The practice is registered with the Information Commissioners Office and fully abides by the principles of the Data Protection Act. We are bound by the General Medical Council guidelines on confidentiality, which is more restrictive than the Data Protection Act.
Confidentiality is one of the keystones of medicine and is central to maintaining trust in the doctor-patient relationship; information you give us is treated in the strictest confidence.
With whom may information about me be shared?
Other than the doctor or nurse treating you, any member of staff may need to have access to your health records. Every member of staff is bound by strict confidentiality codes of conduct, which includes what information they can access and when.
By giving us private information, it is generally understood that that information may be shared with some individuals or organisations without your direct permission. This is called implied consent. Examples include:
· other doctors or nurses within the practice may be asked for a second opinion on your case.
· administration staff will need to access your records to get results, print prescriptions, type referral letters etc
· if you need to be referred to another health professional, such as physiotherapist, counsellor or hospital specialist, we will need to share relevant information with them. This sharing of information may be by paper methods, but may also include electronic sharing, including through an electronic referral system or the Great North Care Record.
· We are participating in the Great North Care Record, which allows health and care organisations to share your information. This is completely secure and can only be accessed by health and care professionals directly involved in caring for you. Organisations will normally ask your permission to view the record except in an emergency where you cannot give permission (eg unconscious). You can opt out of eletronic record sharing at any time; though this may affect the care you receive if the health and care professional does not have access to complete information about you.
· if we need to refer you to the district or community nursing service, because you are housebound, the nursing service are acting on behalf of the practice and instead of our nursing staff. In order to safely treat you and communicate with the practice, we have the ability to view each other’s records.
· if you request us to undertake work on your behalf, relevant information may need to be shared without your express consent, for example: whilst booking an ambulance, the ambulance service will need us to tell them your name, date of birth, address and any significant medical conditions
· selected external organisations may undertake work on our behalf. For example, the practice pharmacist will need to be able to view patient records to ensure patients are on the best medication for them. In most cases this will be done on the premises, but in some circumstances this may be undertaken at another location. Any organisation undertaking work on our behalf will be bound to the same rules of confidentiality.
· we are a teaching practice, so interesting cases may be discussed with other doctors as part of our continued learning, or with registrars and medical students attached to the practice. Wherever possible this is anonymised.
· we may be required to provide anonymous data to Gateshead Clinical Commissioning Group (GCCG) for the purposes of strategic health care planning. This information is collected by NECS (North East Commissioning Support) and stripped of any details that may identify you personally. NECS & GCCG are both NHS organisations and bound by the same rules on confidentiality.
The only other circumstances when information would be shared would be where we are required by law (such as when directed by the courts) or where we believe that a crime may be committed that would endanger other people (an obvious example of this would be suspected child abuse.) The law also allows us to break confidentiality where it is in your best interest; this is only ever used in very exceptional circumstances, such as finding a patient unconscious or incapacitated.
With whom will information about me not be shared?
We will not share medical information with any one else without your express (and usually written) permission. This includes employers the police (except where we directly ordered by the courts or in the detection of serious crime), insurance companies, council and so on.
We will also not share information with relatives, including spouses, without permission.
It surprises many people that in this modern age, each organisation holds its own records and the systems currently do not ‘talk’ to each other – the hospital cannot see a patient’s GP records and vice versa. This means that patients have to keep repeating their medical problems and there is no way of checking what medication they are on.
Summary Care Record
The Summary Care Record is a national initiative to reduce these problems by having a central database that holds a record of patients’ medication and allergies. These are uploaded from GP records every time a change is made to a patient’s drug list. The Summary Care Record can only be accessed by selected health organisations and, except in an emergency, only with a patient’s permission. You have the right to opt out (or opt back in) at any time by informing the practice.
Local Record Viewing
The Summary Care Record allows only a limited view of the records. GPs, hospitals and other relevant Health and Social Care agencies providing care to patients in Gateshead are co-operating to allow each other access to records. The amount of access to read records will be dependent upon the organisation and what it safely needs to treat you – trigger for the release of data will be linked to that required to treat you appropriately.
The system has safeguards in place:
(1) a patient has to be registered with the service for the service to access the records
(2) except in an emergency, a patient has to give permission for records to be accessed (the exception is the district nursing service who have access to our records). It is assumed that if you have been referred to a specialist, that they will have implied consent to view the record in order to offer you the best care possible
(3) organisations can define exactly which part of a record another organisation can access: we can define a different profile for different services
(4) the system keeps a record of everyone who accesses the system and exactly which part of the record they have viewed.
(5) The GP computer system can lock individual patient records and even individual entries, if there is something particularly sensitive.
(6) The records themselves never leave the organisation holding the record. Unlike the summary care record.
You have the right to opt out of this service by advising your GP or hospital. However, we recommend that you do not exercise this right given the safeguards in place and the benefits to you in an emergency.
Organisations currently sharing records:
- GP Practices: have full access to your district nurse and GP Extra Care records
- GP Out of Hours Service: have access to diagnoses, medications, allergies, immunisations and important other information from the GP system. They cannot see consultations. You have to be registered with them as an emergency and give consent for them to view the record.
- GP Extra Care: This service is provided by the same organisation as the GP Out of Hours Service but offers additional routine appointments for practices as part of improving access to General Practice: They have full access to the GP record with your consent (you have to be booked into the service and present). In return we have full access to any records they have about you (in effect, from our point of view it appears as one single record.)
- Northumberland Tyne and Wear Mental Health NHS Trust: have access to diagnoses, medications, allergies, immunisations and important other information from the GP system. They cannot see consultations. You have to be registered with them as a patient and give consent for them to view the record.
- Acute Hospital Trusts within the Northern Region: have access to diagnoses, medications, allergies, immunisations and important other information from the GP system. They cannot see consultations. You have to be registered with them as a patient and give consent for them to view the record. If you have been referred to a specialist, they may seek more information to manage the referral effectively – they may do so either by ringing the practice, or by accessing the Great North Care Record.
- Gateshead Foundation NHS Trust: This organisation provides the community services (for example, Community Matrons and District Nurses). Once we have referred you, they have full access to your GP record, and vice versa. From our point of view, it appears as one combined record.
Health and Social Care Act 2012
Under the powers of this act, the Health and Social Care Information Centre (HSCIC) can, under certain circumstances, require personal confidential data from GP practices without seeking patient consent first. One of the first initiatives using these new powers is the care.data service. This will merge data from GPs, hospitals and other sources so that the NHS can provide a better level of integration and service planning. In future, approved researchers will have access to the information. For more information about care.data, see www.nhs.uk/caredata.
The information will be held securely and confidentially. GPs have no legal right to block requests from the HSCIC for information. However, patients do have a right to block HSCIC using their data. If you wish to opt out, you should inform the practice (you can also opt back in at any time).