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.