Dalston Practice - Protecting your Confidentiality - Privacy Notice

Your information, what you need to know
This privacy notice explains why we collect information about you, how that information may be used and how we keep it safe and confidential.

Why we 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. We collect and hold data for the sole purpose of providing healthcare services to our patients. 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.

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 (eg. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records help to provide you with the best possible healthcare, and, as quickly as possible in an emergency.

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

All health related data is seen as ‘special category’ or ‘sensitive data’ under the Data Protection Act 2018 which means that it is shared and processed with particular care. This applies to your data whether it is in electronic formats or on paper.

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:

• Data Protection Act 2018
• General Data Protection Regulation 2018
• 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.

How we use your information

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.

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS.

Clinical Audit

Information may be used for clinical audit to monitor the quality of the service provided. Some of this information may be held centrally and used for statistical purposes. Where we do this we take strict measures to ensure that individual patients cannot be identified e.g. the National Diabetes Audit.

Clinical Research
Occasionally your information may be requested to be used for research purposes. The surgery will always gain your consent before releasing any information for this purpose.

National Registries
National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.

Cabinet Office
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 Data Protection Act 2018.

Data matching by the Cabinet Office is subject to a Code of Practice. 

Information on the Cabinet Office’s legal powers and reasons why it matches particular information: https://www.gov.uk/government/publications/code-of-data-matching-practice-for-national-fraud-initiative

Telephone call recordings

While we do not routinely record all telephone calls in and out of the Practice, the Practice may from time to time record telephone calls with administrative information only. Telephone call recordings may be used to investigate compliance with the Practice’s policies and procedures, to ensure quality, to support the investigation of complaints, to ensure the Practice complies with regulatory procedures and to provide evidence for any regulatory investigation. Call recordings will usually be accessed for the reasons above with the patient’s permission and knowledge. All recordings are stored securely, and in line with our duty of confidentiality to you as detailed above in this notice. We will never share recordings with third party organisations without your explicit consent unless there are exceptional circumstances such as when the health or safety of others is at risk, or where the law requires it.

Risk Stratification

Risk Stratification is a process for identifying and managing patients who are most likely to need hospital or other healthcare services. Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health and not just the treatment of sickness. Information about you is collected from a number of sources including NHS Trusts and from this GP Practice.
Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes. Further information is available from the following link:
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.

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 the 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.

Supporting Medicines Management

The ICS supports local GP practices with prescribing matters which generally don’t require identifiable information. ICS pharmacists work with the 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 ICS medicines management team will order this on behalf of the practice to support your care.

Safeguarding
The practice is dedicated to safeguarding all its patients, including children and vulnerable adults. To ensure that adult and children’s safeguarding matters are managed appropriately, access to identifiable information will be shared in some limited circumstances where it’s legally required for the safety of the individuals concerned.

Summary Care Record (SCR)

NHS England uses a national electronic record called the Summary Care Record (SCR) to support patient care. It contains key information from your GP record. Your SCR provides authorised healthcare staff with faster, secure access to essential information about you in an emergency or when you need unplanned care, where such information would otherwise be unavailable.

Summary Care Records 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.

If you wish to opt-out of having an SCR please ask for and return a completed opt-out form to the practice reception desk.

COVID-19 regulations

Under the COVID-19 Public Health Directions 2020, NHS England has been directed by the Secretary of State for Health and Social Care to establish and operate the OpenSAFELY service. The OpenSAFELY COVID-19 research service provides a secure analytics service that supports COVID-19 research, COVID-19 clinical audit, COVID-19 service evaluation and COVID-19 health surveillance purposes.

Every GP practice is required under the provisions of s259 of the Health and Social Care Act 2012 to provide access to de-identified (pseudonymised) patient data through the OpenSAFELY service.

The service enables individuals (academics, analysts and data scientists) approved by NHS England to run queries on pseudonymised GP and NHS England patient data which is held within the GP system suppliers’ data environments.  Controls are in place to ensure that individuals only have access to aggregated outputs from the service (i.e. they cannot access information that either directly or indirectly identifies individuals).

Local sharing of information from your medical record

Your patient record is held securely and confidentially on our electronic system. If you require attention from a health professional such as an Emergency Department doctor, or Out Of Hours doctor, those treating you are better able to give appropriate care if some of the information from your GP patient record is available to them. This information can, in some cases, be locally shared electronically.

The practice also pools resources with other primary care organisations in the area, including to provide extended access services out of normal practice hours, and to provide other specialist clinics (e.g. for wound care). Such services may be provided as part of our local Primary Care Network (PCN) or in conjunction with other PCNs.

In all cases, information is only used by authorised health and social care professionals in East London organisations, involved in your direct care. Your permission will be asked by the health professional treating you before the information is accessed, unless the professional is unable to ask you and there is a clinical reason for access, which will then be logged.

Data Retention

We will approach the management of patient records in line with the Records Management NHS Code of Practice for Health and Social Care which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England, based on current legal requirements and professional best practice. You can find out more at:

https://www.nhsx.nhs.uk/information-governance/guidance/records-management-code/

Who are our partner organisations?

We may also have to share your information, subject to strict agreements on how it will be used, with the following organisations:

• NHS Trusts / Specialist Trusts
• Other local general practice organisations, including within our Primary Care Network
• Independent Contractors such as dentists, opticians, pharmacies
• Private Sector Providers
• Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups
• Social Care Services
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police
• Other ‘Data Processors’

We will never share your information outside of health and social care partner organisations without your explicit consent unless there are exceptional circumstances such as when the health or safety of others is at risk, where the law requires it or to carry out a statutory function.
Within the health and social care partner organisations (e.g. NHS and Specialist Trusts) and in relation to the above mentioned themes – Risk Stratification, Supporting Medicines Management, Summary Care Record – we will assume you are happy to for your information to be shared unless you choose to opt-out (see below).

This means you will need to express an explicit wish not to have your information shared with other NHS and social care organisations; otherwise they will be automatically shared. We are required by law to report certain information to the appropriate authorities. This is only provided after formal permission has been given by a qualified health professional. There are occasions when we must pass on information, such as notification of new births, where we encounter infectious diseases which may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS), and where a formal court order has been issued. Our guiding principle is that we are holding your records in the strictest confidence.

Your right to withdraw consent for us to share your personal information (Opt-Out)
If you are happy for your data to be extracted and used for the purposes described in this notice then you do not need to do anything. If you do not want your information to be used for any purpose beyond providing your care you can choose to opt-out (see below). We will respect your decision if you do not wish your information to be used for any purpose other than your care but in some circumstances we may still be legally required to disclose your data.

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

https://understandingpatientdata.org.uk/introducing-patient-data (which covers how and why patient information is used, the safeguards and how decisions are made).

Access to your information and the right to object
Under the Data Protection Act 2018 and the General Data Protection Regulation (GDPR) 2018 you have 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.

If you want to access your data you must make the request in writing. Under special circumstances, some information may be withheld. If you wish to have a copy of the information we hold about you, please contact the Practice Manager.

You also have the right to object to information as detailed above in this notice being processed under Article 21 of the General Data Protection Regulation 2018. Please note that in most cases this is not an absolute right, and the right to object will only apply in certain circumstances. Exercising your right to object may prevent us from providing you with effective care, e.g. if you object to us referring you to the most clinically appropriate service for your needs.

Change of Details
The practice uses your contact details to inform you of progress in your treatment and to work with you in managing your health. 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 Numbers & Email Addresses
If you provide us with your mobile phone number, we may use this to send you reminders about your appointments or other health screening information. Please let us know if you do not wish to receive reminders on your mobile. If you provide us with your email address, we may use this to send you reminders to make an appointment for a review. Please let us know if you do not wish to receive correspondence by email.

Notification – Data Controller information
Dalston Practice is registered with the Information Commissioners Office (ICO) to describe the purposes for which we process personal and sensitive information.
We are a registered Data Controller and our registration can be viewed online digitally or alternatively on hardcopy at the practice.

Data Protection Officer
NHS North East London ICB
4th Floor, Unex Tower, 5 Station Rd. London. E15 1DA  Tel: 0800 917 8607

Complaints
If you have concerns or are unhappy about any of our services, please contact:
The Practice Manager
Dalston Practice, 1B Madinah Road, London, E8 1PG

Further Information
Further information about the way in which the NHS uses personal information and your rights in that respect can be found here: www.nhs.uk/your-nhs-data-matters

Reviews of and changes to our Privacy Notice
We will keep our Privacy Notice under regular review. This notice was last reviewed in June 2023.