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Seven-day GP pilot halted due to NHS England 'incompetence' over data sharing

A seven-day GP access pilot had to be temporarily pulled when GP commissioners realised that NHS England had failed to implement required controls for sharing patient records, potentially putting practices at risk of investigation.

One of four planned Challenge Fund ‘hubs’ in Leicester had already gone live when the CCG discovered that information-sharing agreements were not in place between the hubs and local GP practices, and decided to pause the rollout.

A GPC IT expert said that NHS England’s ‘complete incompetence’ could have led to practices facing a ‘potentially significant fine’.   

NHS England was overseeing implementation of the seven-day access pilot, which is funded by the £100m ‘wave two’ of the national pilot scheme, when the hub at the Willows Medical Centre went live on 7 September. NHS Leicester City CCG discovered the oversight when it took over on 16 September.

The Leicester scheme has now restarted, with NHS Leicester City CCG saying hubs can only access full records where a patient’s practice has signed such an agreement. In other cases, they get access only to the summary care record.

The CCG said that, after being asked to take responsibility for the scheme by NHS England, ‘the CCG identified a delay in robust information sharing agreements being put in place between city practices and the healthcare hubs. This meant that not all patients would be able to receive the level of service that the hubs were envisaged to provide.

‘[The] CCG took the decision to temporarily pause implementation of the pilot project, including the hub at Willows Medical Centre, so that we could be assured about the service patients were receiving.’

The CCG’s statement added that GPs and nurses being able to make decisions ‘with all of the relevant information in front of them’ was an important element of the scheme, which is being run across three GP federations.

Dr Grant Ingrams, deputy chair of the GPC IT committee, told Pulse that the project should not have been given the go-ahead without the information-sharing agreement in place.

He said: ‘It has put the practices involved at risk of investigation by the ICO and potentially a significant fine.’

Dr Ingrams said there should be a ‘full audit’ of what has happened, and patients who had their records accessed should be advised what has happened.

He added: ‘I cannot understand the complete incompetence by NHS England that has led to this disaster. It will further undermine public and professional confidence in schemes like this.’

Dr Mohammed Saqib Anwar, medical secretary at Leicester, Leicestershire and Rutland LMC, said: ‘The LMC has been made aware of the situation in relation to an extended hours hub operating without a signed ISA in place.

‘It is of the view that NHS England and/or the CCG as the commissioners of the service should hold ultimate responsibility for ensuring its preferred providers for the Prime Minister’s Challenge Fund had the necessary and requisite governance arrangements in place prior to giving them the green light to proceed.’

NHS England told Pulse that ‘the Willows Medical Centre only accessed the records of patients who had explicitly consented to their doing so’.

It added that the ‘lawful basis’ of accessing the record is obtaining consent, while an information-sharing agreement is ‘best practice and a requirement set out in the Information Commissioners Office Data Sharing Code of Practice’.

It also wanted to highlight that these pilots are ‘local programmes which NHS England supports but does not manage’.

This is the latest problem with patient record sharing following the botched rollout of the GP record-sharing scheme care.data, which has been delayed since early 2013. 

It comes as almost half of the ‘wave one’ seven-day access pilots are  reducing their weekend hours, while another ‘wave two’ pilot was delayed after leaders underestimated the time needed to complete CQC registration. 

Readers' comments (7)

  • It comes as no surprise to me. NHS England have not exactly covered themselves in glory. The excrement they heap on others should be heaped on them.

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  • Can NHSE and other CCGs across the country confirm that this has not happened elsewhere as well? Are robust and ICO compliant data-sharing agreements in place for all PMCF and 7/7 working schemes?

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  • When medical records need to be shared for direct patient care, surely the requirements of agreeing - and implementing - the technicalities, the IG and agreements needed, the clinical governance and the issue of patient consent have been identified & established by now?
    It would certainly appear from this article that once problems were identified they were very rapidly solved.
    So why did they arise in the first place? i.e. where was the decision that this item on the tick-boxes for establishing integrated projects didn't need to be implemented in this case taken?

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  • 10 months ago I had an accident and was off for two week. I put in paperwork to claim sickness reimbursement and then a second time because the person dealing with this moved on. Yesterday, I learned that this also has been lost and I need to put all the paperwork in a 3rd time. It seems employees at NHSE in Kent vanish with files when they leave !
    I queried non- payment of deprivation/rurality payments as according to fringe details it seems, our Practice should have been paid for at lease a 1000 patients more per year in the last three years. However, for 5 weeks there is no
    response or clarification from the local PCA.
    HSCIC sent an email saying it is the PCA that is responsible for data and then advised to contact another local PCA.
    In the neighbouring PCA, a gentleman defined what fringe details were and that I should pursue the payments with NHSE
    How long do you wait?
    I've always said, if you want to see incompetency and lack of transparency, come to Kent and Medway where even the LMC is a silent onlooker when issues concerning local GPs arise.
    No wonder, for rent review I had to send PREM 2 forms 4 times to get anywhere.
    Do I wrongly feel that I am I being targeted???

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  • What?
    NHSE incompetent?
    Who would ever have thought it?

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  • There is an interesting mismatch here. Grant Ingrams says it shouldn't have gone ahead, NHSE points out that explicit consent was obtained and that ISA are 'best practice' and not essential. NHS England publish a document 'Information Sharing Policy - Personal Information' at http://www.england.nhs.uk/wp-content/uploads/2014/08/info-shar.pdf . Section 5 discusses in a clear, pragmatic and sensible way the value and virtue of the IGSoC and how this obviates the necessity for ISAs between compliant health and social care organisations. Surely with consent (and fair processing notices) the issue of ISAs should not prevent the patient receiving better, safer care thanks to information sharing?

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  • Talking of opaque Kent and Medway -

    http://www.kentonline.co.uk/medway/news/hospital-bosses-astronomical-pay-revealed-19399/
    NHSE is stinking rich but the patients and staff are poorly..

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