Practice Policies

How we use your information

This privacy notice explains why the GP Practice collects information about you, and how that information may be used.

As data controllers, GPs have fair processing responsibilities under the Data Protection Act 1998. In practice, this means ensuring that your personal confidential data (PCD) is handled in ways that are transparent and that you would reasonably expect. The Health and Social Care Act 2012 changed the way that personal confidential data are processed, therefore it is important that patients are made aware of, and understand these changes and that you have an opportunity to object and know how to do so.

The health care professionals who provide you with care maintain records about your health and any treatment or care you have received within the NHS (e.g. NHS Hospital Trust, GP Surgery, Walk-in clinic, etc.). These records help to provide you with the best possible healthcare.

NHS health records may be processed electronically, on paper or a mixture of both, and a combination of working practices and technology are used to ensure that your information is kept confidential and secure. Records held by this GP Practice may include the following information:

  • Details about you, such as address and next of kin
  • Any contact the surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
  • Notes and reports about your health
  • Details about your treatment and care
  • Results of investigations, such as laboratory tests, x-rays, etc.
  • Relevant information from other health professionals, relatives or those who care for you

The Practice collects and holds data for the sole purpose of providing healthcare services to our patients and we will ensure that the information is kept confidential. We can disclose personal information if:

  • It is required by law
  • You consent – either implicitly or for the sake of their own care or explicitly for other purposes
  • It is justified in the public interest

Some of this information will be held centrally and used for statistical purposes. Where we hold data centrally, we take strict measures to ensure that individual patients cannot be identified.

On some occasions it may be necessary to undertake clinical audits of records to ensure that the best possible care has been provided to you or to prevent the spread of infectious disease, wherever possible this will be done in anonymised form.

Sometimes your information may be requested to be used for research purposes – the Practice will always endeavour to gain your consent before releasing the information.

Under the powers of the Health and Social Care Act 2012 (HSCA) the Health and Social Care Information Centre (HSCIC) can request Personal Confidential Data (PCD) from GP Practices without seeking patient consent. Any patient can choose to withdraw their consent to their data being used in this way. When the Practice is about to participate in any new data-sharing scheme we will make patients aware by displaying prominent notices in the surgery and on our website before the scheme is due to start. We will also explain clearly what you have to do to ‘opt-out’ of each new scheme.

A patient can object to their personal information being shared with other health care providers but if this limits the treatment that you can receive then the doctor will explain this to you at the time.

Risk Stratification

Risk stratification is a process for identifying and managing patients who are at high risk of emergency hospital admission. Typically this is because patients have a long term condition such as COPD or cancer. NHS England encourages GPs to use risk stratification tools as part of their local strategies for supporting patients with long-term conditions and to help prevent avoidable admissions.

Information about you is collected from a number of sources including NHS Trusts and from this GP Practice. A risk score is then arrived at through an analysis of your de-identified information using software as the data processor and is only provided back to your GP or member of your care team as data controller in an identifiable form. Risk stratification enables your GP to focus on the preventing ill health and not just the treatment of sickness. If necessary your GP may be able to offer you additional services.

Please note that you have the right to opt out of Risk Stratification.

Should you have any concerns about how your information is managed, or wish to opt out of any data collection at the Practice, please contact the Practice Manager to discuss how the disclosure of your personal information can be limited. Patients have the right to change their minds and reverse a previous decision. Please contact the practice if you change your mind regarding any previous choice.

Invoice Validation

If you have received treatment within the NHS, the CCG may require access to your personal information in order to determine which Clinical Commissioning Group should pay for the treatment or procedure you have received.

Information such as your name, address and date of treatment may be passed on to enable the billing process. These details are held in a secure environment and kept confidential. This information will only be used to validate invoices, and will not be shared for any further Commissioning purposes.

NHS Health Checks

All of our patients aged 40-74 not previously diagnosed with cardiovascular disease are eligible to be invited for an NHS Health Check. We may invite you for an appointment directly or by using a data processor who works entirely under our direction and who will contact you for this purpose only. Nobody outside the healthcare team in the practice will see confidential information about you during the invitation process and contact details only would be securely transferred to a data processor if that method was employed. You may be offered to attend your health check within the practice or at a community venue. If your health check is at a community venue all data collected will be securely transferred back into the practice system and nobody outside the healthcare team in the practice will see confidential information about you during this process.

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with the Data Protection Act 1998 (which is overseen by the Information Commissioner’s Office), Human Rights Act, the Common Law Duty of Confidentiality, and the NHS Codes of Confidentiality and Security.

All of our staff, contractors and committee members receive appropriate and on-going training to ensure they are aware of their personal responsibilities and have contractual obligations to uphold confidentiality, enforceable through disciplinary procedures. Only a limited number of authorised staff have access to personal information where it is appropriate to their role and is strictly on a need-to-know basis.

We maintain our duty of confidentiality to you at all times. We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not 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.

Who are our partner organisations?

The principle partner organisations, with whom information may be shared:

  • Foundation Trusts
  • Clinical Commissioning Group
  • Primary Care Support England
  • Ambulance Services
  • Mental Health Trusts
  • Community Services (Virgin Care)

Subject to strict agreements describing how it will be used, your information may also be shared with:

  • Primary Care Agents
  • Social Services
  • Education Services
  • Local Authorities
  • Voluntary Sector Providers
  • Private Sector Providers

This Practice works alongside Surrey and Borders Partnership NHS Foundation Trust (SABP) who provide the GP Integrated Mental Health Service (MHICS) from within our GP Practice. If you and your GP agree that you would benefit from the MHICS, you will be referred to the service. The clinicians employed by SABP that are responsible for providing treatment under the MHICS will have access to your GP record in order to provide the best care to you. For more information about the MHICS see: https://www.sabp.nhs.uk/application/files/6515/8919/0608/CMHTP_-_MHICS_MHICS_Privacy_Notice_v1.0.pdf

Access to personal information

You have a right under the Data Protection Act 1998 to access/view information the Practice holds about you, and to have it amended or removed should it be inaccurate. This is known as ‘the right of subject access’. If we do hold information about you we will:

  • give you a description of it;
  • tell you why we are holding it;
  • tell you who it could be disclosed to; and
  • let you have a copy of the information in an intelligible form.

If you would like to make a ‘subject access request’. please speak to one of our receptionists. This is normally provided free of charge, however there may be a charge for this service if the records are found to be one of a complex nature, excessive or if multiple requests are made.

Any changes to this notice will be published on our website and on the Practice notice board.

The Practice is registered as a data controller under the Data Protection Act 1998. The registration number is Z491502X and can be viewed online in the public register at http://ico.org.uk/what_we_cover/register_of_data_controllers

Further information

Further information about the way in which the NHS uses personal information and your rights in that respect can be found in:

The NHS Care Record Guarantee: http://www.nigb.nhs.uk/pubs/nhscrg.pdf

The NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england

The HSCIC Guide to Confidentiality gives more information on the rules around information sharing : http://content.digital.nhs.uk/media/12822/Guide-to-confidentiality-in-health-and-social-care/pdf/HSCIC-guide-to-confidentiality.pdf

An independent review of information about patients is shared across the health and care system led by Dame Fiona Caldicott was conducted in 2012. The report, Information: To share or not to share? The Information Governance Review, be found at: https://www.gov.uk/government/publications/the-information-governance-review

NHS England – Data Services for Commissioners provides further information about the data flowing within the NHS to support commissioning. https://www.england.nhs.uk/ourwork/tsd/data-services/

Please visit the Health and Social Care Information Centre’s website for further information about their work. Information about their responsibility for collecting data from across the health and social care system can be found at: http://www.hscic.gov.uk/collectingdata

The Information Commissioner’s Office is the Regulator for the Data Protection Act 1998 and offer independent advice and guidance on the law and personal data, including your rights and how to access your personal information. For further information please visit the Information Commissioner’s Office website at https://ico.org.uk/.

Telephone calls

We sometimes record our telephone calls for two reasons, firstly to protect patients and staff and other health workers. Patients are protected by our having a record of our conversations with you, staff and other health workers are protected from potential abuse. Secondly we record some calls because they can contain clinical information that can become part of your medical records. When you register with us we will make this clear to you and we will also make this clear to you each time you contact us and via our web site and other sources of information Calls that contain only administrative information, such as enquiries about appointments, are only retained for 4 weeks and are then routinely deleted. Some calls are retained for longer periods; this is to assist in drafting up any responses for complaints or feedback. This will be for a maximum period of 1 year. The recordings are stored on secure servers at Gamma who provides Horizon (our telephone providers). Their servers and SBC’s (Session Border Controllers) all use encryption and redundancy These recordings will not usually be shared outside the practice. If you object to your call being recorded we can request you to come in to the surgery to discuss your concerns/ request and have a chaperone present in the room.

We are required by Articles in the General Data Protection Regulations to provide you with the information in the following 9 subsections.

How the NHS and care services use your information

Cemberley Health Centre is one of many organisations working in the health and care system to improve care for patients and the public).

Whenever you use a health or care service, such as attending Accident & Emergency or using Community Care services, important information about you is collected in a patient record for that service. Collecting this information helps to ensure you get the best possible care and treatment. The information collected about you when you use these services can also be used and provided to other organisations for purposes beyond your individual care, for instance to help with:

  • improving the quality and standards of care provided
  • research into the development of new treatments
  • preventing illness and diseases
  • monitoring safety
  • planning services

This may only take place when there is a clear legal basis to use this information. All these uses help to provide better health and care for you, your family and future generations. Confidential patient information about your health and care is only used like this where allowed by law.

Most of the time, anonymised data is used for research and planning so that you cannot be identified in which case your confidential patient information isn’t needed.

You have a choice about whether you want your confidential patient information to be used in this way. If you are happy with this use of information you do not need to do anything. If you do choose to opt out your confidential patient information will still be used to support your individual care. To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters. On this web page you will:

  • See what is meant by confidential patient information
  • Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care
  • Find out more about the benefits of sharing data
  • Understand more about who uses the data
  • Find out how your data is protected
  • Be able to access the system to view, set or change your opt-out setting
  • Find the contact telephone number if you want to know any more or to set/change your opt-out by phone
  • See the situations where the opt-out will not apply

You can also find out more about how patient information is used at: https://www.hra.nhs.uk/information-about-patients/ (which covers health and care research); and https://understandingpatientdata.org.uk/what-you-need-know (which covers how and why patient information is used, the safeguards and how decisions are made)

You can change your mind about your choice at any time.

Data being used or shared for purposes beyond individual care does not include your data being shared with insurance companies or used for marketing purposes and data would only be used in this way with your specific agreement.

Health and care organisations have until 2020 to put systems and processes in place so they can be compliant with the national data opt-out and apply your choice to any confidential patient information they use or share for purposes beyond your individual care. Our organisation ‘is / is not currently’ compliant with the national data opt-out policy.

1) Data Controller contact details Camberley Health Centre
159 Frimley Road
GU15 2QA
2) Data Protection Officer contact details Dr Sarah Oakes
3) Purpose of the processing To facilitate your access to care and in the case of telephone for your direct care.
4) Lawful basis for processing The processing of personal data in the delivery of direct care and for providers’ administrative purposes in this surgery and in support of direct care elsewhere is supported under the following Article 6 and 9 conditions of the GDPR:
Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’.
Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services...” We will also recognise your rights established under UK case law collectively known as the “Common Law Duty of Confidentiality”*
5) Recipient or categories of recipients of the processed data Necessary data will be shared with Health and care professionals and support staff in this surgery. Clinical data or records of consultations may be transcribed or appended to the records we hold on you and may thence be shared at hospitals, diagnostic and treatment centres who contribute to your personal care. Actual recordings will not be shared with anyone outside the practice. Please see our Privacy Notice for Direct Care. The actual recordings are stored [insert place / or who by]
6) Rights to object You have the right to object to some or all the information being processed under Article 21. Please contact the Data Controller or the practice. You should be aware that this is a right to raise an objection, that is not the same as having an absolute right to have your wishes granted in every circumstance
7) Right to access and correct You have the right to access the data that is being shared and have any inaccuracies corrected. We [can / cannot] provide copies of recordings. There is no right to have accurate medical records deleted except when ordered by a court of Law.
8) Retention period We will keep recordings [indicate what your retention period is]. Clinical data transcribed from your telephone or other electronic consultations becomes part of your clinical record and is retained according to relevant rules and regulations, see Privacy Notice on Direct Care.
9) Right to Complain.

You have the right to complain to the Information Commissioner’s Office, you can use this link https://ico.org.uk/global/contact-us/

or calling their helpline Tel: 0303 123 1113 (local rate) or 01625 545 745 (national rate)

There are National Offices for Scotland, Northern Ireland and Wales, (see ICO website)

Risk Stratification

Rationale

Risk stratification is a process that uses de-identified personal data from health care services to determine which people are at risk of experiencing certain outcomes, such as unplanned hospital admissions.

Data Processing activities for Risk Stratification

Risk stratification tools are used by General Practices to help identify those patients at greater risk of unplanned hospital admissions allowing them to take proactive intervention for their patients, the tool can also be used by CCGs to analyse the overall health of a population using data which is anonymised in line with the Information Commissioner's Office (ICO) Anonymisation Code of Practice. The combined CCGs Secondary Use Service (SUS) data and GP data which contains an identifier (usually NHS number) is made available to clinicians with a legitimate relationship with their patients to enable them to identify which patients should be offered targeted preventative support to reduce those risks.

The CCG has commissioned NHS South, Central and West Commissioning Support Unit (SCWCSU) to provide the risk stratification software solution on behalf of itself and its GP practices.

This processing takes place under contract following the below steps:

  • NHS Digital has a legal obligation to obtain data from providers of NHS care such as the local hospital or community hospital. This data is then sent to the SCWCSU DSCRO and amended so that only your NHS number could identify you. The data is then provided to SCWCSU for processing in the risk stratification software. The CCG has signed a Data Sharing Contract with NHS Digital for the use of this data, called Secondary Use Services (SUS) data.
  • Your GP practice enables an organisation called Graphnet Healthcare, to extract data from your records which again, is only identifiable by your NHS Number. This data will only be extracted and provided to SCWCSU for those patients that have not objected to Risk Stratification or where no other type of objection to information sharing has been recorded on your record. The data, containing the same verified NHS numbers, are sent via secure transfer, directly to SCWCSU by Graphnet.
  • SCWCSU then link both sets of data using their risk stratification software. An algorithm is run on the data to generate a risk score for each Patient. The CCG is able to see data only after your NHS number has been removed and replaced by a pseudonymised reference. Your GP will be able to see the data with your NHS number in it so that it can identify if you require further support from them to manage your healthcare needs.

The risk scores are only made available to authorized users within the GP Practice where you are registered via a secure portal managed by SCWCSU.

If you do not wish information about you to be included in the risk stratification programme please contact your GP Practice. They can add a code to your records that will stop your information from being used for this purpose.

Further information about risk stratification is available from:

https//www.england.nhs.uk/ourwork/tsd/ig/risk-stratification/

Type of Data – Identifiable/Pseudonymised/Anonymised/Aggregate Data

Legal Basis

GDPR Art. 6(1) (e) and Art.9 (2) (h). The use of identifiable data by CCGs and GPs for risk stratification has been approved by the Secretary of State, through the Confidentiality Advisory Group of the Health Research Authority (approval reference (CAG 7-04)(a)/2013)) and this approval has been extended to the end of September 2020 NHS England Risk Stratification which gives us a statutory legal basis under Section 251 of the NHS Act 2006 to process data for risk stratification purposes which sets aside the duty of confidentiality. We are committed to conducting risk stratification effectively, in ways that are consistent with the laws that protect your confidentiality

Benefits

CCGs and GPs use risk stratification tools as part of their local strategies for supporting patients with long-term conditions and to help and prevent avoidable admissions. Typically this is because patients have a long term condition such as Chronic Obstructive Pulmonary Disease. NHS England encourages CCGs and GPs to use risk stratification tools as part of their local strategies for supporting patients with long-term conditions and to help and prevent avoidable admissions.

Knowledge of the risk profile of our population will help the CCG to commission appropriate preventative services and to promote quality improvement in collaboration with our GP practices.

Version 1.a
Last updated January 2020