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Answering member
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Caroline Flint
Type
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Answering member
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Flint, Caroline (55)
Legislative stage
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Publisher
To ask the Secretary of State for Communities and Local Government pursuant to the Answer to the hon. Member for Bromley and Chislehurst of 6 June 2008, Official Report, column 1176W, on eco-towns, whether the (a) Maps on Taps and (b) MAGIC databases hold information on green gaps and green...
To ask the Secretary of State for Communities and Local Government pursuant to the Answer to the hon. Member for Bromley and Chislehurst of 6 June 2008, Official Report, column 1176W, on eco-towns, whether the (a) Maps on Taps and (b) MAGIC databases hold information on green gaps and green...
Asked by
Grant Shapps
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Communities and Local Government
Type
Written questions
Status
Answered
Tabled on
23 June 2008
For answer on
25 June 2008
Answered on
1 July 2008
The Maps on Tap service has been discontinued and the MAGIC database, run by the Department for Environment, Food and Rural Affairs does not hold information on green gaps or green wedges.
Subjects
Databases; Green belt
Date
1 July 2008
Reference
478 c790-1W; 213933
House
House of Commons
To ask the Secretary of State for Communities and Local Government which unique property reference number is used to identify a property in a home condition report.
To ask the Secretary of State for Communities and Local Government which unique property reference number is used to identify a property in a home condition report.
Asked by
Lord Pickles
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Communities and Local Government
Type
Written questions
Status
Answered
Tabled on
6 December 2007
For answer on
10 December 2007
Answered on
29 January 2008
The ““Unique Property Reference Number”” (UPRN) generated by the Register is used to identify a property in a home condition report.
Subjects
Databases; Housing
Date
29 January 2008
Reference
471 c231W; 173226
House
House of Commons
To ask the Secretary of State for Health what discussions she has had with the Welsh Assembly Government Health Minister on (a) plans to create an electronic care record for patients, (b) confidentiality matters arising from the proposed system and (c) the cost of implementation of the Choose and Book...
To ask the Secretary of State for Health what discussions she has had with the Welsh Assembly Government Health Minister on (a) plans to create an electronic care record for patients, (b) confidentiality matters arising from the proposed system and (c) the cost of implementation of the Choose and Book...
Asked by
Dai Davies
(Independent (affiliation))
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
19 June 2007
For answer on
21 June 2007
Answered on
26 June 2007
None. Health services in Wales, and the information technology used to support them, including the creation of electronic care records for Welsh patients, are matters for the Welsh Assembly Government. However, officials from the Department and NHS Connecting for Health work closely with officials from the Welsh Assembly Government and Informing Healthcare Wales on a range of matters of common concern.
Subjects
Databases; Medical records
Date
26 June 2007
Reference
144984; 462 c615-6W
House
House of Commons
To ask the Secretary of State for Health what representations she has received from GPs on plans to create an electronic care record for patients; and what assessment she has made of the implications for patient confidentiality of such a scheme.
To ask the Secretary of State for Health what representations she has received from GPs on plans to create an electronic care record for patients; and what assessment she has made of the implications for patient confidentiality of such a scheme.
Asked by
Dai Davies
(Independent (affiliation))
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
19 June 2007
For answer on
21 June 2007
Answered on
25 June 2007
Since the start of the national programme for information technology, the Department and NHS Connecting for Health have worked closely with individual, and groups of general practitioners (GPs), including the Royal College of General Practitioners (RCGP) Health Informatics Standing Group. At the outset, the aim was to ensure that the wealth of some 20 years experience in clinical computing, in particular clinical noting and medication management, was distilled into the output based specification (OBS) for the integrated care records service. The OBS, which was published in July 2003, set the template for the subsequent procurement of all the clinical systems. Week-long design workshops were held to clearly define complex areas of functionality, in which the input of many GPs, both individual, and as representatives from RCGP and British Medical Association committees, was key.Since that time, representatives of around 60 professional organisations, including 14 Royal Colleges, among them the RCGP, have participated on national advisory groups which provide a forum for debate on development and implementation of the national programme, and the sharing of specialist expertise and experience of organisations that are already benefiting from IT implementation. Of NHS Connecting for Health’s eight National Clinical Leads—senior figures representing different areas of the health service—two are for general practitioners.NHS Connecting for Health continues to engage on a daily basis with clinicians throughout England, and as a direct result of feedback from clinicians, improvements continue to be made across the range of programmes. This involvement is impossible to quantify precisely, but equates to hundreds of staff years of input.With regard to patient confidentiality, while no system can be 100 per cent. secure, we believe that the procedural and technical safeguards surrounding the new electronic care, record service provide an unprecedented degree of assurance of security for national programme systems and services, and confidentiality of the personal data they will contain. With regard to specific evaluation arrangements, a ministerial taskforce was established in 2006 specifically to consider matters relating to confidentiality and patient consent. This taskforce reported in December 2006 and the follow up actions are being overseen by an advisory group chaired by the Deputy Chief Medical Officer. In addition, a contract for independent evaluation of the summary care record early adopter programme, now under way in the north west, has been awarded to a team at University College London. The evaluation will involve extensive fieldwork to capture the views and experiences of GPs, practice managers, nurses, other NHS clinical and management staff, and, of course, patients. The final report of the evaluation will be published in summer 2008, but emerging findings will influence the continued rollout of the summary care record.
Subjects
Databases; Medical records
Date
25 June 2007
Reference
144983; 462 c261-2W
House
House of Commons
To ask the Secretary of State for Health what controls she plans to put in place to ensure that patient records entered on the electronic care record database are not misused by researchers using the secondary users service.
To ask the Secretary of State for Health what controls she plans to put in place to ensure that patient records entered on the electronic care record database are not misused by researchers using the secondary users service.
Asked by
Dai Davies
(Independent (affiliation))
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
19 June 2007
For answer on
21 June 2007
Answered on
25 June 2007
The primary purpose of the national health service care records service (NHS CRS) is to support the delivery of care to patients. However, the aim is that data extracted from NHS services supporting direct patient care, including the NHS care records service, choose and book and electronic transmission of prescriptions, will be made available either in aggregate form or, where detailed information is provided, in anonymised or pseudonymised form, via the so-called secondary uses service. The use of consistent pseudonym enables individual cases to be tracked.Identifiable information will be available only where patient consent has been formally given or where specific permissions apply. Permission is required from the Patient Information Advisory Group (PIAG), set up under the Health and Social Care Act 2001. The PIAG assesses each application to test that the use of patient information is justified, taking into account issues of confidentiality and consent.Access to the secondary uses service requires each user to be formally registered and to use individual smart card access, just as for other systems in the national programme for information technology. Each user is allocated a role which determines what reports, and what organisations or geography of data they may access. Key user activities, including logon and extraction of data, are recorded.The Secondary Uses Group set up by the Care Record Development Board to advise on the ethical use of patient data and how the potential for research, statistics and management can be realised without compromising confidentiality or security, is due to report shortly.
Subjects
Databases; Medical records
Date
25 June 2007
Reference
144982; 462 c261W
House
House of Commons
To ask the Secretary of State for Health which data set change notices were issued under her authority to NHS organisations in each year since 1997-98.
To ask the Secretary of State for Health which data set change notices were issued under her authority to NHS organisations in each year since 1997-98.
Asked by
Lord Lansley
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
1 May 2007
For answer on
3 May 2007
Answered on
12 June 2007
The NHS Information Standards Board has responsibility for assuring and signing off information standards for use in the national health service in England. The Board has had direct responsibility for the publication of approved information standards—Data Set Change Notices (DSCNs)—since October 2005. The accountability of the Board's chairman, Professor Martin Severs, is to the NHS chief executive.A table of all DSCNs published since 1997 has been placed in the Library. The number of DSCNs published in each year is shown in the table.
| DSCNs | |
|---|---|
| Yearly totals | |
| 1997 | 47 |
| 1998 | 37 |
| 1999 | 36 |
| 2000 | 19 |
| 2001 | 45 |
| 2002 | 55 |
| 2003 | 37 |
| 2004 | 30 |
| 2005 | 19 |
| 2006 | 21 |
| 2007¹ | 12 |
| Total | 358 |
| ¹ To date. |
Subjects
Databases; NHS
Date
12 June 2007
Reference
135891; 461 c998-9W
House
House of Commons
To ask the Secretary of State for Health what recent assessment she has made of the security of each database containing personal details used by the NHS.
To ask the Secretary of State for Health what recent assessment she has made of the security of each database containing personal details used by the NHS.
Asked by
Lynne Jones
(Labour)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
2 May 2007
For answer on
8 May 2007
Answered on
4 June 2007
Historically each national health service organisation has been responsible for the physical and technical security safeguards, and access arrangements, for the very many local databases containing information about patients and NHS staff. These range in scale and scope from trust-wide patient information systems, to ephemeral personal contact lists held by individual members of staff.NHS organisations are required to comply with comprehensive guidance on information security standards set out in the NHS information governance toolkit. Performance against these standards by NHS trusts and primary care trusts is collected centrally and monitored for compliance. Legal penalties for individuals and organisations misusing personal health and other information are provided for under section 60 of the Data Protection Act 1998. NHS organisations are responsible, as employers, for the actions taken on their behalf by their employees, and for disciplining their staff when they behave inappropriately. The practice expected of NHS organisations in managing the use and protection of patient information is set out in the document, ““Confidentiality: NHS Code of Practice””, published in November 2003.Access to the national systems and services being developed and delivered through the national programme for information technology is determined by the policies, processes and technology provided by the Department's NHS Connecting for Health agency. These include that a user must have a smartcard. Smartcards are issued only after identity and qualifications have been checked under arrangements that conform with the e-Government interoperability framework (eGif) level 3 standards for the registration and authentication of staff. Staff must also be registered as a member of a health care team, for example a general practitioner practice or a clinic, that the patient is registered with or has been referred to, providing that patient with care, and will then only be able to access as much information as is needed for the purpose of their role within the health care team.Users are required to acknowledge their acceptance of the terms and conditions under which they may operate, including that smartcard will not be shared, smartcards and logged-on computers will not be left unattended, and conformity with the NHS Code of Confidentiality. Nominated information assurance leads in each organisation ensure the access controls are being adhered to correctly and that no unauthorised access is allowed.The security of patient identifiable data travelling over the new NHS broadband network (N3) is further protected using various network security controls, and encryption which ensures the two end points of the communication are valid, speak the same cryptographic language, and encrypts the communication that passes between them. In addition to encryption, the network security controls include each NHS trust, and the national spine database, having a firewall to protect it. The N3 network runs intrusion detection and prevention systems alongside other network management processes. Further, all of the data centres being used for national programme systems meet the highest standards of data centre security as defined by the Communications Electronic Security Group, the information assurance arm of the Government Communications Headquarters. Regular reviews of the end-to-end security infrastructure are also undertaken to identify where industry best practice has changed or technologies improved so that these can be incorporated into the overall system.While no system can be 100 per cent. secure, together these safeguards have been devised to provide an unprecedented degree of assurance of security for national programme systems and services, and the personal data they will contain, compared with existing local electronic systems. They are evidence of the very great importance that we attach to protecting the confidentiality of patient information. They contrast sharply with the situation with regard to paper records. As well as often being difficult to read, or inaccessible when they are needed, these are inherently insecure and can be easily lost, as exemplified by a recent case where paper copies of patient information from 2001-02 were found in second-hand filing cabinets.
Subjects
Databases; NHS
Date
4 June 2007
Reference
136144; 461 c308-9W
House
House of Commons
To ask the Secretary of State for Health whether a privacy impact assessment (a) has been produced and (b) is planned for the NHS spine project.
To ask the Secretary of State for Health whether a privacy impact assessment (a) has been produced and (b) is planned for the NHS spine project.
Asked by
Oliver Heald
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
25 January 2007
For answer on
29 January 2007
Answered on
21 May 2007
No. We do not believe that such an assessment would serve any useful purpose at this stage of the project.The aim of a privacy impact assessment is to ensure that privacy is considered at every stage of a project involving the handling of information, and that action is taken to mitigate against identified risks to the privacy of individuals. While this is clearly a useful tool for many projects where these matters might otherwise be neglected, the need to safeguard privacy and confidentiality is a necessary deliverable of any health record system, and the management of risk in this area has been a core deliverable of the national health service care records service (the spine project).The security safeguards around access to patient data held within the new care records will provide an unprecedented level of assurance compared with existing electronic and paper systems. The Department has also produced what we believe is the most comprehensive privacy statement of any public service in the form of the NHS care record guarantee for England, setting out 12 commitments the NHS makes to patients in order to protect their confidentiality.The Information Commissioner has confirmed that, properly deployed, the new systems have the potential to allow the NHS to better meet the various informational and privacy challenges which it faces than the systems currently in existence, and that he is content with the general approach being taken with the care records service.
Subjects
Databases; NHS
Date
21 May 2007
Reference
112572; 460 c1132W
House
House of Commons
To ask the Secretary of State for Health how many Care Records Service computer systems have been installed in hospitals.
To ask the Secretary of State for Health how many Care Records Service computer systems have been installed in hospitals.
Asked by
Lord Lancaster of Kimbolton
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
16 April 2007
For answer on
19 April 2007
Answered on
24 April 2007
[holding answer 19 April 2007]: There are currently 311 hospital-based computer systems deployed through the national programme for information technology that are connected to and use the spine. The spine is the colloquial name given to the national database of key information about patients’ health and care. It forms the core of the national health service care records service (NHS CRS). It also supports other key elements of the national programme for information technology, such as choose and book, the electronic prescriptions service, and general practitioner (GP) to GP record transfer, each of them using the spine’s messaging capabilities as part of their own services.A further 158 systems already deployed through the programme will in due course be enabled to link to the spine following further future releases of the relevant software.
Subjects
Databases; Hospitals; ICT; Medical records
Date
24 April 2007
Reference
132468; 459 c1043W
House
House of Commons
To ask the Secretary of State for Health what steps are being taken to ensure that the Care Records Service computer system at Milton Keynes hospital is fit for purpose; and when this work will be complete.
To ask the Secretary of State for Health what steps are being taken to ensure that the Care Records Service computer system at Milton Keynes hospital is fit for purpose; and when this work will be complete.
Asked by
Lord Lancaster of Kimbolton
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
16 April 2007
For answer on
19 April 2007
Answered on
19 April 2007
Urgent and priority action is being taken to manage resolution of the operational difficulties which have been experienced with the new acute patient administration system (PAS) at Milton Keynes general hospital national health service trust since it went live on 24 February. This is being implemented by a joint Fujitsu and Cerner technical specialist team on behalf of the local service provider and the main subcontractor respectively. The team is in attendance daily at the trust, supervised by a senior Fujitsu management presence on site full time to lead the resolution process. Progress in tackling and overcoming the problems which have arisen, the majority of which have already been resolved, is being monitored daily.In addition, the Department’s NHS Connecting for Health agency’s senior deployment manager for the south of England is for the time being stationed permanently on site to ensure the work of the Fujitsu/Cerner team is completed to the satisfaction of the trust, and that it is managed through to resolution.Work that is now in hand is likely to result in effective operation of the PAS system within the next two to three weeks.
Subjects
Databases; Hospitals; ICT; Milton Keynes; Milton Keynes General NHS Trust
Date
19 April 2007
Reference
132466; 459 c746-7W;459 c744-5W
House
House of Commons
To ask the Secretary of State for Health how many electronic patient records she expects there to be; and how many she expects to have (a) sealed and (b) sealed and locked data on them.
To ask the Secretary of State for Health how many electronic patient records she expects there to be; and how many she expects to have (a) sealed and (b) sealed and locked data on them.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
21 March 2007
In the future, each person using the national health service will have an electronic NHS care record which will be made up of detailed care records, held locally by the NHS body that provides care to the patient, and a summary care record. At the local level detailed care records will be built up over time into a comprehensive health and care history.The objective of sealing, and sealing and locking information is to reduce the number of people who might otherwise feel the need to opt-out completely of having a summary care record because of their concern about only a small amount of sensitive information in their record. It will be open to any patient to ask to limit access to such information, including to request that specific sensitive information is accessible only with their consent. The sealed envelopes approach has the confidence of the professions in being able to provide appropriate controls for the support of patient confidentiality.It is not possible to predict with any certainty how many people may in future choose to exercise this option as this will be the first time such an approach has ever been used. However, there is ample evidence to suggest that only a small minority would have concerns about the content of their medical records that would lead to their choosing to seal information. In response to a Consumer Association Survey (October 2002) question on this subject 60 per cent. of respondents said that they would remove nothing, around a quarter (24 per cent.) said they would remove a little, and around four per cent, said they would remove ““a lot”” or ““all””.This is paralleled by the available evidence about the likelihood of people to opt out of having a summary care record at all. The Scottish emergency care summary, which extracts data from general practitioners’ records and hospital notes, currently contains records for nearly 4.93 million patients and less than 500 have opted out. Similarly, in the course of a consultation on establishing an electronic health record in the Wirral, of patients invited to opt out if they had concerns, only 25 opted out whilst 350,000 records were uploaded. And of the 1.3 million patients likely to be affected by a similar proposal in Hampshire and the Isle of Wight, only some 1,150 decided not to have their records included in the data repository.
Subjects
Databases; Medical records
Date
21 March 2007
Reference
119873; 458 c1015W
House
House of Commons
To ask the Secretary of State for Health what databases are controlled by her Department and its agencies; and what percentage of the data in each database she estimates is inaccurate or out of date.
To ask the Secretary of State for Health what databases are controlled by her Department and its agencies; and what percentage of the data in each database she estimates is inaccurate or out of date.
Asked by
Nick Clegg
(Liberal Democrat)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
23 February 2007
For answer on
27 February 2007
Answered on
21 March 2007
Information relating to the number of databases held electronically and controlled by the Department and its agencies is contained in the following table and is listed by:"Department/agency name; and""Number of databases controlled."
The accuracy and currency of the data contained in the Department and its agencies' databases varies according to the business requirement the database is designed to meet. Where the output from a database is intended for publication as a matter of public record (for example, as a report to Parliament or a press statement), every precaution is taken to ensure that that data within the database has been fully validated to ensure the highest achievable levels of accuracy. However, where the data contained is intrinsically dynamic and is not intended for public: record (for example, the Department's internal staff location database), a lower degree of accuracy and currency is acceptable to meet business needs.It is not possible to undertake an estimate for the accuracy and currency of the data contained in each database because of disproportionate cost.
| Databases controlled by Department of Health and its agencies | |
|---|---|
| Department/agency name | Number of databases controlled |
| Department of Health | 974 |
| Medicines and Healthcare products Regulatory Agency | 47 |
| NHS Connecting for Health | 150 |
| NHS Purchasing And Supply Agency | 35 |
Subjects
Databases; Department of Health
Date
21 March 2007
Reference
458 c1002W; 124033
House
House of Commons
To ask the Secretary of State for Health how patients will opt out of having (a) their detailed patient record and (b) their summary patient record uploaded to the Spine.
To ask the Secretary of State for Health how patients will opt out of having (a) their detailed patient record and (b) their summary patient record uploaded to the Spine.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
16 February 2007
For answer on
22 February 2007
Answered on
14 March 2007
The spine is the colloquial name given to the national database of key information about patients’ health and care which forms the core of the NHS care records service, and which, from later this year, will begin to hold summary care records. Detailed patient records are created, and can be held electronically, in a variety of national health service organisations, depending on where patients have received treatment. They are accessed locally, and will not, unlike summary records, be uploaded onto the spine.It will be open to individuals to choose not to have a summary care record through discussion with their general practitioner (GP). General practices will be responsible for entering care records on the system, and by the time the summary care record is introduced in local areas general practitioners will have been provided with guidance on what they need to do to respond to requests. GPs will be advised to record and act on patient preferences.We believe that holding summary care records on the spine will deliver very significant benefits for safety and the efficient management of NHS services, improving healthcare outcomes for millions whilst preventing thousands of unnecessary deaths. Inevitably patients whose record was not held on the spine, and who might need to be treated in the absence of knowledge of the information they contain, would not receive the same quality of care as others.
Subjects
Databases; Medical records
Date
14 March 2007
Reference
458 c441W; 121951
House
House of Commons
(2) which non-NHS staff will have access to the NHS Care Records database.
(2) which non-NHS staff will have access to the NHS Care Records database.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
5 March 2007
All users of the new care records spine database are issued with a smartcard. As at the end of January 2007 there were some 320,000 authorised users registered for access.The early adopter implementation of the summary care record will be phased, initially being deployed in a small number of healthcare communities. Access to the system across these communities will be limited to healthcare professionals within accident and emergency departments, primary care out of hours services, walk-in centres, and minor injuries units who require access for the provision of care. Over time, our obligations to those patients who receive care outside of traditional national health service settings, for example in the voluntary sector, from mixed teams of health and social care professionals, and in the independent sector under contract to the NHS, will mean that by the time an electronic care record has been created for every NHS patient in England in 2010 we anticipate there will be in excess of 850,000 users.In all case, access to records will only be permitted to the staff of organisations involved in delivering care to NHS patients, working as part of a team that is providing a patient with care, and will be limited to only as much information as is needed for the purpose of the care or other job role being performed in relation to the patient. Where those providing care are not NHS staff then patients will be informed of this and any objections raised respected.
Subjects
Databases; Medical records
Date
5 March 2007
Reference
457 c1688-9W;457 c1674-5W; 119558
House
House of Commons
To ask the Secretary of State for Health (1) which (a) clinical and (b) administrative staff codes will have access to the NHS Care Records database;
To ask the Secretary of State for Health (1) which (a) clinical and (b) administrative staff codes will have access to the NHS Care Records database;
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
5 March 2007
Access to the national health service care records service (NHS CRS) is determined by local NHS organisations using policies, processes and technology provided by NHS Connecting for Health. In general only those staff who are working as part of a team that is providing a patient with care, that is, those having a legitimate relationship with the patient, will be able to see a patient's health record.Because of the differences that exist between and within organisations in the duties and responsibilities of individual staff within their work teams, access is not uniquely determined by profession, specialism or grade. Users are vetted and sponsored by their local organisations for specific access appropriate to their job role and area of work. Stringent proof of identity is required along with the endorsement of the local sponsor, a senior member of staff, in order to receive a smartcard, a secure token that, together with a passcode, confirms the identity of a user at the time of access.NHS organisations must undertake to observe strict conditions to ensure the NHS CRS is used appropriately, and the user is required to sign up to a set of conditions for use of the smartcard. The obligations and conditions are complemented by the various existing codes of conduct and professional responsibilities by which all NHS staff are bound. These obligations and conditions are assessed on a regular basis with the organisation and the user is subject to local and national checking through audit trails and alerts.Actions which do not conform to these obligations and conditions, which includes the sharing of smartcards, are dealt with locally. Sharing of information between members of a team has happened routinely prior to the introduction of smartcards. However, though there is no evidence that smartcards have been shared beyond members working as part of a team that legitimately needs access to a patients record, we recognise that the sharing of smartcards can undermine the assurance that patient confidentiality will always be appropriately respected. Staff who breach patient confidentiality are subject to professional disciplinary measures. Offending doctors and nurses will be reported to their professional regulatory bodies and may face additional disciplinary action, including losing their licence to practice.Arrangements known as role based access controls will limit what a member of staff can do within the system and consequently which parts of a record he or she can see. Access to record content will therefore be controlled by a member of staffs relationship with the patient, and by what they need to see to do their jobs. Senior clinicians within an organisation will also be able to see patient records when assuring the quality of care provided by their staff, but other access will only be authorised when required or permitted by law.
Subjects
Databases; Medical records
Date
5 March 2007
Reference
457 c1689-90W;457 c1675-6W; 119559
House
House of Commons
To ask the Secretary of State for Health (1) how many people have smartcards to access the care records database; and how many it is estimated will have smartcards when the database is fully rolled out;
To ask the Secretary of State for Health (1) how many people have smartcards to access the care records database; and how many it is estimated will have smartcards when the database is fully rolled out;
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
5 March 2007
All users of the new care records spine database are issued with a smartcard. As at the end of January 2007 there were some 320,000 authorised users registered for access.The early adopter implementation of the summary care record will be phased, initially being deployed in a small number of healthcare communities. Access to the system across these communities will be limited to healthcare professionals within accident and emergency departments, primary care out of hours services, walk-in centres, and minor injuries units who require access for the provision of care. Over time, our obligations to those patients who receive care outside of traditional national health service settings, for example in the voluntary sector, from mixed teams of health and social care professionals, and in the independent sector under contract to the NHS, will mean that by the time an electronic care record has been created for every NHS patient in England in 2010 we anticipate there will be in excess of 850,000 users.In all case, access to records will only be permitted to the staff of organisations involved in delivering care to NHS patients, working as part of a team that is providing a patient with care, and will be limited to only as much information as is needed for the purpose of the care or other job role being performed in relation to the patient. Where those providing care are not NHS staff then patients will be informed of this and any objections raised respected.
Subjects
Databases; Medical records
Date
5 March 2007
Reference
457 c1688-9W;457 c1674-5W; 119557
House
House of Commons
To ask the Secretary of State for Health how many times a day the care records database was accessed in the last period for which figures are available; and how many times a day she expects it to be accessed when it is fully rolled out.
To ask the Secretary of State for Health how many times a day the care records database was accessed in the last period for which figures are available; and how many times a day she expects it to be accessed when it is fully rolled out.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
5 March 2007
On a typical working day, by the end of January 2007, the spine database, which forms the core of the NHS care records service (NHS CRS), was being accessed by around 50,000 authenticated unique users. And during the last full week of January 2007, the approximate volumes of messages processed in connection with the following systems and services were:"personal demographic service—six and a half million""choose and book electronic booking service—over 1.4 million""electronic transmission of prescriptions—half a million."Growth in all these volumes is rising dramatically with the increase in functionality across the NHS CRS and continuing roll-out of the various elements of the system, but already the spine is the world's biggest structured health care messaging system.It is not possible to provide a realistic estimate of what these volumes will be by the time substantial integration of health and social care information systems in England has been achieved by 2010. These will depend significantly on the way in which health care management and delivery processes in the NHS adapt and develop to reflect the enormous potential of the systems and services being delivered under the national programme for information technology.
Subjects
Databases; Medical records
Date
5 March 2007
Reference
457 c1690W;457 c1676W; 119561
House
House of Commons
(2) how (a) the audit trail, (b) role-based access and (c) legitimate relationships operate when smartcards are shared between NHS personnel; and what security measures are in place to protect patient confidentiality when smartcard access is shared.
(2) how (a) the audit trail, (b) role-based access and (c) legitimate relationships operate when smartcards are shared between NHS personnel; and what security measures are in place to protect patient confidentiality when smartcard access is shared.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
5 February 2007
For answer on
7 February 2007
Answered on
5 March 2007
Access to the national health service care records service (NHS CRS) is determined by local NHS organisations using policies, processes and technology provided by NHS Connecting for Health. In general only those staff who are working as part of a team that is providing a patient with care, that is, those having a legitimate relationship with the patient, will be able to see a patient's health record.Because of the differences that exist between and within organisations in the duties and responsibilities of individual staff within their work teams, access is not uniquely determined by profession, specialism or grade. Users are vetted and sponsored by their local organisations for specific access appropriate to their job role and area of work. Stringent proof of identity is required along with the endorsement of the local sponsor, a senior member of staff, in order to receive a smartcard, a secure token that, together with a passcode, confirms the identity of a user at the time of access.NHS organisations must undertake to observe strict conditions to ensure the NHS CRS is used appropriately, and the user is required to sign up to a set of conditions for use of the smartcard. The obligations and conditions are complemented by the various existing codes of conduct and professional responsibilities by which all NHS staff are bound. These obligations and conditions are assessed on a regular basis with the organisation and the user is subject to local and national checking through audit trails and alerts.Actions which do not conform to these obligations and conditions, which includes the sharing of smartcards, are dealt with locally. Sharing of information between members of a team has happened routinely prior to the introduction of smartcards. However, though there is no evidence that smartcards have been shared beyond members working as part of a team that legitimately needs access to a patients record, we recognise that the sharing of smartcards can undermine the assurance that patient confidentiality will always be appropriately respected. Staff who breach patient confidentiality are subject to professional disciplinary measures. Offending doctors and nurses will be reported to their professional regulatory bodies and may face additional disciplinary action, including losing their licence to practice.Arrangements known as role based access controls will limit what a member of staff can do within the system and consequently which parts of a record he or she can see. Access to record content will therefore be controlled by a member of staffs relationship with the patient, and by what they need to see to do their jobs. Senior clinicians within an organisation will also be able to see patient records when assuring the quality of care provided by their staff, but other access will only be authorised when required or permitted by law.
Subjects
Databases; Medical records
Date
5 March 2007
Reference
457 c1689-90W;457 c1675-6W; 119563
House
House of Commons
To ask the Secretary of State for Health whether all patients will be able to opt out of having their (a) summary and (b) detailed care record put on (i) the Spine and (ii) any other database other than that of their GP.
To ask the Secretary of State for Health whether all patients will be able to opt out of having their (a) summary and (b) detailed care record put on (i) the Spine and (ii) any other database other than that of their GP.
Asked by
Stephen O'Brien
(Conservative)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
25 January 2007
For answer on
29 January 2007
Answered on
19 February 2007
Patients will be able to ask their general practitioners to prevent a summary care record being created for them on the spine, though the Department advises patients to think carefully before requesting this as the summary care record will enable improved national health service care and reduce clinical risk.Detailed care records, however, are held locally within health communities and are not held on the spine. Clinicians are required to keep adequate records for clinical governance and medico-legal reasons and will generally do so within detailed care records systems. As is currently the case, patients will not be able to specify how or where local detailed records are held, though the new systems will enable patients to place restrictions on how these records may be shared or accessed.In some circumstances it may be possible for clinicians to agree to keeping records outside of the detailed care records systems if to do otherwise would cause substantial distress.However, some forms of care, for example blood tests and x-rays, will in future automatically generate records within the detailed care records systems, and if care is dependent upon use of these systems there can be no flexibility for those who receive that care.
Subjects
Databases; NHS; Medical records
Date
19 February 2007
Reference
117530; 457 c423-4W;457 c406-7W
House
House of Commons
To ask the Secretary of State for Health whether general practitioners and hospital computer systems share a common address base for their patients.
To ask the Secretary of State for Health whether general practitioners and hospital computer systems share a common address base for their patients.
Asked by
Derek Wyatt
(Labour)
Answered by
Caroline Flint
(Labour)
Answering body
Department of Health
Type
Written questions
Status
Answered
Tabled on
12 January 2007
For answer on
16 January 2007
Answered on
5 February 2007
National health service patient address and other demographic information has historically been compiled in individual local records held by general practitioners and hospitals. Information, including changes of address, is sometimes shared in the course of referrals, but data held by one NHS body may not always reflect changes notified to another.Over time, a single authoritative source of patient demographic data, known as the personal demographics service (PDS), will be used by all general practitioners and hospital computer systems in England. Access to the PDS will reduce clinical risks arising from a failure to match patients with their clinical record, and help minimise cases of correspondence and documents being misdirected. Early evidence from one trust has shown a six-fold reduction in misdirected mail addressed using PDS-held data.The PDS, which first went live in June 2004, already contains information for all the patients within England, and is currently accessible across the NHS, with over 310,000 users, and receives over 26 million inquiries per month. The volumes are growing over time, with increasing patient benefits and efficiency improvements.There will be no physical or electronic links between the PDS other non-NHS databases, and other Government departments and public agencies will not be able to access the data it contains.
Subjects
Databases; Health services; Patients; Medical records
Date
5 February 2007
Reference
116306; 456 c719-20W;456 c721-2W
House
House of Commons