As a part of the NHS, we need and want to share data in various ways but we also want to protect your confidential and personal information. Data about health can be used for various reasons, both internally within the practice, and externally with various services.
Internally we analyse our records so that we know who has diabetes, heart disease, etc. so we can arrange regular recalls etc.,and who is on which drug so we can alert you if there is a health warning etc. This is normal good medical care.
Externally we share data with other NHS services,either in anonymous, aggregate form, or in a way that identifies individuals. Aggregate data might be information about numbers of patients with a stroke or vaccinations, so that the NHS can provide appropriate services. Identifiable data might be the letters we send to hospitals about you. Here we attempt to describe some of the ways data is shared with external agencies. Anonymous data relates to data that is about an individual but that any identifying data is sufficiently obscured as to make it impossible to identify them.
Hospital letters (Identifiable data)
Whenever we refer you to hospital or another provider, we routinely send the referral letter, but also add standard information regarding your current medication, your significant medical problems, allergies, relevant information such as height and weight, as well as your contact details, (name DoB, address etc) This is essential so that the hospital is informed of your medical background and helps reduce mistakes.
Insurance Companies etc. (Identifiable data)
Insurance companies ask us for reports in two formats. A general request asking for a standard and nationally agreed set of data, (medication, allergies, medical problem list, blood results etc)and then tailored reports asking about a specific condition that you may be claiming for. We always insist on written consent to release this information and you may see the report first if you wish. Insurance companies may also request a “medical examination” where we act on behalf of the company, to assess their risks.
Solicitors and medical claims. (Identifiable data)
We are asked by solicitors for medical information on your behalf. Increasingly this is a request for your whole notes and you need to be aware that all records will be sent. Alternatively they ask for details following a particular incident (such as a car crash) which we write specifically in response to their request and limit the information to the specific question. Both requests require your consent although solicitors are legally bound to only work on your behalf.
Sharing within the NHS
Data has been used for many years to assess health needs. Information of vaccination rates, disease prevalence (such as numbers of diabetics, heart disease patients, etc) are collected as well as data about age, sex, appointments. Currently there are various ways we share data to enable us to care for you better.
QOF and Enhanced Services (Aggregate data)
As part of the mechanism for being paid the practice has to provide data about various conditions to the government to demonstrate good care. This includes the number of patients with various diseases, (Diabetes, hypertension, smears etc) as well as care indicators like the number of patients with a BP taken and under a certain level. Again no patient identifiable data is uploaded, just numbers. However every year we might be inspected to verify these bits of information, which means an inspection team (of doctors and nurses) visits the practice to check the records of specific patients. This is not about you but to check we have done what we said we have done.
SCR (Identifiable data)
This is a national database (Summary Care Record)that is intended to provide basic health information to all providers who need it. This is being rolled out across Manchester, the practice has been uploaded this data from 6 1 14. It is intended that your demographics (name DOB,address etc) as well as basic medical information (initially drugs and allergies) would be stored and made accessible to anyone needing it within the NHS. You can ask to “opt out” of the SCR if you wish by asking the practice to amend your records.
QResearch (Anonymous data)
The University of Nottingham in conjunction with our clinical software supplier have established a research database of GP records to which we contribute. This extracts the basics of your records in a completely anonymous format to a secure database in Nottingham and has been used for many groundbreaking bits of research including heart and diabetes risk scores which we now use in practice.
Care.data (Rolling out nationally Spring 2014)
The government has proposed to extract large sections of data from GP practices to form a national database from which they intend to analyse health needs across the country but also down to local assessments. When it is implemented we do not have a choice about this extraction and it will be universal, to help support NHS planning. There are two proposed levels of data, identifiable that will be held in the national database, and then anonymised data that can potentially passed onto third parties by the National Information Centre.
also see page on Care.Data
It is possible to “opt out” of data sharing if you wish. Ask at reception for an opt out form. For specific instances you will be asked for consent from solicitors and insurance companies.