Ashford CCG is the Data Controller and therefore accountable for the processes described in this Fair Processing Notice which tells you what to expect when and how Ashford CCG collects and handles personal information.
This notice is to inform you of the type of information (including personal information) that we, as your clinical commissioning group (CCG), holds, how that information is used, who we may share that information with, and how we keep it secure and confidential.
What we do
We are responsible for planning, buying and monitoring (also known as commissioning) health services from healthcare providers, such as hospitals and GP practices, for our local population to ensure the highest quality of healthcare. We also have a performance monitoring role of these services, which includes responding to any concerns from our patients on services offered.
How we use your information
We hold some information about you and this document outlines how that information is used, who we may share that information with, how we keep it secure (confidential) and what your rights are in relation to this.
What are Primary Care Data and Secondary Care Data?
As many people's first point of contact with the NHS, around 90 per cent of patient interaction is with primary care services, e.g. GP Practices. In addition to GP practices, primary care covers dental practices, community pharmacies and high street optometrists. Primary Care Data relates to information which has been sourced from these types of services.
Secondary Care covers treatment and care of a specialised medical service by Clinicians, for example, specialist doctors and nurses, within a health facility or hospital on referral by a primary care clinician (e.g. your GP). Secondary Care data relates to information which have been sourced from these types of services.
The Secondary Uses Service (SUS) is the single, comprehensive repository for healthcare data in England which enables a range of reporting and analyses to support the NHS in the delivery of healthcare services. When a patient or service user is treated or cared for, information is collected which supports their treatment. For further information, please visit NHS Digital’s website.
SUS data is useful to commissioners and providers of NHS-funded care for 'secondary' purposes - purposes other than direct or 'primary' clinical care, as we have stated previously like how the CCG uses information. We go into more detail within the ‘Do you share my information with other organisations’ section below.
What kind of information do we use?
We use the above types of data to plan health care services. Specifically, we use it to:
- check the quality and efficiency of the health services we commission;
- prepare performance reports on the services we commission;
- work out what illnesses people will have in the future, so we can plan and prioritise services and ensure these meet the needs of patients in the future; and
- review the care being provided to make sure it is of the highest standard.
Do you share my information with other organisations?
We commission a number of organisations (both within and outside the NHS) to provide healthcare services to you. A full list of services can be found on our services page. We may also share anonymised statistical information with them for the purpose of improving local services: for example, understanding how health conditions spread across our local area compared to other areas.
The law provides some NHS bodies, particularly NHS Digital (Health and Social Care Information Centre (HSCIC)) ways of collecting and using patient data that cannot identify a person to help commissioners design and procure the combination of services that best suit the population they serve.
Data may be linked and de-identified by these special bodies so that it can be used to improve health care and development, and monitor NHS performance. Where data is used for these statistical purposes, stringent measures are taken to ensure individual patients cannot be identified.
When analysing current health services and proposals for developing future services, it is sometimes necessary to link separate individual datasets to be able to produce a comprehensive evaluation. This may involve linking primary care GP data with secondary care secondary uses service (SUS) data (inpatient, outpatient and A&E).
In some cases there may also be a need to link local datasets, which could include a range of acute hospital-based services such as radiology, physiotherapy and audiology, as well as mental health and community-based services such as IAPT (Improving Access to Psychological Therapies), district nursing and podiatry. When carrying out this analysis, the linking of these datasets is always done using a pseudonym as the CCG does not have access to patient identifiable data without consent from the patient or for purposes other than direct treatment and care of a patient.
The following are the types of organisations NHS Digital (HSCIC) receives data from, and then forwards on to our data processor in a de-identified format or a dataset with a weakly pseudonym identifier (NHS Number) format to link and analysis the data.
Types of organisations and types of information we receive:
- Acute Trusts – Hospitals, for example East Kent Hospitals University Foundation Trust. We receive pseudonymised acute data such as A&E attendances, waiting times, diagnosis, treatments, and follow ups, length of stay, discharge information and next steps.
- Community trusts or community organisations – for example Kent Community Health Foundation NHS Trust. We receive pseudonymised community data such as outpatient information, waiting times, diagnosis and treatments, referrals and next steps, domiciliary and district nursing (which includes home visits) and community rehabilitation units.
- Mental Health Trusts or Mental Health organisations – for example Kent and Medway NHS and Social Care Partnership Trust. We receive pseudonymised mental health data such as rehabilitation and outpatient attendances, waiting times, diagnosis, treatment, length of stay, discharge, referrals and next steps.
- Primary Care organisations, for example your local GP practice. We receive pseudonymised primary care data such as attendances, diagnosis, treatment, GP or GP practice visits, referrals, medication/prescriptions information, follow-ups and next steps.
It is also important to note that if you receive treatment in another part of the country, for example if you are on holiday, NHS Digital (HSCIC) will receive information about your treatment. We will receive this information in a de-identified dataset in accordance with point 2 and 3 above within the ‘what kind of information do we use’, as it’s important to link and analyse your patient pathway.
We may also contract with other organisations to process data. We ensure external data processors that support us are legally and contractually bound to operate this process. They must be able to prove security arrangements are in place where data that could or does identify a person is processed.
Currently, the external data processors we work with include (amongst others):
- Optum CSS
- NHS NEL Commissioning Support Unit
This is how all the above processing works:
*'Data Services for Commissioners Regional Offices’
Ashford CCG uses a Data Processor, Optum CSS for validation of invoices.
The validation of invoices is undertaken in line with NHS requirements to ensure that the CCG is paying for treatments relating to its patients only. Optum CSS receives identifiable data into their Controlled Environment for Finance (CEfF) to securely support the invoice validation process. As Data Processor for the CCG, Optum CSS is allowed to process Personal Confidential Data (PCD) which is required for invoice validation purposes. This approval is subject to a set of conditions. The legal basis for this processing is under the Health Service (Control of Patient Information) Regulations 2002 (a) also known as ‘section 251 support’) and details of Confidentiality Advisory Group (CAG) approval CAG 7-07(a-c)/2013 are provided at https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/confidentiality-advisory-group-registers/
Optum CSS also receives pseudonymised information from Arden and GEM CSU and undertake a number of checks to ensure invoices are valid and should be paid for by the CCG. The CCG does no receive or see any patient level information relating to these invoices.
Your GP uses your data to provide the best care they can for you. As part of this process, your GP will use your personal and health data to undertake risk stratification, also known as case finding.
Risk stratification involves applying computer based algorithms, or calculations, to identify those patients registered with the GP Surgery who are most at risk from certain medical conditions and who will benefit from clinical care to help prevent or better treat their condition.
To identify those patients individually from the patient community registered with your GP would be a lengthy and time-consuming process, which would by its nature potentially not identify individuals quickly and increase the time to improve care.
Your GP Surgery uses the services of a health partner, Optum CSS, to identify those most in need of preventative or improved care. This contract is arranged by us.
Neither we nor Optum CSS will at any time have access to your personal or confidential data. They act on behalf of your GP to organise this service with appropriate contractual and security measures.
Your personal and confidential data is extracted from your GP computer system and will be processed without any staff being able to view the data. Typically they will process your data using indicators such as your age, gender, NHS number and codes for your medical health to identify those who will benefit from clinical intervention.
Only your GP is able to view the outcome and will make the decision on whether you should be contacted with the offer of any extra clinical assistance.
We have implemented strict security controls to protect your confidentiality and recommend this as a secure and beneficial service to you. At all times, your GP remains accountable for how your data is processed. . If you do not wish your information to be used in this way, you can inform your GP that you would like to ‘opt out’ using either Type 1 or Type 2 Opt Outs, see below for more detail on the Opt Outs. Your GP will mark your record with either Type 1 or Type 2 Opt Out so it is not sent to Optum for risk stratification purposes
The lawful basis to use this information for risk stratification has been allowed by s251 NHS Act 2006 and is processed by Optum or other approved providers only. Further information on risk stratification is provided on the NHS England website at the following page (Risk Stratification) and on the Confidentiality Advisory Group (CAG) at CAG
Managing conflicts of interest
We manage conflicts of interest as part of our day-to-day activities. Effective handling of conflicts of interest is crucial to give confidence to patients, tax payers, healthcare providers and parliament that CCG commissioning decisions are robust, fair, transparent and offer value for money. It is essential in order to protect healthcare professionals and maintain public trust in the NHS. Failure to manage conflicts of interest could lead to legal challenge and even criminal action in the event of fraud, bribery and corruption.
Section 140 of the National Health Service Act 2006 (as amended by the Health and Social Care Act 2012) (“the Act”) sets out the minimum requirements of what both NHS England and CCGs must do in terms of managing conflicts of interest.
Any persons who are included in the declaration of interest registers can contact the Head of Corporate Services at Ashford CCG:
Eureka Business Park
Patient right to object to processing/opt-out
There are choices you can make about how your information is used, and you can choose to opt out of your information being shared or used for any purpose beyond providing your care. Please note that not choosing to share your information may have an impact on your care and by sharing your information will improve NHS services and the experience of treatment and care for our patients.
If you do not want your information to be used for any purpose beyond providing your care you can choose to opt-out. If you wish to do so, please inform your GP practice and they will mark your choice in your medical record.
There are two types of opt-out. You can withdraw either opt-out at any time by informing your GP practice.
Type 1 opt-outs
If you do not want information that identifies you to be shared outside your GP practice, for purposes beyond your direct care, you can register a type 1 opt-out with your GP practice. This prevents your personal confidential information from being used other than in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease.
Type 2 opt-outs
NHS Digital (HSCIC) collects information from a range of places where people receive care, such as hospitals and community services. If you do not want your personal confidential information to be shared outside of NHS Digital (HSCIC), for purposes other than for your direct care, you can register a type 2 opt-out with your GP practice.
A direction from Secretary of State sets out the Department of Health policy as to how type 2 opt-outs must be applied and instructs NHS Digital (HSCIC) to apply type 2 opt-outs from 29 April 2016.
When NHS Digital (HSCIS) has collected information about your type 2 opt-out from your GP practice they use that to create a record of all current type 2 opt-outs. Then NHS Digital use that record to check against any set of data that is to be made available by NHS Digital (HSCIC) to another organisation and remove all of your personal confidential information if it is in that data set, before that data are made available.
The direction sets out the scope of when your type 2 opt-out does not apply, such as when there is a legal requirement to release information, or where you have given your consent to a specific release of your information.
There are also some limited circumstances, which are set out in the direction, when we don't apply your type 2 opt-out to information made available. These are cases where:
- The Secretary of State for health has identified the information flow is very important.
- There are complex technical barriers that make it very difficult to apply opt-outs.
For more information on how we collect and use opt-out information see Applying Type 2 Opt Outs
For more information about care records and how to access them see NHS Choices. For details about how public bodies must make information available, see the model publication scheme published by the Information Commissioner's Office.
How long we will keep your information and how we will destroy information
There are different retention schedules for different types of information and types of record. In the NHS, all commissioners and providers apply retention schedules in accordance with the Information Governance Alliance’s Records Management Code of Practice for Health and Social Care.
- NHS organisations have the responsibility to ensure that NHS information held in manual form (regardless of whether originally or printed from the IT systems) is destroyed using a cross cut shredder or subcontracted to a reputable confidential waste company that complies with European Standard EN15713.
- NHS organisations also ensure that electronic storage media used to hold or process NHS Information is destroyed or overwritten to current CESG standards as defined at www.cesg.gov.uk. NHS ICT Teams usually carry out or contract out to an approved company to ensure the secure destruction or permanent removal of information from ICT equipment which are NHS assets. In the event of any bad or unusable sectors that cannot be overwritten, the NHS ICT Team or approved contractor shall ensure complete and irretrievable destruction of the media itself.
- It is the responsibility of NHS organisations to retain copies of all relevant overwriting verification reports and/or certificates of secure destruction of NHS information at the conclusion of the contract.
- Any arrangement made by NHS organisations to sub-contract secure disposal services from another provider, must comply with clause GC 12 of the NHS Standard Contract and with assurance that the sub-contractor’s organisational and technical security measures comply with the 7th Data Protection Act 1998 principle.
Relevant links to associated documents or organisations:
If you would like to find out more information on the wider health and care system approach to using personal information or other useful information, please click on the following links: