Your Personal Information and How We Use Your Information

Your information, what you need to know

This privacy notice explains why we collect information about you, how that information will be used, how we keep it safe and confidential and what your rights are in relation to this.

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.  These records help to provide you with the best possible healthcare and help us to protect your safety.

We collect and hold data for the purpose of providing healthcare services to our patients and running our organisation which includes monitoring the quality of care that we provide. In carrying out this role we will collect information about you which helps us respond to your queries or secure specialist services. We will keep your information in written form and/or in digital form.

Our Commitment to Data Privacy and Confidentiality Issues

As a GP practice, all of our GPs, staff and associated practitioners are committed to protecting your privacy and will only process data in accordance with the Data Protection Legislation.  This includes the General Data Protection Regulation (EU) 2016/679  (GDPR), the Data Protection Act (DPA) 2018, the Law Enforcement Directive (Directive (EU) 2016/680) (LED) and any applicable national Laws implementing them as amended from time to time.  The legislation requires us to process personal data only if there is a legitimate basis for doing so and that any processing must be fair and lawful.

In addition, consideration will also be given to all applicable Law concerning privacy, confidentiality, the processing and sharing of personal data including the Human Rights Act 1998, the Health and Social Care Act 2012 as amended by the Health and Social Care (Safety and Quality) Act 2015, the common law duty of confidentiality and the Privacy and Electronic Communications (EC Directive) Regulations.

Data we collect about you

Records which this GP Practice will hold, or share, about you will include the following:

Personal Data

Personal data means any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.

Special Categories of Personal Data

This term describes personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.

Confidential Patient Information

This term describes information or data relating to their health and other matters disclosed to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. Including both information ‘given in confidence’ and ‘that which is owed a duty of confidence’. As described in the Confidentiality: NHS code of Practice: Department of Health guidance on confidentiality 2003.

Pseudonymised

The process of distinguishing individuals in a dataset by using a unique identifier which does not reveal their ‘real world’ identity.

Anonymised

Data in a form that does not identify individuals and where identification through its combination with other data is not likely to take place.

Aggregated

Statistical data about several individuals that has been combined to show general trends or values without identifying individuals within the data.

How we use your information

Improvements in information technology are also making it possible for us to share data with other healthcare organisations for the purpose of providing you, your family and your community with better care.  For example it is possible for healthcare professionals in other services to access your record with your permission when the practice is closed.  This is explained further as an Activity under ‘Local Information Sharing’ at Appendix A.

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 care 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.

A full list of activities including the legal basis, any Data Processor involvement and the purposes for processing information can be found in Appendix A.

Medical student placements (trainee GPs)

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.

How long do we hold information for?

All records held by the Practice will be kept for the duration specified by national guidance from NHS Digital, Health and Social Care Records Code of Practice. Once information that we hold has been identified for destruction it will be disposed of in the most appropriate way for the type of information it is. Personal confidential and commercially confidential information will be disposed of by approved and secure confidential waste procedures. We keep a record of retention schedules within our information asset registers, in line with the Records Management Code of Practice for Health and Social Care 2016.

Individuals Rights under GDPR

Under GDPR 2018 the Law provides the following rights for individuals (the NHS upholds these in various ways).

• The right to be informed
• The right of access
• The right to rectification
• The right to erasure (not an absolute right) only applies in certain circumstances
• The right to restrict processing
• The right to data portability
• The right to object
• Rights in relation to automated decision making and profiling.

Your right to opt out of data sharing and processing

The NHS Constitution states ‘You have a right to request that your confidential information is not used beyond your own care and treatment and to have your objections considered’. For further information please visit: the NHS Digital website to download the NHS Constitution.

Type 1 Opt Out

This is an objection that prevents an individual’s personal confidential information from being shared outside of their general practice except when it is being used for the purposes of direct care, or in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease. Patients who wish to apply a Type 1 Opt Out to their record they should make their wishes know to the practice secretaries.

National Data Opt-Out

The national data opt-out was introduced on 25 May 2018, enabling patients to opt-out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.  By 30 September 2021 all health and care organisations are required to apply national data opt-outs where confidential patient information is used for research and planning purposes.

The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to share a patient’s confidential patient information for purposes beyond their individual care. Any patient that had a type 2 opt-out recorded on or before 11 October 2018 has had it automatically converted to a national data opt-out. Those aged 13 or over were sent a letter giving them more information and a leaflet explaining the national data opt-out.  For more information go to National data opt out programme.  To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters where 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

Kintbury & Woolton Hill Surgery is compliant with the national data opt-out policy.

Access to your information (Subject Access Request)

Under Data Protection Legislation everybody has the right to have access to, or request a copy of, information we hold that can identify you, this includes your medical record.  There are some safeguards regarding what you will have access to and you may find information has been redacted or removed for the following reasons;

• does not cause harm to the patient
• that legal confidentiality obligations for the non-disclosure of third-party information are adhered to.

You do not need to give a reason to see your data and requests can be made verbally or in writing. We may ask you to complete a form in order that we can ensure that you have the correct information you require. Where multiple copies of the same information is requested, the surgery may charge a reasonable fee for the extra copies. You will need to provide proof of identity to receive this information. If you would like to access your GP record online please ask reception for our online access request form.

Change of Details

It is important that you tell the surgery if any of your contact details such as your name or address have changed, especially if any of your other contacts details are incorrect. It is important that we are made aware of any changes immediately in order that no information is shared in error and that we can contact you in an emergency.

Mobile telephone number

If you provide us with your mobile phone number, we may use this to send you text reminders about your appointments or other health screening information. Please let us know if you do not wish to receive text reminders on your mobile.

Email address

Where you have provided us with your email address, with your consent we will use this to send you information relating to your health and the services we provide.  If you do not wish to receive communications by email please let us know.

Notification

Data Protection Legislation requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information. We are registered as a (Data) Controller and our registration can be viewed online in the public register at:  www.ico.org.uk and any changes to our privacy notices will be promptly updated and displayed in the practice waiting rooms.

Data Protection Officer

Our designated Data Protection Officer is: Seraphim Patel DPO, who is contactable via the practice. Should you have any data protection questions or concerns, please contact her via the surgery by email at: j82054.gdpr@nhs.net.

What is the right to know?

The Freedom of Information Act 2000 (FOIA) gives people a general right of access to information held by or on behalf of public authorities, promoting a culture of openness and accountability across the public sector.  You can request any non-personal information that the GP Practice holds, that does not fall under an exemption.  You may not ask for information that is covered by the Data Protection Legislation under FOIA.  However you have the right to request this under a Subject Access Request (SAR)  – see section above ‘Access to your Information’.

Right to Complain

If you have concerns or are unhappy about any of our services, please contact the Practice Manager via the surgery on j82054.gdpr@nhs.net.  For independent advice about data protection, privacy and data-sharing issues, you can contact the ICO: The Information Commissioner, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF. Phone: 0303 123 1113. Website: www.ico.org.uk/contact-us.

The NHS Care Records Guarantee

The NHS Care Records Guarantee sets out the rules that govern how patient information is used in the NHS, what control and rights individuals have to request copies of their data and how data is protected under Data Protection Legislation.

The NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to.  These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programs available to you, confidentiality, information and your right to complain if things go wrong.

Lawful basis for processing

The processing of personal data in the delivery of direct care and for providers’ administrative purposes in this practice and in support of direct care elsewhere is supported under Articles 6 and 9 conditions of the GDPR:

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’; and
• 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…”

Reviews of and Changes to our Privacy Notices

We will keep our Privacy Notices under regular review. This policy was last reviewed in March 2021.

Appendix A

The practice will share your information with the following organisations where there is a legal basis to do so.

Activity	Rationale
Local Information Sharing, Summary Care Record, GP Connect,	Purpose – The NHS in 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 when you need urgent and safe care, where such information would otherwise be unavailable. Local information sharing also applies to the Out Of Hours service and in our provision of extended access should our patients chose to be seen and treated by GPs in the evening and at weekends at another local practice, if they prefer. Your information is only accessed and used by authorised Health and Social Care professionals, involved in providing or supporting your direct care. Your permission will be asked before the information is accessed, other than in exceptional circumstances (e.g. emergencies), if the healthcare professional is unable to ask you and this is deemed to be in your best interests (which will then be logged). Legal Basis –  Direct Care 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 or telephone. If you wish to opt-out of having an SCR please return a completed opt-out form to the practice. Processor – NHS England and NHS Digital, Local GP Practices Berkshire West CCG, Berkshire, Hampshire, Swindon or Oxfordshire based organisations NHS Foundation Trusts
Child Health Information Service	Purpose – To ensure children have the opportunity to have immunisations and health checks when they are due, to share information about childhood immunisations, the 6-8 week new baby checks and breastfeeding status with Health Visitors and School Nurses. Legal Basis –  Contractual Processor –  Berkshire West Clinical Commissioning Group (CCG)
CCG, PCN, Clinical Audits	Purpose – Anonymous data is used by the CCG/PCN for planning and performance and to monitor the quality of the service provided to patient with long-term conditions, as directed in the practice’s contract. When required information will be held centrally and used for statistical purposes (e.g. the National Diabetes Audit, practice-led local diabetes review meetings with Health Care professionals). Strict measures are undertaken to ensure patients are not identifiable. Legal Basis –  Contractual Processor –  Berkshire West Clinical Commissioning Group (CCG), West Berkshire Rural PCN
Individual Funding Requests	Purpose – We may need to process your personal information where we are required to fund specific treatment for you for a particular condition that is not already covered in our contracts. Legal Basis – The clinical professional who first identifies that you may need the treatment will explain to you the information that is needed to be collected and processed in order to assess your needs and commission your care; they will gain your explicit consent to share this. You have the right to withdraw your consent at any time. Data processors –  e.g. Healthcare provisioning and multi-insurance groups
Safeguarding Adults	Purpose – We will share personal confidential information with the safeguarding team where there is a need to assess and evaluate any safeguarding concerns. Legal Basis – Because of public Interest issues, e.g. to protect the safety and welfare of vulnerable adults, we will rely on a statutory basis rather than consent to process information for this use. Data Processors –  Hampshire County Council/West Berkshire Council
Safeguarding Children	Purpose – We will share children’s personal information where there is a need to assess and evaluate any safeguarding concerns. Legal Basis – Because of public Interest issues, e.g. to protect the safety and welfare of Safeguarding we will rely on a statutory basis rather than consent to share information for this use. Data Processors – Hants Safeguarding Team/West Berkshire Referral Centre
Risk Stratification,  Preventative Care	Purpose – ‘Risk stratification for case finding’ is a process for identifying and managing patients who have or may be at-risk of health conditions (such as diabetes) or who are most likely to need healthcare services (such as people with frailty). 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 before it develops. Information about you is collected from a number of sources including NHS Trusts, GP Federations and your GP Practice. A risk score is then arrived at through an analysis of your de-identified information.  This can help us identify and offer you additional services to improve your health.  If you do not wish inform-ation about you to be included in any risk stratification programmes, please let us know. We can add a code to your records that will stop your information from being used for this purpose. Please be aware that this may limit the ability of healthcare professionals to identify if you have or are at risk of developing certain serious health conditions. Type of Data – Identifiable/Pseudonymised/Anonymised/Aggregate Data Legal Basis – GDPR Art. 6(1) (e) and Art.9 (2) (h). The use of identifiable data by CCGs and GPs for risk stratification has been approved by the Secretary of State, through the Confidentiality Advisory Group of the Health Research Authority (approval reference (CAG 7-04)(a)/2013)) and this approval has been extended to the end of September 2020 NHS England Risk Stratification  which gives us a statutory legal basis under Section 251 of the NHS Act 2006 to process data for risk stratification purposes which sets aside the duty of confidentiality. We are committed to conducting risk stratification effectively, in ways that are consistent with the laws that protect your confidentiality. Processors – NHS South, Central and West Commissioning Support Unit (SCW)
Public Health Screening programmes (identifiable) Notifiable diseases (identifiable) Sexual health (anonymous)	Purpose – Personal identifiable and anonymous data is shared. The NHS provides national screening programmes so that certain diseases can be detected at an early stage. These currently apply to bowel cancer, breast cancer, aortic aneurysms and diabetic retinal screening service. The law allows us to share your contact information with Public Health England so that you can be invited to the relevant screening programme. More information can be found at: https://www.gov.uk/topic/population-screeningprogrammes or speak to the practice Legal Basis – Article 6(1)(e) – “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated above. Data Processors – Public Health and Wellbeing, West Berkshire Council, Health Intelligence (commissioned by NHS England), Hospital Eye Services/NHS Trusts
NHS Digital – General Practice Data for Planning and Research	Purpose – The extracted data will be “pseudonymized” i.e. not directly identifiable, but not fully anonymized – and NHSD reserves the right to de-pseudonymize it in certain circumstances. GPDfPR is the successor to the GPES, to be used for wider purposes than pandemic/COVID research. Legal Basis – Article 6(1)(e) – “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated above. Data Processor – NHS Digital/NHS England
Assessing Treatment Outcomes, NHS Trusts	Purpose – Personal information is shared with other secondary care trusts in order to provide you with direct care services. This could be hospitals or community providers for a range of services, including treatment, operations, physio, and community nursing, ambulance service or to assess the effectiveness of providing psychotherapy to patients with long-term conditions. Legal Basis – The processing of personal data in the delivery of direct care and for providers’ administrative purposes in this surgery and in support of direct care elsewhere is supported under the GDPR Article 6(1)(e) and 9 ((2)(h)conditions as stated above. Processors – e.g. Berkshire Healthcare (BHFT),  Royal Berkshire NHS FT, Hampshire Hospitals NHS FT, NHS Solent Trust, Healthcare NHS Trust, Oxford University NHS FT
Care Quality Commission	Purpose – The CQC is the regulator for the English Health and Social Care services to ensure that safe care is provided. They will inspect and produce reports back to the GP practice on a regular basis. The Law allows the CQC to access identifiable data. More detail on how they ensure compliance with data protection law (including GDPR) and their privacy statement is available on the CQC website: https://www.cqc.org.uk/about-us/our-policies/privacy-statement Legal Basis – Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.” And Article 9(2) (h) as stated above. Processors – Care Quality Commission
Payments, Invoice validation	Purpose – Contract holding GPs in the UK receive payments from their respective governments on a tiered basis. Most of the income is derived from baseline capitation payments made according to the number of patients registered with the practice on quarterly payment days. These amount paid per patient per quarter varies according to the age, sex and other demographic details for each patient. There are also graduated payments made according to the practice’s achievement of certain agreed national quality targets known as the Quality and Outcomes Framework (QOF), for instance the proportion of diabetic patients who have had an annual review. Practices can also receive payments for participating in agreed national or local enhanced services, for instance opening early in the morning or late at night or at the weekends. Practices can also receive payments for certain national initiatives such as immunisation programs and practices may also receive incomes relating to a variety of non-patient related elements such as premises. Finally there are short term initiatives and projects that practices can take part in. Practices or GPs may also receive income for participating in the education of medical students, junior doctors and GPs themselves as well as research. In order to make patient based payments basic and relevant necessary data about you needs to be sent to the various payment services. The release of this data is required by English laws. Legal Basis – Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.” And Article 9(2)(h) ‘as stated above. Data Processors – NHS England, CCG, Public Health West Berkshire
Patient Record data base	Purpose – Your medical record will be shared, in order that a data base can be maintained and managed in a secure way Legal Basis –  Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Processor – Egton Medical Information Systems Ltd (EMIS)
Lexacom digital dictation system	Purpose – Your medical record will be accessed in order to dictate GP referral letters and correspondence and manage workflows in a secure way Legal Basis –  Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Controller – Lexcom Processor – Kintbury & Woolton Hill Surgery
iGPR	Purpose – Your medical record will be shared in order that a report can be provided to agencies such as insurance companies or solicitors. Legal Basis – Your consent will be required to share your record for this purpose. Processor – iGPR
AccurRX, iPlato, Patient Access	Purpose – Your anonymous information will be shared in order to optimise your medication within your record or provide information on your medical appointments and other health-related matters. This will enable your GP to provide a more efficient medication regime and service to you. Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Processors – AccuRX, iPlato Healthcare Ltd, Egton Medical Information Systems Ltd
Medicines Management Team (MOT)	Purpose – your medical record is shared with the medicines management team, in order that your medication can be kept up to date and any changes can be implemented. Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Processor – Berkshire West CCG
GP Federation, Berkshire West Primary Care Networks	Purpose – Your medical record may be shared with surgeries in West Berkshire in order that they can provide direct care services to the patient population. This could be in the form of video consultations, Minor injuries clinics, GP extended access clinics, video or online consultations. Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Processors – West Berkshire Rural PCN, A34, Kennet, West Reading Villages
PCN, Population Health Management	Purpose – Your medical record may be shared with the West Berkshire Rural PCN staff (e.g. Clinical Pharmacists, Social Prescribing Link Workers) in order that they can provide additional care services to the patient population in rural West Berkshire. This approach typically reviews what support and services a particular population group of patients currently receives for their range of health and care needs and consider how this could be improved with multidisciplinary team working. Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) as stated above. Processors – West Berkshire PCN (Kintbury & Woolton Hill, Hungerford and Lambourn Surgeries)
Subject Access Requests	Purpose – Personal information (SAR) may be shared with  a patient/or representative at their request Legal Basis – Contractual agreement with the patient – and consented. Processor – Patients and or their representatives – e.g. family members, solicitors, insurance companies
Medical Reports	Purpose – Personal information will be shared with Insurance companies, or potential or active employers at the patients request. Legal Basis – Consented. Processor – Patients and or their representatives – e.g. Insurance companies, RAF, Navy
Police	Purpose – Personal information may be shared with the police. Legal Basis – Consented under Section 29 of the Data Protection Act or unconsented if the disclosure is in the public interest, under a Court Order or Warrant. Processor – The Police
Coroners	Purpose – Personal information may be shared with the coroner. Legal Basis – Legal Obligation. Processor – The Coroner
Private healthcare providers	Purpose – Personal information will be shared with private healthcare providers at the patients request. Legal Basis – Consented. Processors – e.g. BUPA, Nuffield Health, AXA, Hampshire Clinic etc
DWP	Purpose – Anonymous information on patients issued with a ‘Statement of Fitness for Work’ will be shared for monitoring of Public Health and commissioning and quality of health services. Legal Basis – Legal Obligation. Processor – Department for Work and Pensions
National Registers	National Registries National Registries (such as the Learning Disabilities Register) collect and hold identifiable information about the health status of patients and the care they receive without the need to seek informed consent from each individual service user. Legal Basis – Statutory permission under Section 251 of the NHS Act 2006. Processors – NHS Digital