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GPs told to inform patients of 'state snooping' on sick note records

Exclusive Details around practices’ issuing of Med3 statements for patients are to be extracted by the Government in a move described by GP leaders as amounting to ’state snooping’, Pulse has learnt.

The Department for Work and Pensions (DWP) will extract information from GP records, including the number of Med3s or so-called 'fit notes' issued by each practice and the number of patients recorded as ‘unfit’ or ‘maybe fit’ for work.

As part of the programme beginning next month, GPs will have to inform patients of the extraction, but cannot withhold information unless their patient explicitly objects.

These data will be published anonymously at CCG level, but DWP officials will have access to practice-level data - which they will not be able to pass on to other bodies.

GP experts criticised the decision to obtain practice-level rather than CCG-level data, and warned it could be used to create 'league tables' for practices and have a knock-on effect for other extraction programmes.

The 'fit notes' scheme allows GPs to refer patients who are in employment, but off sick to an occupational health service.

Under the extraction plans, the DWP said that ‘a small number of DWP analysts will have secure password access to the anonymous aggregated data at GP practice level.’

These data - which will be published by the Health and Social Care Information Centre from the spring - will include the duration of fit note, patient gender, type of health condition, their location and whether workplace adaptations were recommended.

The DWP said it will use the data to ‘help provide a better understanding of why people take sickness absence in different areas across the country, so we can make the service as effective as possible for businesses and employees’.

It told Pulse no practice-level information would be shared outside the department, with a spokesperson saying: ‘Only the Department for Work and Pensions will be able to access the data at GP practice level.'

GPs, as data controllers, will be required to tell patients in person, via notices in the practice and on the practice website of the impending extraction.

But GP leaders warned that the scheme is an invasion of privacy.

Family Doctor Association chair Dr Peter Swinyard said: ’I think that is state snooping. Although I am sure some civil servant thought it was a terrific idea somewhere, I am not entirely sure I agree. I don’t know if patients understand that when I write a fit note, some bureaucrat is going to be able to have a look at it.’

GP and data sharing campaigner Dr Neil Bhatia said he was ‘not sure why’ these practice-level data were required, ‘other than to compare practices, create league tables, name and shame’.

He also warned that the extraction could have ‘knock-on effects’ on other secondary use data extraction programmes, such as care.data and the National Diabetes Audit, if it prompts more patients to log 'type 1' objections to data unrelated to direct care being extracted.

Questioning how useful these data would be, he said: ‘I think it would be extremely difficult to make sense of the information out of context of the consultation.’

The GPC was consulted about the plans.

Deputy chair Dr Richard Vautrey said the DWP has ‘responded to the concerns that we raised, not least trying to reduce the workload pressures on GPs that this might create and producing a generic fair processing statement for practices to use’.

Why does the DWP want this data?

‘Fit notes’ form part of the Fit for Work scheme, under which GPs in England and Wales can refer employed patients that are likely to be off sick for four weeks or more to a free occupational health advice service helping them get back into work as quickly as possible. Employers can also refer employees to the service.

The Government’s evaluation of the scheme, rolled out just over a year ago, is still pending.

As reported by Pulse, GPs were unconvinced by the scheme before its launch, and also did not feel equipped for it.

Readers' comments (41)

  • Would this count as the govermnent forcing us to break our oath of confidentiality? Then after this becomes routein, then everything else will follow under different excuses ....

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  • I think the best way out is stop using the Fit for Work referrals to avoid jeopardising the professional trust we have and to avoid a legal minefield. Surely, if a patient realizes that the State has been snooping on his records the only one held to account will be the GP. Should we be seen as collaborating with the DW&P?
    I don't condone people abusing the system but policing is not our job. Somehow, it always ends up with the shot being fired with the gun resting on GP shoulder.

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  • Maybe consider promoting the following message to patients.

    Dear NHS patient. You will probably be aware that traditionally the information in your medical notes has been held confidentially. Due to recent changes in the law this is no longer the case and the Government now has access to your medical record and is currently able to determine whether you have certain medical conditions and whether you have been issued with fit notes (otherwise known as sick certificates). We expect that the Government may well expand the range of information it obtains from your medical notes in the future and we are powerless to prevent this.
    +/- Should you wish to continue to see your doctor in confidence, we are able to offer a private service.

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  • Peter Swinyard

    It may, of course, be the case that the Special LMCs Conference on Saturday votes that GPs should stop writing sick notes at all...

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  • I'm a bit confused about this. People seem to be very angry about the government looking in our patients notes - but that is not what this is doing is it? It's just finding out how many fit notes we issue?

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  • If nobody does it what can HMG do?

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  • Samuel Lewis

    Looking at practice sicknote records is likely to produce rubbish data. Surely no-one has the time to wade through the free text nightmare that most GPs write! Surely the DWP could get quicker more useful data by looking at its own computerised payout records ? Or is that garbage in garbage out too ?

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  • To 10.40
    This issue is wider than just fit notes. There are other examples of intrusion, in particular the diabetes audit which extracts named patient data. This is the thin end of a very sinister wedge.
    No such thing as "free" healthcare. Data has value. Patients are paying with their privacy.

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  • Neil Bhatia

    the secondary uses opt-out (9Nu0) will prohibit extraction and uploading for individual patients
    so if they have already opted out of care.data, their record is protected from this extraction

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  • There is a Practice somewhere in the home counties that says on its web site if you want to protect your privacy we offer a private GP service too! Yes seriously. I have bookmarked it in case I ever need a GP urgently.

    Could patients pay for a private certificate to protect their privacy if it is for a private employer occy health scheme?

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