appointment will not be able to be offered as clinicians MUST have access to the full GP record to carry out an Improved Access consultation. Improved access services also include ensuring access is available during peak times of demand, including bank holidays and across the Easter, Christmas and New Year periods. The Bucks GP Federation will be providing cover for these periods. Details of the practices in your locality are available here: https://www.buckinghamshireccg.nhs.uk/public/about-us/who-we-are/our-localities-and-member-practices/
Keeping data safe in the future
We will approach the longer term management of our patient records in line with the Records Management NHS Code of Practice for Health and Social Care. This sets out the required standards of practice for managing the records that staff working within or under contract to NHS organisations in England must follow; and it is based on current legal requirements and professional best practice. If you transfer to another GP and we are asked to transfer your records we will do this to ensure your care is continued. Currently the NHS is required to keep GP records for 10 years after a patient has died. Exceptions to these rules are detailed in the code of practice.
Who are our partner organisations?
All organisations that we work with are subject to strict data sharing agreements which set out how data will be used; which form part of their contractual obligations. The sort of organisations we work with are as follows:-
- NHS trusts
- GP Federations (which are groups of GP practices working together for your care)
- Local GP practices
- Independent contractors such as dentists, opticians, pharmacists – working to an NHS contract
- Private sector or voluntary sector providers – working to NHS contracts.
- Ambulance services
- Clinical commissioning groups
- Social care providers
- Local authorities
- Education services
- Fire and Rescue Services
We will never share your information outside of health and social care partner organisations without your explicit consent, unless there are exceptional circumstances such as when the health or safety of others is at risk, where the law requires it.
Within the health partner organisations (NHS and Specialist Trusts) and in relation to the above mentioned themes – Risk Stratification, Invoice Validation, Supporting Medicines Management, Summary Care Record – we will assume you are happy to for your information to be shared unless you choose to opt-out.
This means you will need to express an explicit wish not to have your information shared with the other NHS organisations; otherwise they will be automatically shared. We are required by law to report certain information to the appropriate authorities. This is only provided after formal permission has been given by a qualified health professional. There are occasions when we must pass on information, such as notification of new births, where we encounter infectious diseases which may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS), and where a formal court order has been issued. Our guiding principle is that we are holding your records in strictest confidence.
Third Party Processors
In order to deliver the best possible service, the practice will share data (where required) with other NHS bodies such as other GP practices and hospitals. In addition the practice will use carefully selected third party service providers. When we use a third party service provider to process data on our behalf then we will always have an appropriate agreement in place to ensure that they keep the data secure, that they do not use or share information other than in accordance with our instructions and that they are operating appropriately. Examples of functions that may be carried out by third parties includes:
- Companies that provide IT services & support, including our core clinical systems; systems which manage patient facing services (such as our website and service accessible through the same); data hosting service providers; systems which facilitate appointment bookings or electronic prescription services; document management services etc.
- Delivery services (for example if we were to arrange for delivery of any medicines to you).
- Payment providers (if for example you were paying for a prescription or a service such as travel vaccinations).
Further details regarding specific third party processors can be supplied on request.
Your right to withdraw consent for us to share your personal information - (Opt-Out)
If you are happy for your data to be shared and used for the purposes described in this Privacy Notice then you do not need to do anything.
If you do NOT want your information to be used for any purpose beyond providing your care there are several forms of opt-outs available at different levels:
Type 1 opt-out
If you do not want personal confidential information that identifies you to be shared outside your GP practice you can register a ‘Type 1 opt-out’ with your GP practice. This prevents your personal confidential information from being used except for your direct health care needs and in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease. If you do not want your information to be used for any purpose beyond providing your care you can choose to opt-out. If you wish to do so, please let us know so we can code your record appropriately to stop your records from being shared outside of your GP Practice.
National data opt-out
The national data opt-out was introduced on 25 May 2018 and replaces the previous
‘type 2’ opt-out. NHS Digital collects information from a range of places where people receive care, such as hospitals and community services. The new programme provides a facility for individuals to opt-out from the use of their data for research or planning purposes. For anyone who had an existing type 2 opt-out, it will have been automatically converted to a national data opt-out from 25 May 2018 and you will receive a letter giving you more information and a leaflet explaining the new national data opt-out.
The national data opt-out choice can be viewed or changed at any time by using the online service at www.nhs.uk/your-nhs-data-matters. We will respect your decision if you do not wish your information to be used for any purpose other than your care but in some circumstances as already outlined, we may still be legally required to disclose your data.