Protecting Your Confidentiality

(Privacy Notice)

 

Your information, what you need to know

This Privacy Notice explains why we collect information about you, how that information may be used and how we keep it safe and confidential.

 

Why we need information about you

Health care professionals who provide you with care are required by law to maintain records about your health and any treatment or care you have received within any NHS organisation.  The information that makes up your record is also essential to help us provide you with the best possible healthcare and help us to protect your safety.

This practice collects and holds data for the purpose of providing healthcare services to our patients and running our organisation which includes monitoring the quality of care that we provide.  In carrying out this role we may collect information about you which helps us respond to your queries, provide you with the most appropriate care, or arrange specialist services on your behalf. We may keep your information in written form and/or in digital/electronic form. The records will include basic details about you, such as your name and address. They may also contain sensitive information about your health such as outcomes of assessments.  All information about you is treated confidentially and only shared on a ‘need to know’ basis.

 

• who care for you
• Information about care and treatment that you may have had with other health care providers, for example if your GP practice has referred you for treatment.

 

Our Commitment to Data Privacy and Confidentiality Issues

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.  As a GP practice, all of our GPs, staff and associated practitioners is subject to the Common Law Duty of Confidence. They are committed to protecting your privacy and will only process data in accordance with the Data Protection Legislation. This includes the General Data Protection Regulation (EU) 2016/679 (GDPR) now known as the UK GDPR, the Data Protection Act (DPA) 2018, the Law Enforcement Directive (Directive (EU) 2016/680) (LED) and any applicable national Laws implementing them as amended from time to time.  The practice is required to process personal data only if there is a legitimate basis for doing so and that any processing must be fair and lawful.

In addition, consideration will also be given to all applicable Law concerning privacy, confidentiality, the processing and sharing of personal data including the Human Rights Act 1998, the Health and Social Care Act 2012 as amended by the Health and Social Care (Safety and Quality) Act 2015, the common law duty of confidentiality and the Privacy and Electronic Communications (EC Directive) Regulations.

Information provided in confidence will only be used for the purposes advised with consent given by the patient or authorised carer, unless there are other circumstances covered by the law.   All our staff are expected to make sure information is kept confidential and receive regular training on how to do this. NHS staff are not permitted to access information that is not relevant to the patient and the condition they are treating, and our information systems are set up to prevent and track any misuse of information.

The health records we use are electronic and we use a combination of working practices and technology to ensure that your information is kept confidential and secure.  Your records are backed 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 is restricted to authorised personnel.

We also make sure external data processors that support us are legally and contractually bound to operate.  Before they begin any work they have to provide evidence in the form of a Data Security Policy, that adequate security arrangements are in place to protect patients.

 

We maintain our duty of confidentiality to you at all times. We will only share your information where there is a legal basis, such as for: -

 

• Your medical diagnosis and treatment
• To provide you with health or social care
• To manage and plan our local health and social care services
• Where is it required by law, for example the Children’s Act 1989 requires information to be shared in Safeguarding cases
• Protection of vital interests, for example to protect someone's physical integrity of life
• With your consent, providing you have capacity to give this, or with consent from your authorised representative.

 

Data we collect about you

The health care professionals, who provide you with care, maintain records about your health and any treatment or medicines and care you have received previously from providers of health services, such as Buckinghamshire Healthcare NHS Trust, Oxford University Hospitals NHS Trust or Frimley Health NHS Foundation Trust, your GP surgery or the Minor Injuries and Illness Unit.

Records we will hold or share about you will include the following:

 

• Personal Data – means any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.

 

• Special Categories of Personal Data – this term describes personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.

 

• Confidential Patient Information – this term describes information or data relating to their health and other matters disclosed to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. Including both information ‘given in confidence’ and ‘that which is owed a duty of confidence’. As described in the Confidentiality: NHS code of Practice: Department of Health guidance on confidentiality 2003.

 

• Pseudonymised – The process of distinguishing individuals in a dataset by using a unique identifier which does not reveal their ‘real world’ identity.

 

• Anonymised – Data in a form that does not identify individuals and where identification through its combination with other data is not likely to take place

 

• Aggregated – Statistical data about several individuals that has been combined to show general trends or values without identifying individuals within the data.

 

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.  Where your record is accessed without your permission it is necessary for them to have a legitimate basis in law. This is explained further in the Local Information Sharing below.

 

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 by the service
• research into the development of new treatments and care pathways
• preventing illness and diseases
• monitoring safety
• planning services
• risk stratification
• Population Health Management

 

 

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 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 Buckinghamshire on behalf of NHS England. 

 

Clinical audit

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.

National Registries

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

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 Data Protection legislation.

 

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.

https://www.gov.uk/government/publications/code-of-data-matching-practice-for-national-fraud-initiative

 

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.

Safeguarding

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.

 

Clinical Research

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.

 

How long do we hold information for?

All records held by the Practice will be kept for the duration specified by national guidance from Records Management Code of Practice - NHSX. Once information that we hold has been identified for destruction it will be disposed of in the most appropriate way for the type of information it is.  Personal confidential and commercially confidential information will be disposed of by approved and secure confidential waste procedures. We keep a record of retention schedules within our information asset registers, in line with the Records Management Code of Practice for 2021.

Individuals Rights under UK GDPR

Under UK GDPR 2016 the Law provides the following rights for individuals.  The NHS upholds these rights in a number of ways:

1. The right to be informed
2. The right of access
3. The right to rectification
4. The right to erasure (not an absolute right) only applies in certain circumstances
5. The right to restrict processing
6. The right to data portability
7. The right to object
8. Rights in relation to automated decision making and profiling.

 

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 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 - Improved Access

As a result of the 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, who may be located remotely or 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 practice 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/

Multi-disciplinary team meetings

In the interests of providing the most effective patient care, your condition could be discussed as part of a multi-disciplinary meeting of healthcare specialists in order to agree on the best way forward for you.

Your Right to Opt Out of Data Sharing and Processing

The NHS Constitution states, ‘You have a right to request that your personal and confidential information is not used beyond your own care and treatment and to have your objections considered’.

 

Type 1 Opt Out

This is an objection that prevents an individual's personal confidential information from being shared outside of their general practice except when it is being used for the purposes of their individual direct care, or in particular circumstances required by law, such as a public health screening, or an emergency like an outbreak of a pandemic disease. If patients wish to apply a Type 1 Opt Out to their record, they should make their wishes known to the Practice Manager.

 

National data opt-out (NDOO)

The national data opt-out was introduced on 25 May 2018, enabling patients to opt-out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.

 

The national data opt-out replaces the previous ‘Type 2’ opt-out, which required NHS Digital not to use a patient’s confidential patient information for purposes beyond their individual care, for Planning or Research. Any patient that had a type 2 opt-out recorded on or before 11 October 2018 has had it automatically converted to a national data opt-out. Those aged 13 or over were sent a letter giving them more information and a leaflet explaining the national data opt-out.  For more information go to National data opt out programme

 

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

 

Right of Access to your information (Subject Access Request)

Under Data Protection Legislation everybody has the right of access to, or request a copy of, information we hold that can identify them, this includes medical records. There are some safeguards regarding what patients will have access to and they may find information has been redacted or removed for the following reasons;

• It may be deemed to risk causing harm to the patient or others
• The information within the record may relate to third parties who are entitled to their confidentiality, or who have not given their permission for the information to be shared.

Patients do not need to give a reason to see their data. And requests can be made verbally or in writing.  Although we may ask them to complete a form in order that we can ensure that they have the correct information required.

Where multiple copies of the same information is requested the surgery may charge a reasonable fee for the additional copies.

Patients will need to provide proof of identity to receive this information. We will not share information relating to you with other individuals without your explicit instruction or without sight of a legal document.

Patients may also request to have online access to their data, they may do this via the NHS APP, or via Patient Access: https://www.unity-health.co.uk/manage-your-health-online/

COVID Passport access

Patients may access their Covid passport via the link, the practice cannot provide this document as it is not held in the practice record. If you have any issues gaining access to your Covid Passport or letter you should call: 119

Change of Details

It is important that you tell the surgery if any of your contact details such as your name or address have changed, or if any of your other contacts details are incorrect including third party emergency contact details.  It is important that we are made aware of any changes immediately in order that no information is shared in error.

 

Mobile telephone number

If you provide us with your mobile phone number, we will use this to send you text reminders about your appointments or other health related information.  It is within our legal duty as a public authority to keep our patients updated with important information.

Email address

Where you have provided us with your email address, we will use this to send you information relating to your health and the services we provide.  If you do not wish to receive communications by email please let us know. 

Notification

Data Protection Legislation requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.

 

We are registered as a 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

 

Any changes to this notice will be published on our website and in a prominent area at the Practice.

 

What is the right to know?

The Freedom of Information Act 2000 (FOIA) gives people a general right of access to information held by or on behalf of public authorities, promoting a culture of openness and accountability across the public sector.  Unity Health surgeries do not provide patient or staff numbers, where the response is less than or equal to five (≤5) as it would potentially allow identification of the individual patient/staff and would therefore be personal data. The practice considers that release of that information would breach GDPR/DPA18 principles.  This information is therefore exempt under section 40 of the Freedom of Information Act 2000.

 

You can request any non-personal information that the GP Practice holds, that does not fall under an exemption.  You may not ask for information that is covered by the Data Protection Legislation under FOIA.  However, you can request this under a right of access request – see section above ‘Access to your information’. 

 

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
• Independent contractors such as private doctors/consultants, dentists, opticians, pharmacists – working either privately or 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
• Police

 

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 (see page 7).

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.

Data Protection Officer

Should you have any data protection questions or concerns, please contact our Data Protection Officer at:  charlijohnson@nhs.net

Complaints

If you have concerns or are unhappy about any of our services, please contact:

Lesley Munro-Faure our Managing Partner

 

For independent advice about data protection, privacy and data-sharing issues, you can contact:

 

The Information Commissioner

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

 

Phone: 0303 123 1113 Website: www.ico.gov.uk

 

Further Information

Further information about the way in which the NHS uses personal information and your rights in that respect can be found at the NHS Care Record Guarantee, information below.

 

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 Data Protection Legislation. 

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.

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

 

NHS Digital

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.

http://content.digital.nhs.uk/article/4963/What-we-collect

 

Reviews of and Changes to our Privacy Notice

We will keep our Privacy Notice under regular review. This notice was last reviewed in May 2023