Primary Care Fair Processing Notice
This fair processing notice explains why our practice collects information about you and how that information may be used and shared.
Your Information, Your Rights
Being transparent and providing accessible information to patients about how we will use your personal information is a key element of the Data protection Act 1998 and the EU General Data protection Regulations (GDPR).
The following notice reminds you of your rights in respect of the above legislation and how we, your GP Practice, will use your information for lawful purposes in order to deliver your care and the effective management of the local NHS system.
This notice reflects how we use information for:
- The management of patient records;
- Communication concerning your clinical, social and supported care;
- Ensuring the quality of your care and the best clinical outcomes are achieved through clinical audit and retrospective review;
- Participation in health and social care research; and
- The management and clinical planning of services to ensure that appropriate care is in place for the practice population in the future.
As your registered GP Practice, we are the data controller for any personal data that we hold about you.
What information do we collect and use?
All personal data must be processed fairly and lawfully, whether it is received directly from you or from a third party in relation to your care.
We will collect the following types of information from you or about you from a third party (provider organisation e.g. hospital, social services, walk-in centre) engaged in the delivery of your care.
- “Personal data” meaning any information relating to an identifiable person who can be directly or indirectly identified from the data. This includes but is not limited to name, date of birth, full postcode, address, next of kin and NHS number; and
- “Special category / sensitive data” such as medical history including details of appointments and contacts with you, medication, emergency appointments and admissions, clinical notes, treatments, results of investigations, supportive care arrangements, private reports (sent at your request) to other organisations, social care status, race, ethnic origin, genetics, and sexual orientation.
Your healthcare record which contains the aforementioned information maybe either in an electronic format, a paper record or a mixture of both. We use a combination of technologies and working practices to ensure that we keep your information secure and confidential.
You may be offered a remote consultation as an alternative to attending the practice in person. If you agree to a remote consultation the GP or healthcare professional may need to receive and store images taken by patients for clinical purposes; this could include images for the purpose of intimate clinical assessment. This will only be done in the interests of the patient where it is necessary for providing health care and with patient consent. The approach to video consulting, image sharing, and storage is the same as it would be for face to face interactions. If we need to store images on your GP record this will be only for as long as necessary. It is a patient’s choice to share an image either of a patient’s own accord or on request of the health professional treating you. Refusal to share an image does not prevent access to care and treatment or result in patients receiving an inferior standard of care. Further details about how remote consultation works can be obtained by contacting the practice.
Why do we collect this information?
The NHS Act 2006 and the health and Social Care Act 2012 invests statutory functions on GP Practices to promote and provide the health service in England, improve quality of services, reduce health inequalities, conduct research, review performance of services and deliver education and training. To do this our Practice will need to process your information in accordance with current data protection legislation to:
- Protect your vital interests;
- Pursue our legitimate interests as a provider of medical care, particularly where the individual is a child or a vulnerable adult;
- Perform tasks in the public’s interest;
- Deliver preventative medicine, medical diagnosis, medical research; and
- Manage the health and social care system and services.
How do we keep your information confidential and safe?
Everyone working in the NHS is subject to the Common Law Duty of Confidence. Information provided in confidence will only be used for the purposes advised with the consent given by the patient, unless there are circumstances covered by the law. The NHS Digital Code of Practice on Confidential Information applies to all our staff and they are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared. Anyone who accesses your data within the Practice can only do so using a ‘smartcard’ that identifies him/her and what he/she accessed and they are staff are expected to make sure information is kept confidential and receive annual training on how to do this.
As previously advised we use a combination of technology and working practices to ensure that the information contained with your NHS medical record (paper and electronic format) is kept confidential and secure. Your records are back up securely in line with NHS standard procedures. We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access and is restricted to authorised personnel. We make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed.
We are committed to protecting your privacy and will only use information collected lawfully in accordance with:
- Data protection Act 1998
- General Data Protection Regulation 2018
- Human Rights Act
- Common Law Duty of Confidentiality
- NHS Codes of Confidentiality and Information Security
- Health and Social Care Act 2012
We will not therefore, disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), or where the law requires information to be passed on and / or in accordance with the new information sharing principle i.e. “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles, supported by the policies of their employers, regulators and professional bodies.
Information is not held for longer than is necessary. We will hold your information in the accordance with the Records Management Code of Practice for Health and Social Care 2012.
How do we use this information?
To ensure that you receive the best possible care, your records will be used to facilitate the care you receive. You can object to your personal information being shared with other healthcare providers but if this limits the treatment that you can receive the doctor will explain this to you at the time.
Information held about you may be used to protect the health of the public and to help the Department of Health manage the NHS.
Under the powers of the Health and Social Care Act 2012, NHS Digital can request personal confidential data from GP practices without seeking patient consent. Improvements in information technology are also making it possible for us to share data with other healthcare professionals with the objective of providing you with better care. You can choose to withdraw your consent to personal data being used in this way. When we are about to participate in new data-sharing project we will make patients aware by displaying 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 each new scheme.
Information may also 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. Where we do this we take strict measures to ensure that individual patients cannot be identified e.g. the National Diabetes Audit. In addition, your information will be used to identify whether you are at risk of a future unplanned hospital admission and/or require support to effectively manage a long term condition.
Occasionally your information may be requested to be used for research purposes. The Practice will always gain your consent before releasing any information for this purpose.
National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold user identifiable information without the need to seek informed consent from each individual service user.
The use of data by the 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. Data matching by the Cabinet Office is subject to a Code of Practice. Information on the Cabinet Office’s legal powers and reasons why it matches particular information can be found at: https://www.gov.uk/government/publications/fair-processing-national-fraud-initiative/fair-processing-level-3-full-text
Health Risk Screening / Risk Stratification
Health Risk Screening or Risk Stratification is a process for identifying and managing patients who are at a higher risk of emergency hospital admission. This may be because patients have a long term condition such as COPD, cancer or are more frail. NHS England encourages GPs to use risk stratification tools as part of their local strategies for supporting patients with long-term conditions and help reduce the patients’ risk of hospital admissions. Information about you is collected from a number of sources including NHS Trusts and from this GP Practice. Your risk is then ‘scored’ after analysis of your anonymous information using computer programmes. Your information is only provided back to your GP or member of your care team in an identifiable form. Risk stratification enables your GP to focus on the prevention of ill health and not just the treatment of sickness.
To summarise Risk Stratification is used in the NHS to:
- Help decide if a patient is at a greater risk of suffering from a particular condition;
- Prevent an emergency admission;
- Identify if a patient needs medical help to prevent a health condition from getting worse; and/or
- Review and amend provision of current health and social care services.
Your GP will routinely conduct the risk stratification process outside of your GP appointment. This process is conducted electronically and without human intervention. The resulting report is then reviewed by a multidisciplinary team of staff within the Practice. This may result in contact being made with you if alterations to the provision of your care are identified.
Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes, in acknowledgement that it would overburden the NHS to conduct manual reviews of all patient registers held by individual providers. Further information is available from the following link:
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.
However you should be aware that your objection may have a negative impact on the timely and proactive provision of your direct care. Please contact the Practice Business Lead for Governance to discuss how disclosure of your personal data can be limited.
Individual Funding Request
An ‘Individual Funding Request’ is a request made on your behalf, with your consent, by a clinician, for funding of specialised healthcare which falls outside the range of services and treatments that local CCG has agreed to commission for the local population. An Individual Funding Request is taken under consideration when a case can be set out by a patient’s clinician that there are exceptional clinical circumstances which make the patient’s case different from other patients with the same condition who are at the same stage of their disease, or when the request is for a treatment that is regarded as new or experimental and where there are no other similar patients who would benefit from this treatment. A detailed response, including the criteria considered in arriving at the decision, will be provided to the patient’s clinician.
Invoice validation is an important process. It involves using your NHS number to check the CCG that is responsible for paying for your treatment. 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.
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.
Summary Care Record (SCR)
NHS England uses a national electronic record called the Summary Care Record (SCR) to support patient care. It contains key information from your GP 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.
Summary Care Records are there to improve the safety and quality of your care. SCR core information 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 SCR, NHS healthcare staff caring for you outside of this surgery 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 records will stay as they are now with information being shared by letter, email, fax or phone. If you wish to opt-out of having an SCR please return a completed opt-out form (available on request) to the Practice.
How is the information collected?
Your information will be collected either electronically using secure NHS Mail or a secure electronic transferred over an NHS encrypted network connection. In addition physical information will be sent to your Practice. This information will be retained within your GP’s electronic patient record or within your physical medical records.
Who will we share your information with?
In order to deliver and coordinate your health and social care, we may also have to share your information, subject to strict agreements on how it will be used, with the following organisations:
- NHS Trusts / Specialist Trusts
- Independent Contractors such as dentists, opticians, pharmacists
- NHS England, Public Health England and supporting services e.g. PCSE
- Private and / or Voluntary Sector Providers
- Ambulance Trusts
- Clinical Commissioning Groups
- Social Care Services
- Local Authorities
- Education Services
- Fire and Rescue Services
- The National Diabetes Audit
- National Data Extractions (Also known as GPES)*
- Other “Data Processors”
Your information will only be shared if it is appropriate for the provision of your care or required to satisfy our statutory function and legal obligations. Your information will not be transferred outside of the European Union.
We will never share your information outside of health 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 or to carry out a statutory function e.g. GPES.
*National Data Extractions (Also known as GPES)
The Health and Social Care Act 2012 allows NHS Digital to collate personal confidential data from GP practices without seeking your specific consent. This is extracted in order to make increased use of information from medical records and either used just by the NHS with the intention of improving healthcare and the quality of care delivered to patients or may be sold to external companies such as universities or commercial organisations. Please see “opt-out” section if you do not want your data used in this way.
More information about how NHS Digital uses your data can be found at http://content.digital.nhs.uk/gpes
Within the health partner organisations (NHS and Specialist Trusts) and in relation to the above mentioned themes – Risk Stratification, Invoice Validation, Summary Care Record etc. – we will assume you are happy to for your information to be shared unless you choose to opt-out (see below).
This means you will need to express an explicit wish not to have your information shared with 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.
Your right to withdraw consent for us to share your personal information (Opt-Out)
If you are happy for your data to be extracted and used for the purposes described in this fair processing 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 you can choose to opt-out. If you wish to do so, please let us know so we can code your record appropriately. 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 we may still be legally required to disclose your data.
There are two main types of opt-out.
Type 1 Opt-Out
If you do not want information that identifies you to be shared outside the practice, for purposes beyond your direct care, you can register a ‘Type 1 Opt-Out’. This prevents your personal confidential information from being used other than in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease.
Type 2 Opt-Out
NHS Digital collects information from a range of places where people receive care, such as hospitals and community services. If you do not want your personal confidential information to be shared outside of NHS Digital, for purposes other than for your direct care, you can register a ‘Type 2 Opt-Out’. For further information about Type 2 Opt-Outs, please contact NHS Digital contact centre at email@example.com referencing ‘Type 2 Opt-Outs – Data Requests’ in the subject line; or call NHS Digital on (0300) 303 5678; or visit the website http://content.digital.nhs.uk/article/7092/Information-on-type-2-opt-outs .
All patients have the right to change their minds and reverse a previous decision. If you wish to discuss or change your opt-out preferences at any time please contact the Practice Business Lead for Governance.
Right to erasure (‘right to be forgotten’)
The right to erasure applies only in specific circumstances, for example when the processing is no longer necessary or when the processing has been unlawful. It is extremely unlikely, therefore, that these circumstances will be relevant in a health context. This right is separate to requests for amendments to medical records. Whilst it will be extremely rare for information to be deleted from medical records, it is established practice that corrections or amendments can be made; however, the original information, along with an explanation as to why information has been corrected or amended, must remain as an audit trail.
Access to your information
Under the new General Data Protection Regulation (GDPR) 2018 everybody has the right to see, or have a copy, of data we hold that can identify you, with some exceptions. You do not need to give a reason to see your data.
If you want to access your data you must make the request in writing. Under special circumstances, some information may be withheld. If you wish to have a copy of the information we hold about you, please contact a member of the reception.
Change of Details
It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details are incorrect in order for this to be amended. Please inform us of any changes so our records for you are accurate and up to date.
Mobile Numbers & Email Addresses
If you provide us with your mobile phone number, we may use this to send you reminders about your appointments or other health screening information. Please let us know if you do not wish to receive reminders on your mobile.
If you provide us with your email address, in the future we may use this to send you reminders to make an appointment for a review. Please let us know if you do not wish to receive correspondence by email.
Who do we receive information from?
Whilst we might share your information with the above organisations, we may also receive information from them to ensure that your medical records are kept up to date and so that your GP can provide the appropriate care.
In addition we received data from NHS Digital (as directed by the Department of Health) such as the uptake of flu vaccinations and disease prevalence in order to assist us to improve “out of hospital care”.
Do I need to give my consent?
The GDPR sets a high standard for consent. Consent means offering people genuine choice and control over how their data is used. When consent is used properly, it helps you build trust and enhance your reputation. However consent is only one potential lawful basis for processing information. Therefore your GP Practice may not need to seek your explicit consent for every instance of processing and sharing your information, on the condition that the processing is carried out in accordance with this notice. We will contact you if we are required to share your information for any other purpose which is not mentioned within this notice. Your consent will be documented within your electronic patient record.
What will happen if I withhold my consent or raise an objection?
You have the right to write to withdraw your consent to any time for any particular instance of processing, provided consent is the legal basis for the processing. Please contact your GP Practice for further information and to raise your objection.
Sharing of Electronic Patient Records within the NHS
Electronic patient records are kept in most places where you receive healthcare. Our local electronic clinical system, SystmOne, enables your record to be shared with organisations involved in your direct care, such as:
- GP practices
- Community services such as district nurses, rehabilitation services, telehealth and out of hospital services
- Child health services that undertake routine treatment or health screening
- Urgent care organisations, minor injury units or out of hours services
- Community hospitals
- Palliative care hospitals
- Care Homes
- Mental Health Trusts
- Social Care organisations
In addition, NHS England have implemented the Summary Care Record which contains information about medication you are taking, allergies you suffer from and any bad reactions to medication that you have had in the past.
Your electronic health record contains lots of information about you. In most cases, particularly for patients with complex conditions and care arrangements, the shared record plays a vital role in delivering the best care and a coordinated response, taking into account all aspects of a person’s physical and mental health. Many patients are understandably not able to provide a full account of their care, or may not be in a position to do so. The shared record means patients do not have to repeat their medical history at every care setting.
Your record will be automatically setup to be shared with the organisations listed above, however you have the right to ask your GP to disable this function or restrict access to specific elements of your record. This will mean that the information recorded by your GP will not be visible at any other care setting.
You can also reinstate your consent at any time by giving your permission to override your previous dissent.
Your Right of Access to Your Records
You have a right under the Data Protection Act 1998 and General Data Protection Regulations to access/view information the Practice holds about you, and to have it amended or edited should it be inaccurate. This is known as ‘the right of subject access’. We are very keen for you to have access to help you manage your own health and maintain the quality of the records about your health. With some provisos, we are now able to give most adults access to their records on-line if they wish. If you would like access on-line, please ask our receptionists.
You can also request a copy of your records in paper form. If you wish to do this, you will need to do the following,
- Your request must be made in writing to the GP – for information from the hospital you should write direct to them
- We are required to respond to you within 1 month
- You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified and your records located
You should however be aware that some details within your health records may be exempt from disclosure, however this will only be done in the interests of your wellbeing or to protect the identity of a third party.
This Practice is registered with the Information Commissioners Office (ICO) to describe the purposes for which they process personal and sensitive information. We are a registered Data Controller and our registration can be viewed online in the public register at: http://ico.org.uk/what_we_cover/register_of_data_controllers
Further information about the way in which the NHS uses personal information and your rights in that respect can be found here: https://www.england.nhs.uk/contact-us/privacy/privacy-notice/your-information/
The NHS Care Record Guarantee
The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS, what control the patient can have over this, the rights individuals have to request copies of their data and how data is protected under the Data Protection Act 1998. http://systems.digital.nhs.uk/infogov/links/nhscrg.pdf
The NHS Constitution
The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programmes available to you, confidentiality, information and your right to complain if things go wrong.
NHS Digital collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.
Should you have any concerns about how your information is managed at the Practice, please contact the Practice Business Lead for Governance. If you are still unhappy following a review by the Practice, you can then complain to the Information Commissioners Office (ICO) via their website (www.ico.gov.uk).
If you are happy for your data to be extracted and used for the purposes described in this fair processing notice then you do not need to do anything.
If you do not want your personal data being extracted and leaving the GP Practice for any of the purposes described, you need to let us know as soon as possible so please speak to the receptionist and the appropriate opt-out code will be added to your medical notes. (Please be aware that certain regulation such as child protection and court orders may over-rule your choices.)
Reviews of and Changes to our Fair Processing Notice
We will keep our Fair Processing Notice under regular review. This notice was last reviewed following GDPR implementation in May 2018.