Privacy Notice (Practice)

How We Use Your Information

This practice keeps medical records confidential and complies with the General Data Protection Regulation.

We hold your medical record 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 services 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.
• Healthcare staff working in A&E and out of hours care 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.
• You have the right to object to information being shared for your own care. Please speak to the practice if you wish to object. You also have the right to have any mistakes or errors corrected.
• We will use the data that we hold on your medical records to contact you directly in relation to your medical care. This may include text, phone or written communication.

National Opt Out (Type 2 Data)

What is it?

It means where the public can opt out of their information being used for any purpose beyond their care, the patients have to opt out themselves, by using the NHS App, calling the opt out team (0300 3035678) or using the website, www.nhs.uk/your-nhs-data-matters

What does it apply to:-

The opt out is only to sharing of data from the practice where the legal power for using so is the authorisation of the CAG – Confidentiality Advisory Group using s.251 powers – this is usually for research. But includes for GP’s CCG invoice validation, IFR validation and Risk Stratification. It does not apply to:-

• Anonymised data sharing
• Sharing where the patient has given consent (some research projects)
• Public interest disclosures
• Legal requirements to share

Please click here for the patient leaflet with more details.

Care Data

How information about you helps us to provide better care

Confidential information from your medical records can be used by the NHS to improve the services offered so we can provide the best possible care for everyone.

This information along with your postcode and NHS number but not your name, are sent to a secure system where it can be linked with other health information.

This allows those planning NHS services or carrying out medical research to use information from different parts of the NHS in a way which does not identify you.

You have a choice. If you are happy for your information to be used in this way you do not have to do anything.

If you have any concerns or wish to prevent this from happening, please speak to practice staff or complete the opt out form below and return to the surgery.

More information can be found here

http://www.nhs.uk/caredata

Opt Out Form (.pdf)

Fair Processing Notice

This fair processing notice explains why our Surgery collects information about you and how that information may be used and shared.

The employees and Partners of the Surgery use electronic and paper records to create and maintain an in-depth history of your NHS medical care at the Surgery and elsewhere, to help ensure you receive the best possible healthcare. Anyone who accesses your data within the Surgery can only do so using a ‘smartcard’ that identifies him/her and what he/she accessed.

We comply with the Data Protection Act in ensuring your personal information is as confidential and secure as possible.

WHAT INFORMATION DO YOU HOLD?

Records which The Priory Medical Centre holds about you may include the following information;

• Details about you, such as your address, legal representative, emergency contact details
• Any contact the Surgery has had with you, such as appointments, telephone conversations and letters.
• Notes and reports about your physical (including sexual) and mental health
• Details about your treatment and medications
• Results of investigations such as laboratory tests, x-rays etc
• Relevant information from other health professionals, relatives or those who care for you
• Reports from social services such as child protection reports or police reports if relevant to the care of you or your family
• Private reports sent, at your request, to other organisations

CONFIDENTIALITY

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 and contractors 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.

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 and / or in accordance with the new information sharing principle i.e. “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles. They should be supported by the policies of their employers, regulators and professional bodies.

Your information may be used within The Priory Medical Centre for clinical Audit to monitor the quality of the service provided or ensure we are providing appropriate care.

SHARING YOUR DATA OUTSIDE THE PRACTICE

As a result of improvements in information technology and appropriate information governance standards, it is becoming possible to share your GP records across Coventry & Warwickshire Health & Social Care electronically using the practice clinical system. We will only share this information with your explicit consent, when seeing a health worker so that you are able to allow doctors, nurses and other health and social care services in other health organisations to view the information held on your GP records. Therefore, enabling health organisations to provide an appropriate health service required to meet the patients’ needs.

The following are examples of the types of organisations that we are likely to share information with:

• NHS and specialist hospitals, Trusts
• Independent Contractors such as dentists, opticians, pharmacists
• Private and Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups and Primary Care Networks
• Social Care Services and Local Authorities

Any patient can choose to withdraw their consent to their data being used in this way. When the Surgery 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. These schemes are only for direct care so you (or your carer) will be present when the information is accessed and will be asked for consent again, before your records are opened.

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

Coventry & Warwickshire Integrated Care Record

Priory Medical Centre works with other health and social care organisations to share information that will form part of your Integrated Care Record. The Integrated Care Record allows health and care professionals involved in your care to view your records to help them understand your needs and make the best decisions with you, and for you. Information we hold about you will be available, to read only, to other health and care professionals in Coventry and Warwickshire, Birmingham and Solihull, and Herefordshire and Worcestershire when they are involved in your health or social care. 

For more information on how your data is used on the Integrated Care Record and how to exercise your rights please see the full Privacy Notice or copy and paste this link – https://www.happyhealthylives.uk/integrated-care-record/privacy-notice

NHS Digital Data Collection from the Practice

The NHS needs data about the patients it treats to plan and deliver its services and to ensure that care and treatment provided is safe and effective. The General Practice Data for Planning and Research data collection will help the NHS to improve health and care services for everyone by collecting patient data that can be used to do this. For example patient data can help the NHS to:

• monitor the long-term safety and effectiveness of care
• plan how to deliver better health and care services
• prevent the spread of infectious diseases
• identify new treatments and medicines through health research

GP practices already share patient data for these purposes, but this new data collection will be more efficient and effective.

This means that GPs can get on with looking after their patients, and NHS Digital can provide controlled access to patient data to the NHS and other organisations who need to use it, to improve health and care for everyone.

Contributing to research projects will benefit us all as better and safer treatments are introduced more quickly and effectively without compromising your privacy and confidentiality.

NHS Digital has engaged with the British Medical Association (BMA), Royal College of GPs (RCGP) and the National Data Guardian (NDG) to ensure relevant safeguards are in place for patients and GP practices.

NHS Digital purposes for processing patient data

Patient data from GP medical records kept by GP practices in England is used every day to improve health, care and services through planning and research, helping to find better treatments and improve patient care. The NHS is introducing an improved way to share this information - called the General Practice Data for Planning and Research data collection.

NHS Digital will collect, analyse, publish and share this patient data to improve health and care services for everyone. This includes:

• informing and developing health and social care policy
• planning and commissioning health and care services
• taking steps to protect public health (including managing and monitoring the coronavirus pandemic)
• in exceptional circumstances, providing you with individual care
• enabling healthcare and scientific research

Any data that NHS Digital collects will only be used for health and care purposes. It is never shared with marketing or insurance companies.

What patient data NHS Digital collect

This collection will start from 1 September 2021. Patient data will be collected from GP medical records about:

• any living patient registered at a GP practice in England when the collection started - this includes children and adults
• any patient who died after the data collection started, and was previously registered at a GP practice in England when the data collection started

We will not collect your name or where you live. Any other data that could directly identify you, for example NHS number, General Practice Local Patient Number, full postcode and date of birth, is replaced with unique codes which are produced by de-identification software before the data is shared with NHS Digital.

This process is called pseudonymisation and means that no one will be able to directly identify you in the data. The diagram below helps to explain what this means. Using the terms in the diagram, the data we collect would be described as de-personalised.

NHS Digital will be able to use the same software to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason. Only NHS Digital has the ability to do this. This would mean that the data became personally identifiable data in the diagram above. An example would be where you consent to your identifiable data being shared with a research project or clinical trial in which you are participating, as they need to know the data is about you.

More information about when we may be able to re-identify the data is in the who we share your patient data with section below.  

The Data NHS Digital collect

We will only collect structured and coded data from patient medical records that is needed for specific health and social care purposes explained above.

Data that directly identifies you as an individual patient, including your NHS number, General Practice Local Patient Number, full postcode, date of birth and if relevant date of death, is replaced with unique codes produced by de-identification software before it is sent to NHS Digital. This means that no one will be able to directly identify you in the data.

NHS Digital will be able to use the software to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason. This would mean that the data became personally identifiable in the diagram above. It will still be held securely and protected, including when it is shared by NHS Digital. 

NHS Digital will collect 

• data on your sex, ethnicity and sexual orientation
• clinical codes and data about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals and recalls, and appointments, including information about your physical, mental and sexual health
• data about staff who have treated you

More detailed information about the patient data we collect is contained in the Data Provision Notice issued to GP practices.

NHS Digital Does not collect.

• your name and address (except for your postcode in unique coded form)
• written notes (free text), such as the details of conversations with doctors and nurses
• images, letters and documents
• coded data that is not needed due to its age – for example medication, referral and appointment data that is over 10 years old
• coded data that GPs are not permitted to share by law – for example certain codes about IVF treatment, and certain information about gender re-assignment

Opting out of NHS Digital collecting your data (Type 1 Opt-out)

If you do not want your identifiable patient data (personally identifiable data in the diagram above) to be shared outside of your GP practice for purposes except for your own care, you can register an opt-out with your GP practice. This is known as a Type 1 Opt-out.

Type 1 Opt-outs were introduced in 2013 for data sharing from GP practices, but may be discontinued in the future as a new opt-out has since been introduced to cover the broader health and care system, called the National Data Opt-out. If this happens people who have registered a Type 1 Opt-out will be informed. More about National Data Opt-outs is in the section Who we share patient data with.

NHS Digital will not collect any patient data for patients who have already registered a Type 1 Opt-out in line with current policy. If this changes patients who have registered a Type 1 Opt-out will be informed.

If you do not want your patient data shared with NHS Digital, you can register a Type 1 Opt-out with your GP practice. You can register a Type 1 Opt-out at any time. You can also change your mind at any time and withdraw a Type 1 Opt-out.

Data sharing with NHS Digital will start on 1 September 2021.

If you have already registered a Type 1 Opt-out with your GP practice your data will not be shared with NHS Digital.

If you wish to register a Type 1 Opt-out with your GP practice before data sharing starts with NHS Digital, this should be done by returning this form to your GP practice. If you have previously registered a Type 1 Opt-out and you would like to withdraw this, you can also use the form to do this. You can send the form by post or email to your GP practice or call 0300 3035678 for a form to be sent out to you.

If you register a Type 1 Opt-out after your patient data has already been shared with NHS Digital, no more of your data will be shared with NHS Digital. NHS Digital will however still hold the patient data which was shared with us before you registered the Type 1 Opt-out.

If you do not want NHS Digital to share your identifiable patient data (personally identifiable data in the diagram above) with anyone else for purposes beyond your own care, then you can also register a National Data Opt-out. There is more about National Data Opt-outs and when they apply in the National Data Opt-out section below.

NHS Digital legal basis for collecting, analysing and sharing patient data.

When we collect, analyse, publish and share patient data, there are strict laws in place that we must follow. Under the UK General Data Protection Regulation (GDPR), this includes explaining to you what legal provisions apply under GDPR that allows us to process patient data. The GDPR protects everyone's data.

NHS Digital has been directed by the Secretary of State for Health and Social Care under the General Practice Data for Planning and Research Directions 2021 to collect and analyse data from GP practices for health and social care purposes including policy, planning, commissioning, public health and research purposes.

NHS Digital is the controller of the patient data collected and analysed under the GDPR jointly with the Secretary of State for Health and Social Care.

All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the Data Provision Notice issued by NHS Digital to GP practices.

NHS Digital has various powers to publish anonymous statistical data and to share patient data under sections 260 and 261 of the 2012 Act. It also has powers to share data under other Acts, for example the Statistics and Registration Service Act 2007.

Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002 (COPI) also allow confidential patient information to be used and shared appropriately and lawfully in a public health emergency. The Secretary of State has issued legal notices under COPI (COPI Notices) requiring NHS Digital, NHS England and Improvement, arm's-length bodies (such as Public Health England), local authorities, NHS trusts, clinical commissioning groups and GP practices to share confidential patient information to respond to the COVID-19 outbreak. Any information used or shared during the COVID-19 outbreak will be limited to the period of the outbreak unless there is another legal basis to use confidential patient information. 

The legal basis under GDPR for General Practice Data for Planning and Research

How NHS Digital use patient data

NHS Digital will analyse and link the patient data we collect with other patient data we hold to create national data sets and for data quality purposes.

NHS Digital will be able to use the de-identification software to convert the unique codes back to data that could directly identify you in certain circumstances for these purposes, where this is necessary and where there is a valid legal reason. There are strict internal approvals which need to be in place before we can do this and this will be subject to independent scrutiny and oversight by the Independent Group Advising on the Release of Data (IGARD).

These national data  sets are analysed and used by NHS Digital to produce national statistics and management information, including public dashboards about health and social care which are published. We never publish any patient data that could identify you. All data we publish is anonymous statistical data.

For more information about data we publish see Data and Information and Data Dashboards.

We may also carry out analysis on national data sets for data quality purposes and to support the work of others for the purposes set out in Our purposes for processing patient data section above.

Who NHS Digital share patient data with

All data which is shared by NHS Digital is subject to robust rules relating to privacy, security and confidentiality and only the minimum amount of data necessary to achieve the relevant health and social care purpose will be shared.

All requests to access patient data from this collection, other than anonymous aggregate statistical data, will be assessed by NHS Digital’s Data Access Request Service, to make sure that organisations have a legal basis to use the data and that it will be used safely, securely and appropriately.

These requests for access to patient data will also be subject to independent scrutiny and oversight by the Independent Group Advising on the Release of Data (IGARD). Organisations approved to use this data will be required to enter into a data sharing agreement with NHS Digital regulating the use of the data.

There are a number of organisations who are likely to need access to different elements of patient data from the General Practice Data for Planning and Research collection. These include but may not be limited to:

• the Department of Health and Social Care and its executive agencies, including Public Health England and other government departments
• NHS England and NHS Improvement
• primary care networks (PCNs), clinical commissioning groups (CCGs) and integrated care organisations (ICOs)
• local authorities
• research organisations, including universities, charities, clinical research organisations that run clinical trials and pharmaceutical companies

If the request is approved, the data will either be made available within a secure data access environment within NHS Digital infrastructure, or where the needs of the recipient cannot be met this way, as a direct dissemination of data. We plan to reduce the amount of data being processed outside central, secure data environments and increase the data we make available to be accessed via our secure data access environment. For more information read about improved data access in improving our data processing services.

Data will always be shared in the uniquely coded form (de-personalised data in the diagram above) unless in the circumstances of any specific request it is necessary for it to be provided in an identifiable form (personally identifiable data in the diagram above). For example, when express patient consent has been given to a researcher to link patient data from the General Practice for Planning and Research collection to data the researcher has already obtained from the patient.

It is therefore possible for NHS Digital to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason which permits this without breaching the common law duty of confidentiality. This would include:

• where the data was needed by a health professional for your own care and treatment
• where you have expressly consented to this, for example to participate in a clinical trial
• where there is a legal obligation, for example where the COPI Notices apply - see Our legal basis for collecting, analysing and sharing patient data above for more information on this

This would mean that the data was personally identifiable in the diagram above. Re-identification of the data would only take place following approval of the specific request through the Data Access Request Service, and subject to independent assurance by IGARD and consultation with the Professional Advisory Group, which is made up of representatives from the BMA and the RCGP. If you have registered a National Data Opt-out, this would be applied in accordance with the National Data Opt-out policy before any identifiable patient data (personally identifiable data in the diagram above) about you was shared. More about the National Data Opt-out is in the section below.

Details of who we have shared data with, in what form and for what purposes are published on our data release register.

Where NHS digital stores patient data

NHS Digital only stores and processes patient data for this data collection within the United Kingdom (UK).

Fully anonymous data (that does not allow you to be directly or indirectly identified), for example statistical data that is published, may be stored and processed outside of the UK. Some of our processors may process patient data outside of the UK. If they do, we will always ensure that the transfer outside of the UK complies with data protection laws.

RISK STRATIFICATION

Risk stratification is a process for identifying and managing patients who are at a higher risk of emergency hospital admission. This may be because patients have a long term condition such as COPD, cancer or are more frail. NHS England encourages GPs to use risk stratification tools as part of their local strategies for supporting patients with long-term conditions and help reduce the patients’ risk of hospital admissions.

Information about you is collected from a number of sources including NHS Trusts and from The Priory Medical Centre. Your risk is then ‘scored’ after analysis of your anonymous information using computer programmes. Your information is only provided back to your GP or member of your care team in an identifiable form. Risk stratification enables your GP to focus on the prevention of ill health and not just the treatment of sickness.

NATIONAL DATA EXTRACTIONS (Also known as GPES)

The Health and Social Care Act 2012 allows NHS Digital to collate personal confidential data from GP practices without seeking your specific consent. This is extracted in order to make increased use of information from medical records and either used just by the NHS with the intention of improving healthcare and the quality of care delivered to patients or may be sold to external companies such as universities or commercial organisations. Please see below if you do not want your data used in this way.

More information about how NHS Digital uses your data can be found at https://digital.nhs.uk/services/general-practice-extraction-service

WHAT IF I WANT TO SEE MY RECORDS?

You have a right under the Data Protection Act 1998 to access/view information the Surgery holds about you, and to have it amended or removed should it be inaccurate. This is known as ‘the right of subject access’. We are very keen for you to have access to help you manage your own health and maintain the quality of the records about your health. With some provisos, we are now able to give most adults access to their records on-line if they wish. If you would like access on-line, please ask our receptionists.

You can also request a copy of your records in paper form. If you wish to do this, you will need to do the following,

• Your request must be made in writing to the GP - for information from the hospital you should write direct to them
• There will be a charge to have a printed copy of the information held about you
• We are required to respond to you within 40 days
• You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified and your records located

WHAT IF I WANT TO SEE WHO HAS ACCESSED MY RECORDS?

On our computer system called EMIS WEB you can look at your GP Shared Record History to find out when your GP record has been accessed. To do this all you need is the username and password that you use to order prescriptions or make appointments with via our website. (If you have chosen to have sharing functionality disabled this will not be available.) This only covers instances where your record has been accessed outside of The Priory Medical Centre for direct care purposes, i.e. it does not cover accesses by your own GP, and it does not cover the data that gets copied for research and to NHS Digital.

NOTIFICATION

The Data Protection Act 1998 requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.

This information is publicly available on the Information Commissioners Office website www.ico.org.uk

The Surgery is registered with the Information Commissioners Office (ICO) as a data controller under the Data Protection Act 1998. The registration number is Z4794614 and can be viewed online in the public register at https://ico.org.uk/ESDWebPages/Search

OBJECTIONS/COMPLAINTS

Should you have any concerns about how your information is managed at the Surgery, please contact our Practice Manager. If you are still unhappy following a review by the Surgery, you can then complain to the Information Commissioners Office (ICO) via their website (https://ico.org.uk).

If you are happy for your data to be extracted and used for the purposes described in this fair processing notice then you do not need to do anything.

If you do not want your personal data being extracted and leaving the Surgery for any of the purposes described, you need to let us know as soon as possible so please speak to the receptionist.

There are 3 levels of opt-out to prevent your data being shared. Each opt-out requires the practice to add a different code to your medical notes. (Please be aware that certain regulation such as child protection and court orders may over-rule your choices.)

1. You do not want your data to leave the Surgery even for direct patient care.
2. You are happy to share your data for your care but do not want NHS Digital extracting your data.
3. You are happy to share your data for your care and improving public health but do not want NHS Digital selling or sharing your data to third parties.

All patients have the right to change their minds and reverse a previous decision. Please contact the Surgery if you change your mind regarding any previous choice.