Fair Processing Notice: Appendix A

Activity

• Commissioning and contractual purposes 
• 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

• 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 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 Your NHS Data Matters to apply a National Data Opt Out

Processor

Buckinghamshire, Oxfordshire & Berkshire ICB

Activity

• Clinical Audits

Rationale

Purpose

Information will be used by Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System and the Care Quality Commission (CQC) for clinical audits to monitor the quality of the service provided to patients with long terms conditions. When required, information will be held centrally and used for statistical purposes (e.g. the National Diabetes Audit). When this happens, strict measures are taken to ensure that individual patients cannot be identified from the 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’

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 by 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.

Processor

Buckinghamshire, Oxfordshire & Berkshire ICB

Activity

• Summary Care Record
  Including  additional information

Rationale

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

• 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. 

Processor

NHS England

Activity

• Research

Rationale

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 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)(a) – 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 CRN Thames Valley and Oxford 

Activity

• Individual Funding Requests

Rationale

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 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

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

Data Processor

Buckinghamshire, Oxfordshire & Berkshire ICB 

Activity

• Safeguarding Adults

Rationale

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 required to share information for this purpose.

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’

Consent may not be required to share this information.

Data Processor

West Berkshire Council 

Activity

• Safeguarding Children 

Rationale

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.

Processors

West Berkshire Council

Activity

• Risk Stratification – Preventative Care

Rationale

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 Processors

Buckinghamshire, Oxfordshire & Berkshire ICB  

Activity

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

Rationale

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

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) ‘…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 

Processors

The Thames Valley School of Public Health 

Activity

• Direct Care
• NHS Trusts
• Community Providers
• Pharmacies
• Enhanced care providers
• Nursing Homes
• Other Care Providers

Rationale

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) ‘…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

Processors

Berkshire Healthcare NHS Foundation Trust 

Activity

• Care Quality Commission

Rationale

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 on our website.

Legal Basis

• Article 6(1)(c) ‘…processing is necessary for compliance with a legal obligation’; and
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine 

Data Processors

Care Quality Commission

Activity

• Population Health Management

Rationale

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.

Type of Data

Identifiable/Pseudonymised/Anonymised/Aggregate Data.  NB only organisations that provide your care will see your identifiable 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 Processors

Optum, Cerner 

Activity

• Payments

Rationale

Purpose

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 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) ‘necessary for the purposes of preventative or occupational medicine’.

Processor

NHS England, ICB, Public Health

Activity

• Patient Record database

Rationale

Purpose

Your medical record will be processed in order that a data base 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 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

EMIS and PCSE

Activity

• Medical reports 
• Subject Access Requests 

Rationale

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 reports where you have applied for services offered by then 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.

Processor

Solicitors and insurance organisations

Activity

• Medicines Management Team
• Medicines Optimisation

Rationale

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 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

Buckinghamshire, Oxfordshire & Berkshire ICB

Activity

• Primary Care Network (PCN)

Rationale

Purpose

Your medical record will be shared with the Arun Integrated Care (AIC) in order that they can provide direct care services to the patient population. 

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

Eastfield House Surgery, Strawberry Hill Medical & Downland Practice 

Activity

• Smoking cessation

Rationale

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)(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

Stop Smoking Berkshire

Activity

• Police

Rationale

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

• Article 6(1)(c) – to comply with a legal obligation; and
• Article 9(2)(j) – ‘for reasons of substantial public interest’

Processor

Police Constabulary

Activity

• Coroner

Rationale

Purpose

Personal health records or information relating to a deceased patient may be shared with the coroner.

Legal Basis

• Article 6(1)(c) – to comply with a legal obligation; and
• Article 9(2)(h) – ‘necessary for the purposes of preventative or occupational medicine’.

Processor

The coroner

Activity

• Medical Examiner Service 

Rationale

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 Berkshire Health 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”

Processor

Medical Examiners service – Royal Berkshire Health Foundation Trust 

Activity

• Non-commissioned, private healthcare providers (e.g. BUPA, Virgin Care, etc.)

Rationale

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

• Articles 6(1)(a) and 9(2)(a) consent by the patient given under contract to the provider.

Processor

Various

Activity

• Messaging Service

Rationale

Purpose

Personal identifiable information shared with the messaging service in order that messages including; appointment reminders; results; campaign messages related to specific patients health needs; and direct messages to patients, can be transferred to the patient in a safe way.

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

AccuRX, NHS APP, Anima

Activity

• Remote consultation
• Including – Video Consultation
• Clinical photography

Rationale

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 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 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.

Processor

Livi, Accurx

Activity

• MDT meetings

Rationale

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 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

Berkshire Health Foundation Trust 

Activity

• 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

Rationale

Purpose

GP practices are required to provide data extraction of their patients personal confidential information for various purposes to NHS England. The objective of this data collection is on an ongoing basis to identify patients registered at General Practices who fit within a certain criteria, 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 England 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

Legal Basis

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

Further detailed legal basis can be found in each link.

Any objections to this data collection should be made directly to NHS England.  enquiries@nhsdigital.nhs.uk

Processor

NHS England

Activity

• Medication/Prescribing

Rationale

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 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

Pharmacy of choice

Activity

• Telephony

Rationale

Purpose

The practice use 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 calls only / incoming and outgoing calls.

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 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’

Provider

Surgery Connect – X-ON

Activity

• Learning Disability Mortality Programme
• LeDer  

Rationale

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 criteria 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 criteria. 

Processor

ICB, NHS England

Activity

• Shared Care Record

Rationale

Purpose

In order for the practice to have access to a shared record, the Integrated Care Service has commissioned a number of systems including GP connect, which is managed by NHS England, to enable a shared care record, which will assist in patient information to be used for a number of care related services. These may include Population Health Management, Direct Care, 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 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

NHS England

Activity

• Local shared care record 
• Plexus

Rationale

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 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.

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

Connected Care

Activity

• Therapy Review

Rationale

Purpose

The Practice is currently working with an independent company, Interface Clinical Services (an IQVIA business), to review data from the records of patients who have Type 2 Diabetes and Asthma to help provide you with the best possible care and outcome. 

The company fully complies with data protection legislation and their work is overseen by your GP. 

Your personal data will be treated as strictly confidential but anonymised summary (which does not identify individual) data may be collated for the purposes of reporting. 

If you have any concerns about your data being used in this way, please contact the practice staff.

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) ‘…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

Interface Clinical Services

Activity

• Improving Access to NHS Health Checks

Rationale

Purpose

We are working with the Berkshire West Primary Care Alliance as part of a Community Wellness Outreach Project to increase NHS health checks, we are using third party providers who will have access to aspects of patient data only where this would be relevant. All parties have completed a Data Protection Impact Assessments.  If you have any questions please get in touch with – Solutions4Health.

Activity

• Medical Reports Subject Access Requests (SARs)

Rationale

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 reports where you have applied for services offered by then 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.

Processor

Provider of Choice

Activity

• Anticoagulation Monitoring

Rationale

Purpose

Personal Confidential data is shared with Berkshire Health Foundation Trust in order to provide an anticoagulation clinic to patients who are on anticoagulation medication. This will only affect patients who are within this criteria. 

Legal Basis

• Article 6(1)e - “processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller”;
• Article 9(2)h - “processing is necessary for the purposes of preventive or occupational medicine”;

Processor

Berkshire Health Foundation Trust