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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 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)

  • I agree with all your concerns IF the patient is identified but as I read it, the extracted data is aggregated and unidentifiable for each practice in the same way that GPES data is extracted for QOF
    If this is so, I don't understand your objections,

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  • DPA (1998) schedule 2

    5 The processing is necessary—

    (c)for the exercise of any functions of the Crown, a Minister of the Crown or a government department, or

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  • Surely this is an inevitable progression from computer generated Med3's. There are probably plans for us to send them electronically to the DWP as we do with electronic prescriptions. Then the DWP will have patient identifiable data electronically as the PPA has for prescriptions. - Add the two together, add and summary care record - What have you got?,
    Put the NHS Number in the mix and Hospital records open out.
    Cross reference DOB & address (on the med3) & social service records - where does it end??

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  • Has no one noticed the small delay between pressing OK and it being printed where the data is uploaded to a remote server (I presumed DWP) in order for the 2d bar code and unique ID to be generated before it is printed. The form also asks patient to sign to give the DWP permission to look into it if they are on benefits and it is given to the DWP by the employer for a statutory sick pay claim.

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  • Remember that lovely line uttered by Sharon Stone? 'Waddya gunna do, arrest me for smoking?'
    Just ignore it.

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  • I don't register with an NHS GP due to issues of privacy and lack of trust borne out over last decade yet the number of times I have received a shocked response to this on the few times I have needed a dentist or hospital appointment is worrying - surely there is no obligation to register? Gps are no longer the gatekeepers to all services but now this has been raised it is a mystery

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  • @otherphealthprofessional NO this no obligation to register. I am not registered either for the same reasons plus ethical objections to the GP Contract. I would be interested to chat to you.

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  • Ditch the DWP comrades!!!

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  • I am so glad I am no longer managing a practice in an area of high deprivation. I can see the vultures hovering!

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  • When the 'enhanced service'* arrived my suspicions were triggered (*unpaid work is not an enhanced service).

    If it is lawful for HSCIC to extract the data, why would practices have to 'agree' by signing the enhanced service?

    I checked with ICO as our registration for the DPA is limited to data held for delivering healthcare.

    The primary care challenge for dementia for instance is not delivering healthcare, it is propaganda, just like the sick note is for policing, not for healthcare delivery.

    I challenged ICO for a statement that I would not be breaching my registration if HSCIC used the 'shared' data for purposes other than our registered conditions. ICO did not confirm it was OK to share data with HSCIC.

    I am still waiting for a reply from ICO whether vulnerable patients (E.G. patients with dementia) have had a realistic chance to opt out of the data collection. Opting out involves being aware, finding forms and codes on the internet and then ensuring the GP has added them to the records.

    Lastly, there should be a written agreement if you share data, there is no agreement between HSCIC and our practice so again we would be in breach of the DPA if we 'share' patient data.

    If the GPC agreed to the scheme, I guess they either caught the GPC napping or maybe favours are going to and fro in smoky back rooms?

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