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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)

  • To Helen Wilkinson, the answer to this is at least partly yes. A fit note is simply evidence that you have advised a patient to refrain from work or limit their work etc. It should be considered by employers but they are not legally bound to accept it as evidence of actual fitness to work or not. This function can be achieved by providing a private cert. However, it may not be acceptable to the DWP to claim back SSP.

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  • OK so patients are, in theory able to opt out of these extractions etc. But the organisational turmoil created and the unfunded expense incurred to seek consent/dissent etc makes managing this so unweildy that effectively patients will be denied these opportunities.

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  • It is very worrying and concerning with PIP assessments also looming. I am registered disabled and work but use a motability adapted car to do so, if PIP removed I would not have transport and so could not work. I have not had a day off work due to mobility issues for many years as I have suitable work adaptations etc in place and the ability to work from home if necessary. Certainly DWP wont find anything in fit to work in my records so does that mean I am not disabled any more?

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  • Presumably this relates to their expected 30% reduction in grant in aid. I think in business this is referred to as 'deversification of income streams'. Or getting what the DH can't afford from another dept.

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  • "The GPC was consulted about the plans."
    Could someone - maybe Pulse? - look at the formal consultation processes for consultation between government organisations asking for information, the HSCIC which will be charged with extracting the data, and the part of the GPC responding to such requests? (this is one of many which would have been considered by the GPES IAG before it was abolished on 30th June 2015: AFAIAA there is as yet no replacement of IAG functions)

    "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’."
    Could we have a full account of the concerns raised, the response to these concerns and the remedies - if any?
    GPES IAG (TOR established *before the HSCA*) published everything - approved application, conditions of approval and minutes of all meetings.
    I'm not clear why this now seems to be regarded as unnecessary.
    Wasn't ther at one stage a 'committment to Transparency'?

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  • @LocumGP 12.33 There is NO law to say you legally have to register with an NHS GP so how does DWP process SSP claims for patients with a private GP and NOT an NHS of which there are number especially in London?

    I am not and would not consent to be an NHS patient due to these privacy issues and ethically objections to the GP Contract.

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  • To Helen. You seem a bit annoyed with me. Maybe I am reading it wrong.
    I was just explaining what I know. What I don't know is the what happens about SSP although having issued a number of private certs myself, I have never had any comebacks or heard of it being a problem. I just didn't want to mislead anyone. Can anyone else add clarity?

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  • Vinci Ho

    (1) I still see this as my old argument in care.data.
    Trust and credibility of this government . Hence , simply, do you believe in IDS running DWP?
    (2) The double edge sword of ensuring people are claiming the benefit of sickness correctly and legitimately with a big- brother snooping , is perhaps 'necessary' but would you trust this big brother swinging the sword. I don't.
    (3) Confidentiallity is always one of our virtues , at least as far as GMC is concerned. This virtue is going to be radically challenged by this newly found freedom of DWP and of course HMOs. If justice is about maintaining the well-being(s) of both the state and individuals , the implementer(s) and operator(s) must be trustworthy...,.

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  • @LocumGP No not at all annoyed just raising the question. I am going to FOIA DWP! There is generally assumption that everyone has an NHS GP someone asked on Mumsnet the other week if was the law!!! I think DWP work to this assumption!

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  • Mary Hawking | GP Partner25 Jan 2016 12:56pm
    Spot on!

    To all - this may be another reason we can justify to our patients our resignations from the NHS.

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