Activity

• Commissioning and contractual purposes, Invoice Validation, Planning Quality and Performance

Rationale

Purpose – Anonymous data is used by the Integrated Care Board (ICB) for planning, performance and commissioning purposes, as directed in the practices contract, to provide services as a public authority.

Legal Basis – UK GDPR 6 1(b) Contractual obligation as set out in the Health and Social Care Act for Quality and Safety 2015

Patients may opt out of having their personal confidential data used for planning or research.

Please contact your surgery to apply a Type 1 Opt-out or logon to apply a National Data Opt-Out

Data Processor – Berkshire, Buckinghamshire & Oxfordshire ICB

• Summary Care Record Including additional information

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 or when you need unplanned care, where such information would otherwise be unavailable.

Legal Basis – Direct Care under UK 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

Patients have the right to opt out of having their information shared with the SCR by completion of the form which can be downloaded here and returned to the practice. Please note that opting out of having your information shared with the Summary Care Record could result in a delay to care that may be required in an emergency.

Data Processor – NHS England

• Research

Purpose – We may share anonymous or pseudonymised patient information with research companies for the purpose of exploring new ways of providing healthcare and treatment for patients with certain conditions. This data will not be used for any other purpose.
Where personal confidential data is shared your consent will need to be required.

Where you have opted out of having your information shared for this planning or research your information will not be shared.

Legal Basis –

• Articles 6(1)(a) and 9(1)(h) – explicit consent; OR
• Article 6(1)(c) (where we are legally obligated to share your personal data) for your standard personal data and Article 9(2)(j) (scientific research) for your health data.

Where identifiable data is required for research, patient consent will be needed, unless there is a legitimate reason under law to do so or there is support under the Health Service (Control of Patient Information Regulations) 2002 (‘section 251 support’) applying via the Confidentiality Advisory Group in England and Wales Sharing of aggregated non identifiable data is permitted.

Data Processor – NIHR Clinical Research Network, Synexus Clinical Research, and Clinical Practice Research Datalink (CPRD) MHRA

• 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 standard NHS contract.

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 but this may affect the decision to provide individual funding.

Legal Basis –

• 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

Data processor – BOB ICB (Integrated Care Board)

• 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 and to protect the safety of individuals.

Consent is not be required to share information for this purpose.

Legal Basis – in some case consent will be required otherwise

• 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

Data Processor – Oxfordshire Safeguarding Adults Board

• Safeguarding Children  

Purpose – We will share children’s personal information where there is a need to assess and evaluate any safeguarding concerns and to protect the safety of children.

Legal Basis –

• 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

Consent may not be required to share this information.

Data Processor – Oxfordshire Safeguarding Children Board

• 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 information 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 –

• 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

Data processor – BOB ICB (Integrated Care Board)

• Public Health Screening programmes (identifiable)
• Notifiable disease information (identifiable) 
• Smoking cessation (anonymous)
• Sexual health (anonymous)
• Vaccination Programmes

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 to name a few. The law allows us to share your contact information, and certain aspects of information relating to the screening with Public Health England so that you can be appropriately invited to the relevant screening programme.

More information can be found here or speak to the practice.

Patients may not opt out of having their personal information shared for Public Health reasons.
Patients may opt out of being screened at the time of receiving an invitation.

Legal Basis – Sharing personal data for this purpose is governed by the COPI Reg 2.

• Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’
• Article 6 1 (f) Legitimate interests
• Article 9(2)(h) Health data as stated above (see p.7).
• Article 9 2 (i) Public health

Data Processors – Thames Valley Public Health Team, NHS England SE, UK Health Security Agency (HSA) South East, Oxfordshire County Council, Public Health dept

• Direct Care - (NHS Trusts, Community Providers, Pharmacies, Enhanced care providers, Nursing Homes, Other Care Providers.)

Purpose – Personal information is shared with other secondary care trusts and providers in order to provide you with individual direct care services. This could be hospitals or community providers for a range of services, including treatment, operations, physio, and community nursing, ambulance service.

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 following Article 6 1 (e) direct care and 9 2 (h) to provide health or social care:

In some cases patients may be required to consent to having their record opened by the third party provider before patients information is accessed. Where there is an overriding need to access the GP record in order to provide patients with lifesaving care, their consent will not be required.

Data Processors – Oxford Health NHS Foundation Trust, Oxford University Hospitals NHS Foundation Trust, Local pharmacies – you will be informed of which pharmacy you are referred to at the time of booking an appointment with them.

• 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 UK GDPR) and their privacy statement is available here.

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 (see p.7).

Processors – Care Quality Commission

• Population Health Management (BOB ICB, NHS England, The Thames Valley & Surrey (TVS) Care Records.)

Purpose – Health and care services work together as ‘Integrated Care Systems’ (ICS) and are sharing data in order to:

• Understand the health and care needs of the care system’s population, including health inequalities
• Provide support to where it will have the most impact
• Identify early actions to keep people well, not only focusing on people in direct contact with services, but looking to join up care across different partners.

(NB this links to the Risk Stratification activity identified above)

Type of Data – Identifiable/Pseudonymised/Anonymised/Aggregate Data. Only organisations that provide your care will see your identifiable data.

Anonymous data is also shared with the National Association of Primary Care to support work on health inequalities.

In addition to the BOB ICB, the TVS Shared Care Record is also undertaking this activity over the Thames Valley & Surrey area.

To opt out of this data sharing, patients can register a “Type One Opt-Out” with the GP practice.

You can find more information about how to do this on the NHS website.

Legal Basis –

• Article 6(1)(e): “necessary… in the exercise of official authority vested in the controller
• Article 9(2)(g): “processing is necessary for reasons of substantial public interest”
• Article 9(2)(h): “processing is necessary… for the provision of health or social care or treatment or the management of health or social care systems and services”
• Article 9(2)(i): “processing is necessary for reasons of public interest in the area of public health”

Data Processor – Optum, Cerner, Graphnet

• 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 amounts paid per patient per quarter vary according to the age, sex and other patient demographic details.

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.
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 (see p.7).

Data Processors – NHS England, BOB ICB, Public Health

• Patient Record database

Purpose – Your medical record will be processed in order that a database can be maintained, this is managed in a secure way and there are robust processes in place to ensure your medical record is kept accurate, and up to date. Your record will follow you as you change surgeries throughout your life.

Closed records will be archived by NHS England.

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 (see p.7).

Data Processor – EMIS Health and Primary Care Support England (PCSE)

• Medical reports - Subject Access Requests

Purpose – Your medical record may be shared in order that:

• Solicitors/persons acting on your behalf can conduct certain actions as instructed by you.
• Insurance companies seeking a medical report where you have applied for services offered by them can have a copy to your medical history for a specific purpose.

Legal Basis –

• Article 6(1)(a) – consent for personal data; and
• Article 9(2)(a) – explicit consent for special-category data.

Data Processor – iGPR, Solicitors, Insurance organisations

• Medicines Management Team - Medicines Optimisation
   

Purpose – your medical record is shared with the medicines management team pharmacists, in order that your medication can be kept up to date and any necessary changes to medication 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) Health data as stated above (see p.7).

Data Processor – Berkshire, Buckinghamshire & Oxfordshire ICB

GP Federation Providing services such as:

• Urgent Care Centre
• College Nursing
• Primary Consultation & Advice Service (CAS)
• Winter Paediatric Hub
• Community Gynaecology Service

Purpose – Your medical record will be shared with PML 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, Oxford College Nursing Service. The Federation will be acting on behalf of the GP practice.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – PML

Oxford Central Primary Care Network (PCN)

Includes services such as:

• Enhanced Access
• Physiotherapy
• Social prescribing
• COVID vaccination

Purpose – Your medical record will be shared with the Oxford Central PCN in order that they can provide direct care services to the patient population.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – KES@Northgate, 27@Northgate, 28@Northgate, Dr Leaver & Partners, Observatory Medical Practice

Oxford City Primary Care (OCPC) Ltd

Providing services such as:

• Primary Care Visiting Service
• Urgent Care Centre

Purpose – Your medical record will be shared with our local Oxford City Primary Care company in order that they can provide direct care services to the patient population. This could be in the form of the Urgent Care Centre or the Primary Care Visiting service.

Access to the Primary Care record and PCN EMIS Clinical Services care record for both the GP Practice and the cross-organisational multi-disciplinary teams will ensure that healthcare professionals are able to make informed, timely decisions when planning, delivering and/or managing your care and treatment. Authorised staff involved in your care can securely view your primary care record and new information captured can be instantly shared back to your registered GP 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 (see p.7).

Processor – EMIS, Oxford City Primary Care (OCPC), Oxford Central PCN

• Smoking Cessation

Purpose – personal information is shared in order for the smoking cessation service to be provided.

Only those patients who wish to be party to this service will have their data shared.

Legal Basis – Article 6 1 (a) and 9 2 (h) consent

Data Processor – Stop for Life Oxon

• Police

Purpose – Personal confidential information may be shared with the Police authority for certain purposes. The level of sharing and purpose for sharing may vary. Where there is a legal basis for this information to be shared consent will not always be required.

The Police will require the correct documentation in order to make a request. This could be but not limited to, DS 2, Court order, s137, the prevention and detection of a crime. Or where the information is necessary to protect a person or community.

Legal Basis – UK GDPR –6 1 (c) Legal Obligation. Article 6 1 (f) legitimate interest
Article 9 2 (f) requests for legal reasons

Data Processor – Police Constabulary

• Coroner

Purpose – Personal health records or information relating to a deceased patient may be shared with the coroner or medical examiner upon request.

Legal Basis – UK GDPR Article 6 1 (c) Legal Obligation 9 2 (h) Health data

Data Processor – The Coroner

• Medical Examiners’ Office for Oxfordshire

Purpose – Medical records associated with deceased patients are outside scope of the UK GDPR.

However, next of kin details are within the scope of the UK GDPR. We will share specified deceased patient records and next of kin details with the Medical Examiners within Oxford University Hospitals NHS Foundation Trust.

Legal Basis –

• Article 6(1)(c) – necessary under a legal obligation to which the controller is subject”; and
• Article 9(2)(h)– “processing is necessary for the purposes of preventive 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”.

Data Processor – Medical Examiners Service, OUH NHS FT

• Private healthcare providers

Purpose – Personal information shared with private health care providers in order to deliver direct care to patients at the patient’s request. Consent from the patient will be required to share data with Private Providers.

Legal Basis – Article 6 1 (a) and 9 2 (a) Consented and under contract between the patient and the provider

Data Processor – BUPA, Nuffield Health, etc.

Remote consultation Including:

• Video Consultation
• Clinical photography

Purpose – Personal information including images may be processed, stored and with the patients consent shared, in order to provide the patient with urgent medical advice.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Patients may be videoed or asked to provide photographs with consent. There are restrictions on what the practice can accept photographs of. No photographs of the full face, no intimate areas, no pictures of patients who cannot consent to the process. No pictures of children.

Data Processor – e-Consult, Accurx

• MDT Meetings

Purpose – For some long-term conditions, the practice participates in meetings with staff from other agencies involved in providing care, to help plan the best way to provide care to patients with these conditions. Personal data will be shared with other agencies in order that mutual care packages can be decided.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – MS Teams

General Practice Extraction Service (GPES)

1. At risk patients data collection Version 3
2. CVDPREVENT Audit
3. Physical Health Checks for people with Severe Mental Illness
4. National Obesity Audit

Purpose – GP practices are required to provide data extraction of their patients’ personal confidential information for various purposes to NHS Digital. The objective of this data collection is on an ongoing basis to identify patients registered at General Practices who fit within a certain criterion, in order to monitor and either provide direct care, or prevent serious harm to those patients. Below is a list of the purposes for the data extraction, by using the link you can find out the detail behind each data extraction and how your information will be used to inform this essential work:

1. At risk patients including severely clinically vulnerable
2. NHS England has directed NHS Digital to collect and analyse data in connection with Cardiovascular Disease Prevention Audit
3. GPES Physical Health Checks for people with Severe Mental Illness (PHSMI) data collection
4. National Obesity Audit - NHS Digital

Legal Basis – All GP Practices in England are legally required to share data with NHS Digital for this purpose under section 259(1)(a) and (5) of the Health and Social Care 2012 Act

Further detailed legal basis can be found in each link.

Any objections to this data collection should be made directly to NHS Digital.

Data Processor – NHS England

• Medication/Prescribing

Purpose – Prescriptions containing personal identifiable and health data will be shared with organisations who provide medicines management including chemists/pharmacies, in order to provide patients with essential medication regime management, medicines and/or treatment as their health needs dictate. This process is achieved either by face-to-face contact with the patient or electronically.

Pharmacists may be employed to review medication, patients may be referred to pharmacists to assist with diagnosis and care for minor treatment, patients may have specified a nominated pharmacy they may wish their repeat or acute prescriptions to be ordered and sent directly to the pharmacy making a more efficient process. Arrangements can also be made with the pharmacy to deliver care and medication.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – Pharmacy of choice

• Professional Training

Purpose – We are a training surgery. Our clinical team are required to be exposed to on the job, clinical experience, as well as continual professional development. On occasion you may be asked if you are happy to be seen by one of our GP registrars, pharmacists or other clinical team to assist with their training as a clinical professional.

You may also be asked if you would be happy to have a consultation recorded for training purposes. These recordings will be shared and discussed with training GPs at the surgery, and also with moderators at the RCGP and HEE.

Legal Basis –

• 6 1 (a) consent, patients will be asked if they wish to take part in training sessions.
• 9 2 (a) - explicit consent will be required when making recordings of consultations.

Recordings remain the control of the GP practice and they will delete all recordings from the secure site once they are no longer required.

Data Processor – RCGP, HEE

• Telephony

Purpose – The practice uses an internet-based telephony system that records telephone calls, for their own purpose and to assist with patient consultations. The telephone system has been commissioned to assist with the high volume and management of calls into the surgery, which in turn will enable a better service to patients. We record incoming and outgoing calls.

Our phone system is set to automatically retain calls for 3 years. After this point, the recordings are automatically deleted. The 3 year retention period enables us to download and retain exact and unaltered copies of calls where required for medico-legal purposes.

Legal Basis – While there is a robust contract in place with the processor, the surgery has undertaken this service to assist with the direct care of patients in a more efficient way.

• Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ and
• Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – Surgery Connect, X-On

• Learning Disability Mortality Programme LeDeR

Purpose – The Learning Disability Mortality Review (LeDeR) programme was commissioned by NHS England to investigate the death of patients with learning difficulties and Autism to assist with processes to improve the standard and quality of care for people living with a learning disability and Autism. Records of deceased patients who meet with this criterion will be shared with NHS England.

Legal Basis – It has approval from the Secretary of State under section 251 of the NHS Act 2006 to process patient identifiable information who fit within a certain criterion.

Data Processor – BOB ICB (Integrated Care Board), NHS England

• Anticoagulation Monitoring

Purpose – Personal Confidential data is shared with LumiraDX in order to provide an anticoagulation clinic to patients who are on anticoagulation medication. This will only affect patients who are within these criteria.

Legal Basis –

• 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’
• Processor : LumiraDX INRStar

• Shared Care Record

Purpose – In order for the practice to have access to a shared record, the Integrated Care Board has commissioned a number of systems including GP connect, which is managed by NHS Digital, to enable a shared care record, which will enable patient information to be used for a number of care related services (see separate GP Connect section below). These systems may also include Population Health Management and analytics to assist with planning services for the use of the local health population.

Where data is used for secondary uses no personal identifiable data will be used.

Where personal confidential data is used for Research explicit consent will be required.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Data Processor – NHS England

Local shared care record:

• The Thames Valley & Surrey (TVS) Care Records,
• Health Information Exchange (HIE)

Purpose – Health and social care services are developing shared systems to share data efficiently and quickly. It is important for anyone treating you to be able to access your shared record so that they have all the information they need to care for you. This will be during your routine appointments and in urgent situations such as going to A&E, calling 111 or going to an Out-Of-Hours appointment. It is also quicker for staff to access a shared record than to try to contact other staff by phone or email.

Only authorised staff can lawfully access the systems and the information they see is carefully checked so that it relates to their job. Systems do not share all your data, just data which services have agreed is necessary to include.

For more information on the TVS Care Records and HIE, you can visit their website.

If you wish to opt out from this data sharing, you will need to let the practice know so they can change your record sharing settings.

Please contact the surgery and ask us to record that you have refused consent for upload to local shared electronic record.

Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated above (see p.7).

Data Processors – Graphnet, Cerner