Uploading of data to the Summary Care Record

The request was successful.

Dr Neil Bhatia

Dear South Western Ambulance Service NHS Trust,

I would like to make some requests under the FOI Act.

For the purposes of the Act, the date of your receipt of this request will be 27th May 2010.

I understand that your trust will be uploading data to the Summary Care Record at some point between May 2010 and October 2010.

Although Bournemouth and Poole PCT state that you will be uploading "core data" only, this is obviously incorrect, as "core data" is only uploaded by GP practices. You will obviously be uploading "non-GP data", otherwise known as "Release 2 information".

I would be grateful for the following information:

• Please could you state the date that you intend to commence uploading of data to the SCR.

• Please could you specify, exactly and in detail, what data you will be uploading to the SCR.

The Department of Health have commented on the fact that many patients across England have opted out of the SCR and as a result have the read code "93C3" in their GP records. However, the vast majority of these patients do not have this code synchronised with their Central Spine Flag, which is therefore not set to "Patient does not wish to store a Summary Care Record" but remains at "Implied consent". Accordingly, despite their wishes not to have a SCR, Release 2 Information can still be uploaded to the SCR (even if they do not have a GP summary).

Connecting for Health have stated ""Until the National Spine holds information about those patients who have expressed a preference not to have a Summary Care Record, it is possible that a contribution to the Summary Care Record of a patient who has expressed the wish not to have a Summary Care Record (via their GP) could be made (for example from an A&E department). It is agreed that this must not be allowed to happen".

• Please could you specify what policies and procedures you have in place to ensure that patients (from wherever in England) who have the code "93C3" in their GP records - but do not yet have their Central Spine Flag set accordingly - cannot, under any circumstances, have data uploaded by you to the SCR.

• Please could you specify whether you will be uploading data to the SCR about patients under the age of 16yrs who might present unaccompanied to your trust for medical help (e.g. for the morning after pill, STI, alcohol ingestion, accidental or deliberate overdose etc). Will you be uploading data to the SCR for such attenders?

• Please could you specify what policies and procedures you have in place to ensure fully informed consent is obtained prior to uploading of data to the SCR from people who are under the influence of drugs or alcohol. Will you be uploading data to the SCR for such attenders?

• Please could you specify what policies and procedures you have in place to ensure fully informed consent is obtained prior to uploading of data to the SCR from people who appear to be suffering from psychiatric illness (e.g. pyschosis, severe depression, dementia). Will you be uploading data to the SCR for such attenders?

• Please could you specify which staff members, of what profession and grade, will be entering the data onto computers for upload to the SCR.

• Please could you specify Who the registered data controller is for information recorded at your site.

• Please could you state whether your trust will be downloading/importing, and storing, a copy of a patient's SCR (which may have already have been "enriched") to your local computer system (i.e. into the patient's local trust-held record) when that patient is seen.

• If you are downloading a copy of the SCR onto your local system:

a) Will you be making patient's aware that a copy of their SCR will be downloaded and stored locally?
b) Will you be seeking the patient's explicit consent before downloading and storing a copy of their SCR?
c) Will you be subsequently deleting the downloaded SCR data once the patient has been discharged?
d) What provisions are in place to ensure that the downloaded and locally-held copy of the SCR cannot be subsequently viewed by anyone within your trust without both appropriate smartcard privileges and the patient's contemporaneous and explicit consent?
e) Will patients be able to have the downloaded and locally-held copy of their SCR deleted should they be unhappy that you have stored a copy of it?

As per Section 4a of Part 1 of the FOI Act
( http://www.opsi.gov.uk/acts/acts2000/ukp... ) I would like the information in question held at the time when my request is received (draft or otherwise), except that account may be taken of any amendment or deletion made between now and the latest time by which the information is to be communicated to me, being an amendment or deletion that would have been made regardless of the receipt of my request.

I would be grateful if you would be kind enough to send me the requested information promptly and in any event not later than the twentieth working day following the date of receipt of my request - that is by then end of the working day of 25th June 2010.

If my request is denied in whole or in part, or specific items within the responses are withheld from disclosure, then you must justify all deletions by reference to specific exemptions of the act, as per Section 17 of the Act
( http://www.opsi.gov.uk/acts/acts2000/ukp... ). Where you rely on a qualified exemption to withhold disclosure, you are obliged to consider the public interest in your decision and the refusal notice must explain not only which exemption applies and why, but also the public interest arguments addressed in reaching the decision.

I wish to receive the information by email; I believe such a request would be reasonable in these circumstances. As per Section 11 of Part 1 of the FOI Act ( http://www.opsi.gov.uk/acts/acts2000/ukp... ) I would be grateful if you would "so far as reasonably practicable give effect to that preference"; if you determine that it is not reasonably practicable to comply with this preference then you are required by law to notify me of the reasons for your determination.

The “return address” (to which the information that I have requested be should be sent ) is the email address that this particular request originates from.

I would be grateful if you would kindly acknowledge receipt of this request as recommended by the ICO (“It would be good practice to acknowledge receipt of requests and to refer to the 20 working day time limit, so that applicants know their request is being dealt with”).

Thank you once again.

Yours sincerely,

Dr Neil Bhatia

Dr Neil Bhatia

Dear South Western Ambulance Service NHS Trust,

I would be very grateful if you would kindly acknowledge receipt of my request.

Yours faithfully,

Dr Neil Bhatia

Dr Neil Bhatia

Dear South Western Ambulance Service NHS Trust,

Just a polite reminder that you must respond to my request by the end of this week, that is Friday 25th June.

Yours faithfully,

Dr Neil Bhatia

Dr Neil Bhatia

Dear South Western Ambulance Service NHS Trust,

Just a polite reminder that you must respond to my request by the end of Friday 25th June.

Yours faithfully,

Dr Neil Bhatia

Dr Neil Bhatia

Dear South Western Ambulance Service NHS Trust,

Just a polite reminder that you must respond to my request by the end of today,Friday 25th June, otherwise you will be in breach of the Act.

Yours faithfully,

Dr Neil Bhatia

Information Governance, South Western Ambulance Service NHS Trust

1 Attachment

Our Ref: Req444/CJSB

Dear Dr Neil Bhatia

Further to my acknowledgement on 15 June 2010, I am pleased to now be in a
position to respond to your request for information about upload of data
to the Summary Care Record under the provisions of the Freedom of
Information Act.

Our response to your request is as follows:

+------------------------------------------------------------------------+
|Information Requested |General Comments |
|---------------------------------------+--------------------------------|
|1 a) The date that uploading of data to|We have a link to the Summary |
|the Summary Care Record (SCR) will |Care Record for the GP out of |
|commence. |hours service we run for |
| |Somerset and Dorset but we only |
|b) Details of what data will actually |have the provision to view the |
|be uploaded onto the SCR |data uploaded by GP practices. |
| |We will not be uploading any |
| |data to the SCR ourselves. |
|---------------------------------------+--------------------------------|
|2. a) What policies and procedures are |We do not hold this information |
|in place to ensure that patients (from |as we will not be uploading |
|wherever in England) who have the code |records. This will need to be |
|"93C3" in their GP records - but do not|obtained from GP practices. |
|yet have their Central Spine Flag set | |
|accordingly - cannot, under any | |
|circumstances, have data uploaded by | |
|you to the SCR. | |
|---------------------------------------+--------------------------------|
|3. Specifiy whether data will be |As above. |
|uploaded to SCR about patients under | |
|the age of 16 who might present | |
|unaccompanied to SWAST for medical | |
|help. | |
|---------------------------------------+--------------------------------|
|5. To specifiy what policies are in |We will not be uploading any |
|place to ensure fully informed consent |data as explained above, but the|
|is obtained prior to uploading of data |system checks the consent status|
|on the SCR for people who are under the|of the patient's SCR when it is |
|influence of drugs/alcohol. |located. A note then appears to |
| |say there is a record available |
| |to view. |
| | |
| | |
| | |
| |When the clinician clicks to |
| |access this, a pop up message |
|---------------------------------------|called the "permission to view" |
|6. To specify what policies are in |box asks them whether they have |
|place to ensure fully informed consent |got consent from the patient to |
|is obtained prior to uploading of data |view the summary care record. |
|to the SCR regards patients with |They have the option to select |
|psychiatric illness. |"yes", "no", or "emergency". If |
| |"emergency" is clicked the |
| |privacy officer (local |
| |Cauldicott Guardian) will be |
| |alerted via the reports to |
| |investigate why "emergency" was |
| |clicked. |
|---------------------------------------+--------------------------------|
|7. What staff members/profession/grade |We will not be uploading data to|
|will upload the data onto computers for|the SCR. |
|SCR | |
|---------------------------------------+--------------------------------|
|8. To specify the registered data |We - South Western Ambulance |
|controller is for information recorded |Service NHS Trust - are the |
|at site. |registered data controller for |
| |information we record on our |
| |clinical information systems. |
| |Details of our registration can |
| |be viewed on the Information |
| |Commissioner's web site. We will|
| |not, however, be recording any |
| |information that will be added |
| |to the SCR. |
|---------------------------------------+--------------------------------|
|9. Will SWAST be downloading/importing,|A copy of the SCR is temporarily|
|and storing, a copy of the patients SCR|cached on the clinical system |
|to the local computer system when the |used in our GP out of hours |
|patient is seen. |service when a clinician |
|---------------------------------------|accesses the record so it can be|
|10. If you are downloading a copy of |viewed by them. Please see |
|the SCR onto your local system: |response to question 5/6 above |
| |for details of consent that is |
|a) Will you be making patient's |obtained for this. |
|aware that a copy of their SCR will be | |
|downloaded and stored locally? | |
| | |
|b) Will you be seeking the |The record remains cached so it |
|patient's explicit consent before |can be accessed whilst the case |
|downloading and storing a copy of their|is open, but is automatically |
|SCR? |deleted by the system once the |
| |case has been closed. We do not |
|c) Will you be subsequently |store a copy of the record that |
|deleting the downloaded SCR data once |can be accessed after the case |
|the patient has been discharged? |is closed. |
| | |
|d) What provisions are in place to | |
|ensure that the downloaded and | |
|locally-held copy of the SCR cannot be | |
|subsequently viewed by anyone within | |
|your trust without both appropriate | |
|smartcard privileges and the patient's | |
|contemporaneous and explicit consent? | |
| | |
|e) Will patients be able to have | |
|the downloaded and locally-held copy of| |
|their SCR deleted should they be | |
|unhappy that you have stored a copy of | |
|it? | |
+------------------------------------------------------------------------+

We are aware this response will automatically be published. In view of
this, we have considered whether we would give permission for re-use of
this information in this way if this had been sought as required under the
Re-use of Public Sector Information Regulations. We confirm our permission
for this by responding to this e-mail address.

I trust this provides you with the information you sought but please feel
free to contact me if you require further clarification of the information
provided, or to discuss any aspect of our response to your request.
However, if you are dissatisfied with our response, you also have the
right to make use of the following procedures to submit a complaint:

. In the first instance you may write to the Chief Executive of
this Trust

Mr Ken Wenman

South Western Ambulance Service NHS Trust

Abbey Court

Eagle Way

Exeter EX2 7HY

Mr Wenman will then either make arrangements for your complaint to be
reviewed and for the outcome to be communicated to you, or will convene a
panel of Trust Directors to consider an appeal against a decision to
withhold information.

. If you are unhappy with the response to your complaint, or
findings of the Panel, you can write to the Information Commissioner at:

Information Commissioner's Office,

Wycliffe House,

Water Lane,

Wilmslow,

Cheshire. SK9 5AF

Tel: 01625 545 700

Fax: 01625 524 510

Yours sincerely

Carla Bryan | Information Governance Manager

South Western Ambulance Service NHS Trust
[1]ftnewlogoemail09new

Sign up [2]https://www.nhs-membership.co.uk/swas to be a member now!
Direct Line 01392 261670 | Fax 01392 261516 | [3]www.swast.nhs.uk
Abbey Court, Eagle Way, Exeter EX2 7HY

show quoted sections

Dr Neil Bhatia

Dear Information Governance,

Thank you for your response, which for clarity I summarise below.

----------------------------------------

Q: The date that uploading of data to the Summary Care Record (SCR) will commence.

A: We have a link to the Summary Care Record for the GP out of hours service we run for Somerset and Dorset but we only have the provision to view the data uploaded by GP practices. We will not be uploading any data to the SCR ourselves.

----------------------------------------

Q: Details of what data will actually be uploaded onto the SCR

A: We do not hold this information as we will not be uploading records. This will need to be obtained from GP practices.

----------------------------------------

Q: What policies and procedures are in place to ensure that patients (from wherever in England) who have the code "93C3" in their GP records - but do not yet have their Central Spine Flag set accordingly - cannot, under any circumstances, have data uploaded by you to the SCR.

Specifiy whether data will be uploaded to SCR about patients under the age of 16 who might present unaccompanied to SWAST for medical help.

To specifiy what policies are in place to ensure fully informed consent is obtained prior to uploading of data on the SCR for people who are under the influence of drugs/alcohol.

To specify what policies are in place to ensure fully informed consent is obtained prior to uploading of data to the SCR regards patients with psychiatric illness.

A: We will not be uploading any data as explained above, but the system checks the consent status of the patient's SCR when it is located. A note then appears to say there is a record available to view. When the clinician clicks to access this, a pop up message called the "permission to view" box asks them whether they have got consent from the patient to view the summary care record. They have the option to select "yes", "no", or "emergency". If "emergency" is clicked the privacy officer (local Cauldicott Guardian) will be alerted via the reports to investigate why "emergency" was clicked.

----------------------------------------

Q: What staff members/profession/grade will upload the data onto computers for SCR

A: We will not be uploading data to the SCR.

----------------------------------------

Q: To specify the registered data controller is for information recorded at site.

A: We - South Western Ambulance Service NHS Trust - are the registered data controller for information we record on our clinical information systems. Details of our registration can be viewed on the Information Commissioner's web site. We will not, however, be recording any information that will be added to the SCR.

----------------------------------------

Q: Will SWAST be downloading/importing, and storing, a copy of the patients SCR to the local computer system when the patient is seen.

A: A copy of the SCR is temporarily cached on the clinical system used in our GP out of hours service when a clinician accesses the record so it can be viewed by them. The record remains cached so it can be accessed whilst the case is open, but is automatically deleted by the system once the case has been closed. We do not store a copy of the record that can be accessed after the case is closed.

----------------------------------------

Kind regards,

Dr Neil Bhatia