Your Data, Privacy and the Law

How We Use Your Medical Records

• This practice handles medical records according to the laws on data protection and confidentiality
• We share medical records with health professionals who are involved in providing you with care and treatment. This is on a need to know basis and event by event
• Some of your data is automatically copied to the shared care summary record / ECS (Scotland, etc.)
• We do share some of your data with local out of hours / urgent or emergency care service
• Data about you is used to manage national screening campaigns such as flu, cervical cytology and diabetes prevention
• Data about you, usually de-identified, is used to manage the NHS and make payments
• We share information when the law requires us to do, for instance when we are inspected or reporting certain illnesses or safeguarding vulnerable people
• Your data is used to check the quality of care provided by the NHS
• We may also share medical records for medical research

Registering for NHS Care

• All patients who receive NHS care are registered on a national database
• This database holds your name, address, date of birth and NHS number but it does not hold information about the care you receive
• The database is held by NHS digital a national organisation which has legal responsibilities to collect NHS data

Identifying Patients who Might be at Risk of Certain Diseases

• Your medical records will be searched by a computer programme so that we can identify patients who might be at high risk from certain diseases such as heart disease or unplanned admissions to hospital
• This means we can offer patients additional care or support as early as possible
• This process will involve linking information from your GP record with information from other health or social care services you have used
• Information which identifies you will only be seen by this practice

Safeguarding

• Sometimes we need to share information so that other people, including healthcare staff, children or others with safeguarding needs, are protected from risk of harm
• These circumstances are rare
• We do not need your consent or agreement to do this
• That practice has a written policy on safeguarding

Checking the Quality of Care – National Clinical Audits

Painswick Surgery contributes to national clinical audits so that healthcare can be checked and reviewed.

• Information from medical records can help doctors and other healthcare workers measure and check the quality of care which is provided to you
• The results of the checks or audits can show where hospitals are doing well and where they need to improve
• The results of the checks or audits are used to recommend improvements to patient care
• Data are sent to NHS Digital, a national body with legal responsibilities to collect data
• The data will include information about you, such as your NHS Number and date of birth and information about your health which is recorded in coded form – for example the code for diabetes or high blood pressure
• We will only share your information for national clinical audits or checking purposes when the law allows
• For more information about national clinical audits see the Healthcare Quality Improvements Partnership website: www.hqip.org.uk or phone 020 7997 7370
• You have the right to object to your identifiable information being shared for national clinical audits. Please contact the practice if you wish to object

Legal Requirements

The law requires Painswick Surgery to share information from your medical records in certain circumstances. Information is shared so that the NHS or Public Health England can, for example:

• Plan and manage services
• Check that the care being provided is safe
• Prevent infectious diseases from spreading

We will share information with NHS Digital, the Care Quality Commission and local health protection team (or Public Health England) when the law requires us to do so.

We must also share your information if a court of law orders us to do so.

NHS Digital

• NHS Digital is a national body which has legal responsibilities to collect information about health and social care services
• It collects information from across the NHS in England and provides reports on how the NHS is performing. These reports help to plan and improve services to patients
• This practice must comply with the law and will send data to NHS Digital, for example, when it is told to do so by the Secretary of State for Health or NHS England under the Health and Social Care Act 2012
• More information about NHS Digital and how it uses information can be found at: www.digital.nhs.uk/home

Care Quality Commission (CQC)

• The CQC regulates health and social care services to ensure that safe care is provided
• The law says that we must report certain serious events to the CQC, for example, when patient safety has been put at risk
• For more information about the CQC see: www.cqc.org.uk

Public Health

• The law requires us to share data for public health reasons, for example to prevent the spread of infectious diseases or other diseases which threaten the health of the population
• We will report the relevant information to local health protection team or Public Health England
• For more information about Public Health England and disease reporting see: www.gov.uk/notifiable-diseases-and-causative-organisms-how-to-report

National Screening Programmes

• The NHS provides national screening programmes so that certain diseases can be detected at an early stage
• These screening programmes include bowel cancer, breast cancer, cervical cancer, aortic aneurysms and a diabetic eye screening service
• The law allows us to share your contact information with Public Health England so that you can be invited to the relevant screening programme
• More information can be found at: www.gov.uk/population-screening-programmes or speak to the practice

Privacy Notice Direct Care

Plain English Explanation

This practice keeps data on you relating to who you are, where you live, what you do, your family, possibly your friends, your employers, your habits, your problems and diagnoses, the reasons you seek help, your appointments, where you are seen and when you are seen, who by, referrals to specialists and other healthcare providers, tests carried out here and in other places, investigations and scans, treatments and outcomes of treatments, your treatment history, the observations and opinions of other healthcare workers, within and without the NHS as well as comments and aide memoires reasonably made by healthcare professionals in this practice who are appropriately involved in your health care.

When registering for NHS care, all patients who receive NHS care are registered on a national database, the database is held by NHS England a national organisation which has legal responsibilities to collect NHS

GPs have always delegated tasks and responsibilities to others that work with them in their surgeries, on average an NHS GP has between 1,500 to 2,500 patients for whom he or she is accountable. It is not possible for the GP to provide hands on personal care for each and every one of those patients in those circumstances, for this reason GPs share your care with others, predominantly within the surgery but occasionally with outside organisations.

If your health needs require care from others elsewhere outside this practice we will exchange with them whatever information about you that is necessary for them to provide that care. When you make contact with healthcare providers outside the practice but within the NHS it is usual for them to send us information relating to that encounter. We will retain part or all of those reports. Normally we will receive equivalent reports of contacts you have with non NHS services but this is not always the case.

Your consent to this sharing of data, within the practice and with those others outside the practice is assumed and is allowed by the Law.

People who have access to your information will only normally have access to that which they need to fulfil their roles, for instance admin staff will normally only see your name, address, contact details, appointment history and registration details in order to book appointments, the practice nurses will normally have access to your immunisation, treatment, significant active and important past histories, your allergies and relevant recent contacts whilst the GP you see or speak to will normally have access to everything in your record.

You have the right to object to our sharing your data in these circumstances but we have an overriding responsibility to do what is in your best interests. Please see below.

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

Data Controller Contact Details

Painswick Surgery
Hoyland House
Painswick
GL6 6RD

Data Protection Officer Contact Details

Dr Rhys Evans, c/o Painswick Surgery

Purpose of the Processing

Direct care is care delivered to the individual alone, most of which is provided in the surgery. After a patient agrees to a referral for direct care elsewhere, such as a referral to a specialist in a hospital, necessary and relevant information about the patient, their circumstances and their problem will need to be shared with the other healthcare workers, such as specialist, therapists, technicians etc. The information that is shared is to enable the other healthcare workers to provide the most appropriate advice, investigations, treatments, therapies and or care.

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”*

Recipient or Categories of Recipients of the Processed Data

The data will be shared with health and care professionals and support staff in this surgery and at hospitals, diagnostic and treatment centres who contribute to your personal care.

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.

Right to Access and Correct

You have the right to access the data that is being shared and have any inaccuracies corrected. There is no right to have accurate medical records deleted except when ordered by a court of law.

Retention Period

The data will be retained in line with the law and national guidance. www.digital.nhs.uk/Records-Management-Code-of-Practice-for-Health-and-Social-Care-2016 or speak to the practice.

Right to Complain

You have the right to complain to the Information Commissioner’s Office, you can use this link www.ico.org.uk/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).

“Common Law Duty of Confidentiality”, common law is not written out in one document like an Act of Parliament. It is a form of law based on previous court cases decided by judges; hence, it is also referred to as ‘judge-made’ or case law. The law is applied by reference to those previous cases, so common law is also said to be based on precedent.

The general position is that if information is given in circumstances where it is expected that a duty of confidence applies, that information cannot normally be disclosed without the information provider’s consent.

In practice, this means that all patient information, whether held on paper, computer, visually or audio recorded, or held in the memory of the professional, must not normally be disclosed without the consent of the patient. It is irrelevant how old the patient is or what the state of their mental health is; the duty still applies.

Three circumstances making disclosure of confidential information lawful are:

• Where the individual to whom the information relates has consented
• Where disclosure is in the public interest
• Where there is a legal duty to do so, for example a court order