Our ref: DE000428941

 

5 August 2009

 

Dear Dr Bhatia

Thank you for your email of 7 July asking a number of questions about patients’ Personal demographics Service (PDS) records flagged as ‘sensitive’. 

I should first of all make the general point that PDS controls over handling of sensitive demographic data are quite separate from those governing the patient preference for having a Summary Care Record (SCR). All patients can choose not to have a SCR, but that option, and the means of implementing it, are independent and irrespective of the patient preference for withholding sensitive demographic data. In either case it is always possible for the patient to change their mind, and status, at any time.

In relation to your specific questions:

If a patient's PDS record is flagged as "sensitive", then for such patients

1.  Is a Summary Care Record still capable of being created for them by their GP practice?

It is currently possible to create a record on the system, but the future system requirement is that SCRs should not be created for patients flagged as ‘sensitive’ on PDS

2.  If a patient wishes to opt out of a SCR creation, does the 93C3 code still need to be added to their GP record (for patients of those GP practices who are uploading with implied consent)?

Yes.  The two decisions/actions operate, and need to be recorded, separately. 

3.  Can a Summary Care Record, if one already exists for the patient, be subsequently viewed by a GP practice, A&E department, OOH GP provider etc?

Yes, since GP or other users will normally look to identify the patient via PDS, using information supplied by the patient or already available to the user.  PDS will match on any sensitive demographic information that is provided, such as address and GP practice code, but PDS will not include this information when confirming the patient’s identity.

4.  If a Summary Care Record can still be viewed, does accessing it then automatically generate a "privacy alert"?

No.  A ‘sensitive’ flag on PDS is not intended to act as a SCR safeguard. However, without the patient being present to provide the additional information to support a trace on PDS, locating the SCR for that individual would be very difficult, and this results in a form of safeguard for the SCR.

5.  Is there a mechanism for marking the clinical Summary Care Record as "restricted" or "sensitive" in the same way as the PDS (that is, not viewable except in extreme clinical circumstances where explicit consent cannot be obtained)? If so, please could you kindly indicate the exact mechanism by which patients can get their SCR so marked - please provide me with any guidance for GPs or patients and any necessary form(s) that needs to be filled in to enable this.

No.  However, setting the PDS flag to not sharing would have this effect, as will the sealed envelope functionality when it is available.

I hope that this is helpful.  If you are unhappy with the Department’s handling of the Freedom of Information aspect of your request, you have the right to ask for an internal review.  Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to:
 
Head of the Freedom of Information Team
Department of Health
Room 317
Richmond House
79 Whitehall,
London
SW1A 2NS
  
Email: xxxxxxxxxxxxxxxxxxxx@xx.xxx.xxx.xx

If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Department.  The Information Commissioner can be contacted at:

The Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Please contact me if you have any queries about this letter.

Yours sincerely,

Lynn Swyny
FOI Case Manager