Your information, what you need to know
This privacy notice explains
- Why we collect information about you
- What details we collect about you
- The different ways in how that information may be used:
- To provide you with healthcare
- For medical research and to measure the quality of care
- For national screening programmes
- To meet legal requirements
- How we keep your information safe and confidential
- How you can access your medical records
- Legal information about how we handle your data
1. Why we collect 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. These records help to provide you with the best possible healthcare.
In carrying out this role we may collect information about you which helps us respond to your queries or secure specialist services. We may keep your information in written form and/or in digital form. The records may include basic details about you, such as your name and address. They may also contain more sensitive information about your health and also information such as outcomes of needs assessments.
2. What details we collect about you
The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records help to provide you with the best possible healthcare.
Records which this GP Practice may hold about you may include the following:
- Details about you, such as your 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
3. a) How we use your information to provide you with healthcare
Forest Health Care keeps medical records confidential and complies with the General Data Protection Regulation (GDPR).
We hold your medical records so that we can provide you with safe care and treatment.
We will also use your information so that this practice can check and review the quality of the care we provide. This helps us to improve our service to you.
- We will share relevant information from your medical record with other health or social care staff or organisations when they provide you with care. For example, your GP will share information when they refer you to a specialist in a hospital. Or your GP will send details about your prescription to your chosen pharmacy.
- We will share relevant information from your record with an approved pharmacist, either working directly linked to this practice or as part of a local mutli-disciplinary team, to support and ensure that medication prescribing is effectively implemented, in particular changes following discharge from hospital.
- Within Gloucestershire, there is an electronic information sharing system known as Joining Up Your Information (JUYI). If you require attention from a health professional such as an Emergency Department, Minor Injury Unit or Out Of Hours location, those treating you are better able to give appropriate care if some of the information from your GP patient record is available to them through the JUYI system. The information is only used by authorised health and social care professionals in Gloucestershire-based organisations, involved in your direct care. Your permission will be asked before the information is accessed, unless the health and social care user is unable to ask you and there is a valid reason for access, which will then be logged. Further information about JUYI and their fair processing notice can be found on our website or at: http://www.juyigloucestershire.org/
- As part of the Forest of Dean locality group, Forest Health Care participates in an Improved Access programme, offering evening and weekend appointments at any of the 11 locality surgeries. Doctors who treat you during these appointments will have access to your GP medical record in order to provide you with the best possible care. More information about the participating surgeries and how your information is shared can be found online at http://www.forestgpsurgeries.co.uk/
- Healthcare staff working in A&E and out of hours care in Gloucestershire and across the country will also have access to your information. For example, it is important that staff who are treating you in an emergency know if you have any allergic reactions. This will involve the use of your Summary Care Record (SCR). SCRs 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 to the practice. More information about SCRs can be found online at https://digital.nhs.uk/summary-care-records
- 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. Improvements in information technology are also making it possible for us to share data with other healthcare providers with the objective of providing you with better care. You may choose to withdraw your consent to personal data being used in this way. When we are about to participate in a 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. You can object to your 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.
Other important information about how your information is used to provide you with healthcare
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.
- More information can be found at: https://digital.nhs.uk/about-nhs-digital/our-work/keeping-patient-data-safe/how-we-look-after-your-health-and-care-information or the phone number for general enquires 0300 303 5678.
Medical student placements
Our practice is involved in the training of medical students. As part of this programme medical students will work in the practice and may be involved in your care. If staff would like a student to be present they will always ask for your permission before the start of the consultation. The treatment or care you receive will not be affected if you refuse to have a student present during your appointment.
It is usual for GPs to discuss patient case histories as part of their continuing medical education or for the purpose of training GPs and/or medical students. In these situations the identity of the patient concerned will not be revealed.
Identifying patients who might be at risk of certain diseases (Risk Stratification)
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 and enable us to focus on preventing ill health and not just the treatment of sickness.
Information about you is collected from a number of sources including NHS Trusts and from Forest Health Care. A risk score is then arrived at through an analysis of your de-identified information using software managed by Sollis and hosted by South, Central & West Commissioning Support Unit and provided back to this practice.
Information which identifies you will only be seen by this practice.
In Gloucestershire, risk stratification is commissioned by the NHS Clinical Commissioning Group (CCG). Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes. Further information about 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.
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.
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 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.
Supporting Medicines Management
CCGs support local GP practices with prescribing queries which generally don’t require identifiable information. CCG 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 CCG medicines management team will order this on behalf of the practice to support your care.
3. b) How we use your information to measure the quality of care and for medical research
Forest Health Care 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 these audits are used to recommend improvements to patient care
- Data is 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
- For more information about national clinical audits see the Healthcare Quality Improvements Partnership website: https://www.hqip.org.uk or phone 020 7997 7370
National Diabetes Audit
This practice is taking part in an important national project about people at risk of diabetes and diabetes care and treatment in the NHS. The project is called the National Diabetes Audit (NDA). If you have diabetes, non-diabetic hyperglycaemia, impaired glucose tolerance or pre-diabetes, your GP practice will share information about your diabetes care and treatment with the NDA. The type of information and how it is shared, is controlled by law and enforced by strict rules of confidentiality and security.
Taking part in the NDA shows that this practice is committed to reducing and improving care for people with diabetes.
If you do not want your information to be used, please inform the receptionist, GP or nurse. This will not affect your care.
More information can be found by reading the information on the websites listed below:
Forest Health Care also shares information from medical records in order to support medical research when the law allows us to do so, for example to learn more about why people get ill and what treatments might work best. We will also use your medical records to carry out research within the practice.
This is important because the use of information from GP medical records is very useful in developing new treatments and medicines and to help answer questions about illnesses and disease so that improvements can be made to the care and treatment patients receive.
We share information with the following medical research organisations with your explicit consent or when the law allows:
- Clinical Practice Research Datalink (CPRD) more information can be found by visiting their website https://www.cprd.com/public/
- The Health Improvement Network (THIN) database – The staff at this practice record information about you and your health so that you can receive the right care and treatment. We need to record this information, together with the details of the care you receive, so that it is available each time we see you. The information recorded about you may also be used for reasons other than your personal care, for example, to help to protect the health of the general public, to plan for the future, to train staff and to carry out medical and other health research or studies. Thus, we are involved in a health observatory based on anonymised patient information. The reasonable security measures and anonymisation processes are in place to comply with the relevant data protection regulations. If you would like to opt out of this data collection scheme, please let your doctor know and your records will not be collected for use for this Observatory. This will not affect your care in any way. If anything to do with the Observatory or derivate research would require that you provide additional information about yourself, you will be contacted by your GP to see if you are willing to take part; you will not be identified in any published results.
- PRIMIS – PRIMIS quality improvement tools are designed to enable GP practices to extract, analyse and review data from their electronic patient records, in order to:
- improve patient care
- undertake easy clinical audit
- assure the completeness and accuracy of their patient records
- participate in national data collection activities
You have the right to object to your identifiable information being shared for national clinical audits or to support medical research. Please speak to a member of the practice staff if you wish to object.
3. c) How we use your information to conduct 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 online at www.gov.uk
3. d) How your information is shared so that Forest Health Care can meet its legal requirements
The law requires Forest Health Care to share information from your medical records in certain circumstances. Information is shared so that the NHS, Public Health England or other statutory government bodies 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, our local health protection team (or Public Health England) or other statutory government bodies when the law requires us to do so. Please see below for more information.
We must also share your information if a court of law orders us to do so.
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.
Forest Health Care must comply with the law and will send data to NHS Digital, for example, when we are 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 service 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: http://www.cqc.org.uk/
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. Forest Health Care will report the relevant information to our local health protection team or Public Health England.
For more information about Public Health England and disease reporting, see: https://www.gov.uk/guidance/notifiable-diseases-and-causative-organisms-how-to-report
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.
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 General Data Protection Regulation 2018.
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.
4. How we keep your information confidential and safe
Everyone working for the NHS is subject to the Common Law Duty of Confidence. Information provided in confidence will only be used for the purposes advised with consent given by the patient, unless there are other 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. All our staff are expected to make sure information is kept confidential and receive annual training on how to do this.
NHS health records may be electronic, on paper or a mixture of both, 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 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:
- General Data Protection Act
- Data Protection Act
- Human Rights Act
- Common Law Duty of Confidentiality
- NHS Codes of Confidentiality and Information Security
- Health and Social Care Act 2015
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.
5. How you can access your medical records
Under the General Data Protection Regulation 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.
All patients can access their online medical records by signing up to our online patient system. Please speak to any member of our team in order to do this.
For requests for written copies of your medical records, we will process all requests within 30 calendar days – or up to a maximum of 90 days for complex requests.
If you want to access your data you can make the request verbally or in writing (forms are available at reception).
All initial requests for your data will be provided free of charge. We may charge a reasonable fee for further copies to cover administration charges.
If you wish a third party to have access to your data – such as a solicitor or insurance company – they must prove that they are acting on your behalf and we will verify that you wish them to have access to the data. Under special circumstances, some information may be withheld.
iGPR enables practice staff to create, screen (using iGPR’s redaction engine) and to send insurance reports completely electronically via secure encrypted transfer. IGPR makes the process of providing necessary medical reports for your patient’s policy faster, safer and more secure.
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 telephone number
If you provide us with your mobile phone number we may use this to send you reminders about your appointments, annual reviews, other health screening information or health campaigns. Please let us know if you do not wish to receive reminders on your mobile.
We record all calls, these records are held on a dedicated and secure PC located within the practice and are only accessed by authorised staff where there are concerns about a call e.g. for the purposes of training, complaints review process and where threats have been received. They may be shared with indemnity providers where the content relates to a clinical complaint or the police in the event of an extreme threat.
We will keep our Privacy Notice under regular review. This notice was last reviewed in December 2019.
6. Legal information about how we handle your data
We are required by law to provide you with the following information about how we handle your information.
|Data Controller contact details
|Forest Health Care, Dockham Road, Cinderford, Glos, GL14 2AN|
|Data Protection Officer contact details
|Caroline Dominey- Strange
|Purposes of the processing
|· To give direct health or social care to individual patients. For example, when a patient agrees to a referral for direct care, such as to a hospital, relevant information about the patient will be shared with the other healthcare staff to enable them to give appropriate advice, investigations, treatments and/or care.
· To check and review the quality of care (this is called audit and clinical governance).
· For medical research.
· To conduct national health screening programmes to detect diseases or conditions early. The information is shared so that the correct people are invited for screening, which means that those who are most at risk can be offered treatment.
· To comply with legal obligations or court orders.
|Lawful basis for processing
|The use of your data to provide you with healthcare and to contact patients for screening is supported under the following section 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…’; and
The use of your data to check the quality of care (clinical audit and governance), to contact patients for screening and to comply with legal obligations or court orders is supported under the following section of the GDPR:
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…”
The use of your data to support medical research is supported under the following section of GDPR:
Article 9(2)(j) ‘…necessary for…scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member States law which shall be proportionate to the aim pursued, respect he essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and interests of the data subject.’
The use of your data to comply with legal obligations is supported under the following section of GDPR:
Article 6(1)(c) – ’processing is necessary for compliance with a legal obligation to which the controller is subject…’
Healthcare staff will also respect and comply with their obligations under the common law duty of confidence.
|Recipient or categories of recipients of the processed data
|For the provision of your healthcare, the data will be shared with:
· healthcare professionals and staff in this surgery;
· participants of the Joining Up Your Information (JUYI) scheme.
· healthcare professionals in the Forest of Dean locality group.
· local hospitals, such as the Dilke Community Hospital, Lydney Community Hospital, Gloucester Royal Hospital and Cheltenham General Hospital;
· out of hours services, such as Care UK and GDoc;
· diagnostic and treatment centres;
· or other organisations involved in the provision of direct care to individual patients such as opticians or dentists
· NHS Trusts
· Special Trusts
· Private Sector Providers
· Voluntary Sector Providers
· Ambulance Trusts
· Local Authorities
· Education Services
· Fire and Rescue
For the purposes of risk stratification and screening programmes, your data will be shared with the South Central & West Commissioning Support Unit.
For national clinical audits which check the quality of care the data will be shared with NHS Digital.
To comply with legal obligations or court orders the data will be shared with:
· NHS Digital;
· The Care Quality Commission;
· Our local health protection team or Public Health England;
· Other statutory government bodies as required by law, and
· The court, if ordered
|Rights to object||· You have the right to object to information being shared between those who are providing you with direct care. This may affect the care you receive – please speak to the practice.
· You are not able to object to your name, address and other demographic information being sent to NHS Digital. This is necessary if you wish to be registered to receive NHS care.
· You are not able to object when information is legitimately shared for safeguarding reasons. In appropriate circumstances it is a legal and professional requirement to share information for safeguarding reasons. This is to protect people from harm. The information will be shared with the local safeguarding services. More information can be found online at https://www.gloucestershire.gov.uk/gsab/ and https://www.gscb.org.uk/
· You have a right to object under the GDPR and the right to ‘opt-out’ under the national data opt-out model for the sharing of your data for medical research and clinical audit. The national data opt-out model provides an easy way for you to opt out of information that identifies you being used medical research and quality checking or audit purposes.
· For national screening programmes you can opt to no longer receive an invitation to a screening programme: https://www.gov.uk/government/publications/opting-out-of-the-nhs-population-screening-programmes
There are very limited rights to object when the law requires information to be shared, but government policy allows some rights of objection as set out below.
· You have the right to object to information being shared with NHS Digital for reasons other than your own direct care. This is called a ‘Type 1’ objection. You can ask a member of the practice staff to apply this code to your record. Please note: The ‘Type 1’ objection will no longer be available after 2020. This means you will not be able to object to your data being shared with NHS Digital when it is legally required under the Health and Social Care Act 2012.
· Legally information must be shared under public health legislation. This means that you are unable to object.
Care Quality Commission
· Legally information must be shared under public health legislation. This means that you are unable to object.
· Your information must be shared if it is ordered by a court. This means that you are unable to object.
|Right to access and correct||· You have the right to access your medical record and have any errors or mistakes corrected. Please speak to a member of staff.
|GP medical records will be kept in line with the law and national guidance. Information on how long records are kept can be found at: https://digital.nhs.uk/article/1202/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. If you wish to complain follow this link https://ico.org.uk/global/contact-us/ or call the helpline 0303 123 1113|
|Data we get from other organisations||We receive information about your health from other organisations who are involved in providing you with health and social care. For example, if you go to hospital for treatment or an operation the hospital will send us a letter to let us know what happens. This means your GP medical record is kept up-to date when you receive care from other parts of the health service.|
NHS Transparency Statement
How the NHS and care services use your information
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
www.understandingpatientdata.org.uk (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 currently compliant with the national data opt-out policy.
For more information, please visit: www.nhs.uk