Commissioners barred from using patient data

NHS England, clinical commissioning groups and commissioning support units are currently unable to handle patient identifiable data from the “secondary uses service” for purposes other than the direct commissioning of patient care.

This means, for example, that NHS England and the 19 CSUs it hosts cannot process information containing patients’ NHS numbers in order to analyse health outcomes for patients with a particular condition.

The restriction would also prevent analysis of patient identifiable data for the purposes of gaining insight into population health, monitoring provider performance, or developing national guidelines.

HSJ reported last month that NHS England, previously known as the NHS Commissioning Board, was set to apply to the NHS Ethics and Confidentiality Committee for a legal exemption under section 251 of the 2006 Health and Social Care Act.

If approved, the exemption would allow patient identifiable secondary uses service data to flow legally between the NHS Information Centre and NHS England, CCGs and CSUs.

The exemption would set aside normal confidentiality requirements where there is no practical alternative, and where it is in the public interest to do so.

The case is now with the NHS Health Research Authority, which took over responsibility for such decisions at the beginning of April.

Although it had been hoped that the issue would be considered quickly, no decision has yet been reached.

NHS England does not know how long it will have to wait before an answer is given. A spokeswoman could say only that the hold-up was expected to last “weeks rather than months”.

The Health Research Authority will consider the issue at a meeting on April 18 and April 19. However it is not certain that the matter will be resolved then.

Commissioners are in the meantime able to use fully anonymised data. This, however, will not allow patients to be tracked across different care settings such as primary care, mental health and acute services.

One CCG leader told HSJ that they were awaiting guidance from the board, and that the issue could impact on their ability to monitor outcomes data from providers. “We need clarity immediately really, regarding access to data, to make sure we keep care quality at the forefront,” he said.

NHS England is understood to be dramatically extending its data analytics capabilities. While this project is still under development, it cannot begin analysis of patient identifiable data until the legal status is granted.

The function is also the key component in CSUs’ business intelligence services.