Privacy Notice

General Practices are usually the first point of contact if you have a health problem. They can treat many conditions and give health advice. They also refer patients to hospitals and other medical services for urgent and specialist treatments.

The data we hold may also be used to shape the way we work together to plan service improvements, improve the health and wellbeing of our communities, and take action to prevent illness and disease for individuals as well as wider communities.

The categories of personal information

Dependent on the purpose of processing, different categories of data may be used by the Practice. Data can be categorised using the following terms:

Anonymised data

• data where personal identifiable identifiers have been removed. Data protection laws and the Common Law of Confidentiality to do not apply to anonymised data.

Pseudonymised data

• data where any information which could be used to identify an individual has been replaced with a fake identifier. Pseudonymised data remains personal data and as such the Common Law Duty of Confidentiality and Data Protection legislation apply and there must be a lawful reason for using such data.

Person identifiable information (or personal data)

• any information about an individual from which, either on its own or together with other information, that person may be identified. The Common Law Duty of Confidentiality and Data Protection legislation apply and there must be a lawful reason for using such data.

In addition to the above types of data, some information is considered protected regardless of the purpose of processing; this information does not form part of your shared care record and is not disclosed to any other third parties without your permission unless there are exceptional circumstances, such as if the health and safety of others is at risk or if the law requires us to pass on such information.

The purpose(s) of processing personal data

Waders Medical Centre processes data for the following purposes:

•    Direct Care Privacy Notice
•    Human Resources Privacy Notice
•    Planning and Research Privacy Notice
•    GP Statutory Purposes Privacy Notice
•    Kent and Medway Care Record Privacy Notices

What is the lawful basis for the sharing?

Each purpose of sharing has its own lawful basis, and these can be found in detail on the associated Privacy Notices above.

Organisations we share your personal information with

Personal Data (including special category data) will only be shared between the general Practice and health and social care organisations that have signed a Joint Controller or Data Processing Agreement. These currently include:

• Dartford and Gravesham NHS Trust (D&G)
• East Kent Hospitals University NHS Foundation Trust (EKHUFT)
• Medway Maritime Hospital - Medway NHS Foundation Trust (MFT)
• Maidstone and Tunbridge Wells NHS Trust (MTW)
• Kent and Medway Partnership NHS and Social Care Partnership Trust (KMPT)
• North East London Foundation Trust (NELFT)
• Kent Community Health NHS Foundation Trust (KCHFT)
• HCRG Care Group Limited
• Medway Community Healthcare (MCH)
• South East Coast Ambulance Service (SECAmb)
• Integrated Care 24 (IC24)
• Out of hours providers (currently IC24, SECAmb, MCH and KCC Children’s Services)
• NHS Kent and Medway
• Kent County Council (children and adults social care departments) (KCC)
• Medway Council (children and adults social care departments) (MWC)
• GP federations.
• Other Practice’s that form the Tonbridge Primary Care Network
• NHS Commissioning Support Units
• Independent Contractors such as dentists, opticians, pharmacists
• Private Sector Providers
• Voluntary Sector Providers
• Health care partnerships
• Other Primary Care networks that we work in partnership with
• Mental Health providers
• Community trusts
• Kent County Council/Medway council Social Care Services
• NHS England
• Local Authorities
• School Nurse
• Police & Judicial Services

How long do we keep your record?

The Practice maintains your records in accordance with the NHS Records Management Code of Practice.  

How we keep your personal information safe and secure

To protect personal and special category data, we make sure the information we hold is kept in secure locations and access to information is restricted to authorised personnel only.

Our appropriate technical and security measures include:

•  all employees and contractors who are involved in the processing of personal data are suitably trained, on an annual basis, in maintaining the confidentiality and security of the personal data and are under contractual or statutory obligations of confidentiality concerning the personal data.
• robust policies and procedures for example password protection
• technical security measures to prevent unauthorised access
• use of ‘user access authentication’ mechanisms to make sure all instances of access to any personal data held on clinical systems are auditable against an individual, such as role-based access and Smartcard use to make sure appropriate and authorised access reminding staff of their responsibilities in complying with data protection legislation
• encrypting information transmitted between partners
• implementing and maintaining business continuity, disaster recovery and other relevant policies and procedures
• completion of the Data Security and Protection Toolkit (DSPT) an annual self-assessment requirement that ensure organisation are compliant with the latest data protection and cyber requirements. 
• regular audit of policies and procedures to ensure adherence against these criteria 

The NHS Digital Code of Practice on Confidential Information applies to all staff who access clinical systems. They are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared.

What are your rights?

Under data protection legislation, you have the right:

• to be informed of the uses of your data: this enables you to be informed how your data is processed
• of access: this enables you to have sight of or receive a copy of the personal information held about you and to check the lawful processing of it
• to rectification: this enables you to have any incomplete or inaccurate information held about you corrected
• to erasure: this enables you to request we erase personal data about you we hold. This is not an absolute right, and depending on the legal basis that applies, we may have overriding lawful grounds to continue to process your data
• to restrict processing: this enables you to ask us to suspend the processing of personal information about you, for example, if you want us to establish its accuracy or the reason for processing it
• to data portability: this enables you to transfer your electronic personal information to another party, where appropriate.
• to object: this enables you to object to processing of personal data about you on grounds relating to your situation. The right is not absolute, and we may continue to use the data if we can demonstrate compelling legitimate grounds. 
• in relation to automated decision making and profiling: this enables you to be told if your data is being processed using automated software in relation to automated decision making and profiling note: No automated decision making or profiling is undertaken by the Practice.

Please note not all these rights are absolute, please see our ROPA for more details 

If you wish to exercise your rights in any of the ways described above, you should in the first instance contact us directly

Right to complain

You can get further advice or report a concern directly to us

Our Data Protection Officer function is provided by NHS Kent and Medway who can be contacted via email kmicb.gpdpoteam@nhs.net

You also have the right to contact the UK’s data protection supervisory authority (Information Commissioner’s Office)

HOW TO CONTACT THE ICO

Information about the way in which the NHS uses personal information and your rights is published by NHS Digital.

The NHS Constitution

The constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access health services, the quality of care you will receive, the treatments and programmes available to you, confidentiality, information and your right to complain, if things go wrong.

NHS England

NHS England collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.

Reviews of and changes to this privacy notice

We will review the information contained within this notice regularly and update it as required. We therefore recommend you check this webpage regularly to remain informed about the way in which we use your information.

How we use your personal information

Being transparent and providing accessible information to patients about how we will use your personal information is a key element of the GDPR Regulations.

The following notice reminds you of your rights in respect of the above legislation and how your GP Practice will use your information for lawful purposes in order to deliver your care and the effective management of the local NHS system.

This notice reflects how we use information for:

• The management of patient records;
• Communication concerning your clinical, social and supported care;
• Ensuring the quality of your care and the best clinical outcomes are achieved through clinical audit and retrospective review;
• Participation in health and social care research; and
• The management and clinical planning of services to ensure that appropriate care is in place.

Data Controller

As your registered GP practice, we are the data controller for any personal data that we hold about you.

What information do we collect and use?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

• The General Data Protection Regulations Legislation (GDPR)
• Human Rights Act 1998
• Common Law Duty of Confidentiality
• Health and Social Care Act 2012
• NHS Codes of Confidentiality and Information Security

Personal data must be processed fairly and lawfully, whether is it received directly from you or from a third party in relation to your care.  ‘Personal data’ means any information relating to an identifiable person who can be directly or indirectly identified from the data.  This includes, but is not limited to, name, date of birth, full postcode, address, next of kin and NHS Number; and ‘Special category / sensitive personal data’ includes, such as, medical history including details of appointments and contact with you, medication, emergency appointments and admissions, clinical notes, treatments, results of investigations, supportive care arrangements, social care status, race, ethnic origin, genetics and sexual orientation.

We will collect the following types of information from you or about you from a third party (provider organisation) engaged in the delivery of your care:

• Details about you, such as your address, legal representative, emergency contact details
• Any contact the surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
• Notes and reports about your health
• Details about your treatment and care
• Results of investigations such as laboratory tests, x-rays etc
• Relevant information from other health professionals, relatives or those who care for you
• Your records will be retained in accordance with the NHS Code of Practice for Records Management

Your healthcare records contain information about your health and any treatment or care you have received previously (e.g. from an acute hospital, GP surgery, community care provider, mental health care provider, walk-in centre, social services). These records maybe electronic, a paper record or a mixture of both.  We use a combination of technologies and working practices to ensure that we keep your information secure and confidential.

Why do we collect this information?

The NHS Act 2006 and the Health and Social Care Act 2012 invests statutory functions on GP Practices to promote and provide the health service in England, improve quality of services, reduce inequalities, conduct research, review performance of services and deliver education and training.  To do this we will need to process your information in accordance with current data protection legislation to:

• Protect your vital interests;
• Pursue our legitimate interests as a provider of medical care, particularly where the individual is a child or a vulnerable adult;
• Perform tasks in the public’s interest;
• Deliver preventative medicine, medical diagnosis, medical research; and
• Manage the health and social care system and services.

How do we use this information?

To ensure that you receive the best possible care, your records will be used to facilitate the care you receive.  Information held about you may be used to protect the health of the public and to help us manage the NHS.  Information may also be used for clinical audit to monitor the quality of the service provided.  In addition, your information will be used to identify whether you are at risk of a future unplanned hospital admission and/or require support to effectively manage a long term condition.

How is the information collected?

Your information will be collected either electronically using secure NHS Mail or a secure electronic transfer over an NHS encrypted network connection.  In addition physical information will be sent to your practice. This information will be retained within your GP’s electronic patient record or within your physical medical records.

Who will we share your information with?

In order to deliver and coordinate your health and social care, we may share information with the following organisations:

• NHS Trusts / Foundation Trusts
• GP’s
• NHS Commissioning Support Units
• Independent Contractors such as dentists, opticians, pharmacists
• Private Sector Providers
• Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups
• Social Care Services
• NHS Digital
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police & Judicial Services
• Other carefully selected third party service providers. When we use a third party service provider to process data on our behalf then we will always have an appropriate agreement in place to ensure they keep the data secure, that they do not use or share information other than in accordance with our instructions and that they are operating appropriately. Examples of functions that may be carried out by third parties includes:
  • Companies that provide IT services & support, including our core clinical systems; systems; systems which manage patient facing services (such as our website and services accessible through the same); data hosting service providers; systems which facilitate appointment bookings or electronic prescription services; document management services etc.
  • Payment providers (if for example you were paying for a prescription or a service such as travel vaccinations)

Your information will only be shared if it is appropriate for the provision of your care or required to satisfy our statutory function and legal obligations.

Your information will not be transferred outside of the European Union.

Who do we receive information from?

Whilst we might share your information with the above organisations, we may also receive information from them to ensure that your medical records are kept up to date and so that your GP can provide the appropriate care.

In addition we receive data from NHS Digital (as directed by the Department of Health) such as the uptake of flu vaccinations and disease prevalence in order to assist us to improve "out of hospital care".

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information that has been collected lawfully. Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential.  We maintain our duty of confidentiality by conducting annual training and awareness, ensuring access to personal data is limited to the appropriate staff and information is only shared with organisations and individuals that have a legitimate and legal basis for access.

Information is not held for longer than is necessary.   We will hold your information in accordance with the Records Management Code of Practice for Health and Social Care 2016.

Do I need to give my consent?

The GDPR sets a high standard for consent. Consent means offering people genuine choice and control over how their data is used. When consent is used properly, it helps you build trust and enhance your reputation. 

However, consent is only one potential lawful basis for processing information. Therefore, your GP practice may not need to seek your explicit consent for every instance of processing and sharing your information, on the condition that the processing is carried out in accordance with this notice. Your GP Practice will contact you if they are required to share your information for any other purpose which is not mentioned within this notice.  Your consent will be documented within your electronic patient record.

What will happen if I withhold my consent or raise an objection?

You have the right to write to withdraw your consent at any time for any particular instance of processing, provided consent is the legal basis for the processing.  Please contact your GP Practice for further information and to raise your objection.

Health Risk Screening / Risk Stratification

Health Risk Screening or Risk Stratification is a process that helps your GP to determine whether you are at risk of an unplanned admission or deterioration in health.  By using selected information such as age, gender, NHS number, diagnosis, existing long term condition(s), medication history, patterns of hospital attendances, admissions and periods of access to community care your GP will be able to judge if you are likely to need more support and care from time to time, or if the right services are in place to support the local population’s needs.

To summarise Risk Stratification is used in the NHS to:

• Help decide if a patient is at a greater risk of suffering from a particular condition;
• Prevent an emergency admission;
• Identify if a patient needs medical help to prevent a health condition from getting worse; and/or
• Review and amend provision of current health and social care services.

Your GP may use computer based algorithms or calculations to identify their registered patients who are at most risk, with support from the local Commissioning Support Unit and/or a third party accredited Risk Stratification provider.

Your GP will routinely conduct the risk stratification process outside of your GP appointment. This process is conducted electronically and without human intervention. The resulting report is then reviewed by a multidisciplinary team of staff within the Practice. This may result in contact being made with you if alterations to the provision of your care are identified.

A Section 251 Agreement is where the Secretary of State for Health and Social Care has granted permission for personal data to be used for the purposes of risk stratification, in acknowledgement that it would overburden the NHS to conduct manual reviews of all patient registers held by individual providers. You have the right to object to your information being used in this way.  However, you should be aware that your objection may have a negative impact on the timely and proactive provision of your direct care.  Please contact the Practice Manager to discuss how disclosure of your personal data can be limited.

The National Data opt-out service is available from May 25th 2018. Patients can decide if they want to share their personally identifiable data to be used for planning and research purposes. Please see information in the Practice for more details or refer to NHS Digital.

Sharing of Electronic Patient Records within the NHS

Electronic patient records are kept in most places where you receive healthcare.  Our local electronic systems (such as, EMIS, CPMS and Vision) enables your record to be shared with organisations involved in your direct care, such as:

• GP practices
• Community services such as district nurses, rehabilitation services, telehealth and out of hospital services.
• Child health services that undertake routine treatment or health screening
• Urgent care organisations, minor injury units or out of hours services
• Community hospitals
• Palliative care hospitals
• Care Homes
• Mental Health Trusts
• Hospitals
• Social Care organisations
• Pharmacies

In addition, NHS England have implemented the Summary Care Record which contains information about medication you are taking, allergies you suffer from and any bad reactions to medication that you have had in the past.

Your electronic health record contains lots of information about you.  In most cases, particularly for patients with complex conditions and care arrangements, the shared record plays a vital role in delivering the best care and a coordinated response, taking into account all aspects of a person’s physical and mental health.  Many patients are understandably not able to provide a full account of their care, or may not be in a position to do so.  The shared record means patients do not have to repeat their medical history at every care setting.

Your record will be automatically setup to be shared with the organisations listed above, however you have the right to ask your GP to disable this function or restrict access to specific elements of your record.  This will mean that the information recorded by your GP will not be visible at any other care setting.

You can also reinstate your consent at any time by giving your permission to override your previous dissent.

Invoice Validation

If you have received treatment within the NHS, the local Commissioning Support Unit (CSU) may require access to your personal information to determine which Clinical Commissioning Group is responsible for payment for the treatment or procedures you have received.  Information such as your name, address, date of treatment and associated treatment code may be passed onto the CSU to enable them to process the bill.  These details are held in a secure environment and kept confidential.  This information is only used to validate invoices in accordance with the current Section 251 Agreement, and will not be shared for any further commissioning purposes.

Change of Details

It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details such as date of birth is incorrect in order for this to be amended. You have a responsibility to inform us of any changes so our records are accurate and up to date for you.

Your Right of Access to Your Records

The General Data Protection Regulations allows you to find out what information is held about you including information held within your medical records, either in electronic or physical format.  This is known as the "right of subject access".  If you would like to have access to all or part of your records, you can make a request in writing to the organisation that you believe holds your information.  This can be your GP, or a provider that is or has delivered your treatment and care. You should however be aware that some details within your health records may be exempt from disclosure, however this will be in the interests of your wellbeing or to protect the identity of a third party. If you would like access to your GP record please submit your request in writing to:

The Practice Manager
Warders Medical Centre
47 East Street
TN9 1LA

Recording telephone calls

We record our telephone calls to protect patients, staff and other health workers. Patients are protected by our having a record of our conversations with you, staff and other health workers are protected from potential abuse. Calls are only retained for three months and are then routinely deleted. The recordings are stored at the surgery.

Complaints

In the event that you feel your GP Practice has not complied with the current data protection legislation, either in responding to your request or in our general processing of your personal information, you should raise your concerns in the first instance in writing to the Practice Manager at the address above.

If you remain dissatisfied with our response you can contact the Information Commissioner’s Office at Wycliffe House, Water Lane, Wimslow, Cheshire SK9 5AF – Enquiry Line: 01625 545700 or online at the ICO website.