Social Prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. NHS England describes social prescribing as “enabling all local agencies to refer people to a link worker”. Link workers – known locally as Community Connectors – give people time, and focus on what matters to the person. They connect people to community groups and agencies for practical and emotional support. If you have an appointment with a Community Connector, only limited information would be passed on. There are agreements in place to protect your data.

Local Information Sharing

Your GP electronic patient record is held securely and confidentially on an electronic system managed by your registered GP Practice. If you require attention from a local Healthcare Professional outside of your usual practice services, such as in an Evening and Weekend GP Access Clinic, GP Federation Service, Emergency Department, Minor Injury Unit or Out Of Hours service, the professionals treating you are better able to give you safe and effective care if some of the information from your GP record is available to them.

Where available, this information can be shared electronically with other local healthcare providers via a secure system designed for this purpose. Depending on the service you are using and your health needs, this may involve the Healthcare Professional accessing a secure system that enables them to view parts of your GP electronic patient record ,or a secure system that enables them to view your full GP electronic patient record (e.g. EMIS remote consulting system).

In all cases, your information is only accessed and used by authorised staff who are involved in providing or supporting your direct care. Your permission will be asked before the information is accessed, other than in exceptional circumstances (e.g. emergencies) if the Healthcare Professional is unable to ask you and this is deemed to be in your best interests (which will then be logged).

Disclosure and sharing of your information

Information we obtain from third parties

We sometimes receive data that is indirectly made up from your personal information from third parties whose services we use. No such information is personally identifiable to you.

Information provided on the understanding that it will be shared with a third party

We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), where the law requires information to be passed on and / or in accordance with the new information sharing principle following Dame Fiona Caldicott’s information sharing review (Information to share or not to share) where “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that Health and Social Care Professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles. They should be supported by the policies of their employers, regulators and professional bodies.

Who are our partner organisations?

We may also have to share your information, subject to strict agreements on how it will be used, with the following organisations;

• NHS Trusts / Foundation Trusts
• GPs
• 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
• Health and Social Care Information Centre (HSCIC)
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police & Judicial Services
• Voluntary Sector Providers
• Private Sector Providers
• Other ‘data processors’ which you will be informed of

You will be informed who your data will be shared with and in some cases asked for explicit consent for this to happen, when required.

We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure.

What to do if you don’t want your information shared

Please tell us if you don’t want your information to be shared – either in some or all circumstances. We can make a note on your record that will ensure that your records can only be accessed by a health professional in the Practice (i.e. no administrative staff will be able to look at your records) or we can block your health data so that it can’t be accessed by other health service bodies e.g. Electronic Care Record.

Information submitted online

The practice website allows for the submission of some personal information for the purposes of updating your medical record e.g. new contact details. The service is provided by accredited suppliers, and all information submitted is covered by the same regulations as all other patient information.

Patient Rights (as the Data Subject)The right to erasure

The right to erasure is also known as “the right to be forgotten” and in general refers to an individual’s right to request the deletion or removal of personal information where there is no compelling reason for the Practice to continue using it.

As with other rights, there are particular conditions around this right and it does not provide individuals with an absolute right to be forgotten.

Individuals have the right to have their personal information deleted or removed in the following circumstances:

• When it is no longer necessary for the purpose for which it was collected
• When the Practice no longer have a legal basis for using you your personal information, for example if you gave us consent to use your personal information in a specific way, and you withdraw your consent, we would need to stop using your information and erase it unless we had an overriding reason to continue to use it
• When you object to the Practice using your personal information and there is no overriding legitimate interest for us to continue using it.
• If we have used your personal information unlawfully
• If there is a legal obligation to erase your personal information for example by court order

The Practice can refuse to deal with your request for erasure when we use your personal information for the following reasons:

• to comply with a legal obligation for the performance of a public interest task or exercise of official authority
• for public health purposes in the public interest
• archiving purposes in the public interest, scientific research historical researchor statistical purpose
• the exercise or defence of legal claims

The right to restrict processing

You have the right to control how we use your personal information in some circumstances. This is known as the right to restriction. When processing is restricted, the Practice is permitted to store your personal information, but not further use it until an agreement is reached with you about further processing. We can retain enough information about you to ensure that your request for restriction is respected in the future.

Examples of ways you can restrict our processing would be:

• If you challenge the accuracy of your personal information, stop using it until we check its accuracy
• If you object to processing which is necessary for the performance of our tasks in the public interest or for the purpose of legitimate interests, we will restrict our processing while we consider whether our legitimate grounds override your individual interests, rights and freedoms
• If our use of your personal information is found to be unlawful and you ask for restriction instead of full erasure we will restrict our processing
• If we no longer need your personal information but you need it to establish, exercise or defend a legal claim, we will restrict our processing.

If we have shared your personal information with any individuals or organisations, if we restrict our processing, we will tell those individuals or organisations about our restriction if it is possible and not an unreasonable amount of effort.
Whenever we decide to lift a restriction on processing we will tell you.

Direct Care Emergencies

There are occasions when intervention is necessary in order to save or protect a patient’s life or to prevent them from serious immediate harm, for instance during a collapse or diabetic coma or serious injury or accident. In many of these circumstances the patient may be unconscious or too ill to communicate.

In these circumstances we have an overriding duty to try to protect and treat the patient. If necessary we will share your information and possibly sensitive confidential information with other emergency healthcare services, the police or fire brigade, so that you can receive the best treatment.

When you contact us, whether by telephone, through our website or by e-mail, we collect the data you have given to us in order to reply with the information you need. We record your request and our reply in order to increase the efficiency of our Practice. We keep personally identifiable information associated with your message, such as your name and email address so as to be able to track our communications with you to provide a high quality service.

The Practice is dedicated to ensuring that the principles and duties of safeguarding adults and children are holistically, consistently and conscientiously applied with the wellbeing of all, at the heart of what we do.

Our legal basis for processing For the General Data Protection Regulation (GDPR) purposes is: –

Article 6(1)(e) ‘…exercise of official authority…’. 

For the processing of special categories data, the basis is: –

Article 9(2)(b) – ‘processing is necessary for the purposes of carrying out the obligations and exercising specific rights of the controller or of the data subject in the field of employment and social security and social protection law…’

‘Risk stratification for case finding’ is a process for identifying and managing patients who have or may be at-risk of health conditions (such as diabetes) or who are most likely to need healthcare services (such as people with frailty). Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health before it develops.
Information about you is collected from a number of sources including NHS Trusts, GP Federations and your GP Practice. A risk score is then arrived at through an analysis of your de-identified information. This can help us identify and offer you additional services to improve your health. Risk-stratification data may also be used to improve local services and commission new services, where there is an identified need. In this area, risk stratification may be commissioned by the our NHS Clinical Commissioning Group (OCCG). Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes.

Further information about risk stratification.

If you do not wish information about you to be included in any risk stratification programmes, please let us know. We can add a code to your records that will stop your information from being used for
this purpose. Please be aware that this may limit the ability of healthcare professionals to identify if you have or are at risk of developing certain serious health conditions.

NHS Digital 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.

• All patients who receive NHS care are registered on a national database
• This database holds your name, address, date of birth and NHS Number but it does not hold information about the care you receive
• The database is held by NHS Digital, a national organisation which has legal responsibilities to collect NHS data.
• More information can be found at NHS Digital or you can telephone general enquiries on 0300 303 5678
• NHS England’s privacy notice
• NHS App privacy policy

Public health encompasses everything from national smoking and alcohol policies, the management of epidemics such as flu, the control of large scale infections such as TB and Hepatitis B to local outbreaks of food poisoning or Measles. Certain illnesses are also notifiable; the doctors treating the patient are required by law to inform the Public Health Authorities, for instance Scarlet Fever.

This will necessarily mean the subjects personal and health information being shared with the Public Health organisations.

Some of the relevant legislation includes: the Health Protection (Notification) Regulations 2010 (SI 2010/659), the Health Protection (Local Authority Powers) Regulations 2010 (SI 2010/657) ,  the Health Protection (Part 2A Orders) Regulations 2010 (SI 2010/658) ,  Public Health (Control of Disease) Act 1984, Public Health (Infectious Diseases) Regulations 1988 and The Health Service (Control of Patient Information) Regulations 2002

The basis on which we process information about you

The Law requires us to determine under which of six defined bases we process different categories of your personal information, and to notify you of the basis for each category. If a basis on which we process your personal information is no longer relevant then we shall immediately stop processing your data. If the basis changes then, if required by Law, we shall notify you of the change and of any new basis under which we have determined that we can continue to process your information.

Lawful basis for processing

The legal basis will be

Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.”

And

Article 9(2)(h) “processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards ”

Information we process because we have a contractual obligation with you

When you join our Practice, receive medical services from us, or otherwise agree to our terms and conditions, a contract is formed between you and us. In order to carry out our obligations under that contract we must process the information you give us. Some of this information may be personal information.

We may use it in order to:

• verify your identity for security purposes
• provide you with our services
• provide you with suggestions and advice and how to obtain the most from using our website

We process this information on the basis there is a contract between us, or that you have requested we use the information before we enter into a legal contract. Additionally, we may aggregate this information in a general way and use it to provide class information, for example to monitor our performance with respect to a particular service we provide. If we use it for this purpose, you as an individual will not be personally identifiable.

We shall continue to process this information until the contract between us ends or is terminated by either party under the terms of the contract.

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.

About the personal information we use

We use personal information on different groups of individuals including:

• Patients
• Staff
• Contractors
•  Suppliers
• Complainants, enquirers
• Survey respondents
• Professional experts and consultants
• Individual captured by CCTV

The personal information we use includes information that identifies you like your name, address, date of birth and postcode.We also use more sensitive types of personal information, including information about racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic and biometric data, health; sex life or sexual orientation.The information we use can relate to personal and family details; education, training and employment details; financial details; lifestyle and social circumstances; goods and services; visual images; details held in the patient record; responses to surveys.

Information we process with your consent

Through certain actions when otherwise there is no contractual relationship between us, such as when you browse our website or ask us to provide you with more information about our business, including job opportunities and our services, you provide your consent to us to process information that may be personal information.

Wherever possible, we aim to obtain your explicit consent to process this information, for example, by asking you to agree to our use of cookies.

Sometimes you might give your consent implicitly, such as when you send us a message by e-mail to which you would reasonably expect us to reply.

Except where you have consented to our use of your information for a specific purpose, we do not use your information in any way that would identify you personally. We may aggregate it in a general way and use it to provide class information, for example to monitor the performance of a particular page on our website.

We continue to process your information on this basis until you withdraw your consent or it can be reasonably assumed that your consent no longer exists.

You may withdraw your consent at any time by instructing us in writing. However, if you do so, you may not be able to use our website or our services further.

Information we process for the purposes of legitimate interests

We may process information on the basis there is a legitimate interest, either to you or to us, of doing so.

Where we process your information on this basis, we do after having given careful consideration to:

• whether the same objective could be achieved through other means
• whether processing (or not processing) might cause you harm
• whether you would expect us to process your data, and whether you would consider it reasonable to do so

For example, we may process your data on this basis for the purposes of:

• record-keeping for the proper and necessary administration of our business or profession
• responding to unsolicited communication from you to which we believe you would expect a response
• protecting and asserting the legal rights of any party
• insuring against or obtaining professional advice that is required to manage business or professional risk
• protecting your interests where we believe we have a duty to do so

Information we process because we have a legal obligation

We are subject to the Law like everyone else. Sometimes, we must process your information in order to comply with a statutory obligation.

For example, we may be required to give information to legal authorities if they so request or if they have the proper authorisation such as a search warrant or court order.

This may include your personal information.

Information we process may be categorised as special category data

Special category data is personal data which the GDPR says is more sensitive, and so needs more protection. For example information about an individuals:

• race
• ethnic origin
• health
• sex life or
• sexual orientation

We may process this information for the purposes of medical diagnosis, provision of health treatment and management of the health of our patients and the community we serve.

Specific uses of information you provide to us

Healthcare Professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records are used to help to provide you with the best possible healthcare.

NHS healthcare records may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Records we hold about you may include the following information;

• Details about you, such as your name, address, carers, legal representatives and 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 Healthcare Professionals, relatives or those who care for you

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information may be used within our GP Practice for clinical audit to monitor the quality of the service provided. Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified.

Sometimes your information may be requested to be used for research purposes – the Surgery will always gain your consent before releasing the information for this purpose.

Who else may ask to access your information

• The Court can insist that we disclose medical records to them
• Solicitors often ask for medical reports. These will always be accompanied by your signed consent for us to disclose information. We will not normally release details about other people that are contained in your records (e.g. wife, children parents etc.) unless we also have their consent
• Social Services – The Benefits Agency and others may require medical reports on you from time to time. These will often be accompanied by your signed consent to disclose information. Failure to cooperate with these agencies can lead to loss of benefit or other support. However, if we have not received your signed consent we will not normally disclose information about you
• Insurance Companies frequently ask for medical reports on prospective clients. These are always accompanied by your signed Consent Form. We will only disclose the relevant medical information as per your consent. You have the right, should you request it, to see reports prepared for Insurance Companies or employers before they are sent. We may contact you on receipt of a third party request to discuss your consent and clarify what will be shared.
• We use a Processor, iGPR Technologies Limited( ”iGPR”), to assist us with responding to report requests relating to your patient data, such as subject access requests that you submit to us (or that someone acting on your behalf submits to us) and report requests that insurers submit to us under the Access to Medical Records Act 1988 in relation to a life insurance policy that you hold or are applying for. iGPR manages the reporting process for us by reviewing and responding to requests in accordance with our instructions and all applicable laws, including UK data protection laws. The instructions we issue to iGPR include general instructions on responding to requests and specific instructions on issues that will require further consultation with the GP responsible for your care.
• If you have any questions about the above points please contact the Practice.

Access to to your own information

• Confirmation that your personal information is being held or used by us
• Access to your personal information
• Additional information about how we use your personal information

Although we must provide this information free of charge, if your request is considered unfounded or excessive, or if you request the same information more than once, we may charge a reasonable fee.

If you would like to access your personal information, you can do this by submitting a written request to the Practice at the address shown at the top of this page.

Once we have received your request and you have provided us with enough information for us to locate your personal information, we will respond to your request without delay, within one month (30 days). However If your request is complex we may take longer, by up to two months, to respond. If this is the case we will tell you and explain the reason for the delay.

Rights to object

You have the right under Article 21 of the GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance.

GP Practices process personal data under Article 6(1)(c) on a lawful and legitimate basis where the organisation is obliged under law to comply with

• The General Data Protection Regulations (GDPR)
• The Freedom of Information Act
• The NHS Constitution
•  The Local Authority Social Services and National HealthService Complaints (England) Regulations 2009
  By complying with these laws, the Practice has compelling legitimate grounds for the processing which override the interests, rights and freedoms in the right to object.

The right to rectification

If the personal information we hold about you is inaccurate or incomplete you have the right to have this corrected.

If it is agreed that your personal information is inaccurate or incomplete we will aim to amend your records accordingly, normally within one month, or within two months where the request is complex. However, we will contact you as quickly as possible to explain this further if the need to extend our timescales applies to your request. Unless there is a risk to patient safety, we can restrict access to your records to ensure that the inaccurate or incomplete information is not used until amended.

If for any reason we have shared your information with anyone else, such as for a referral to another service, we will notify them of the changes required to ensure their records are accurate.
If on consideration of your request we do not consider the personal information to be inaccurate then we will add a comment to your record stating your concerns about the information. If this is the case we will contact you within one month to explain our reasons for this.

Processing of prescriptions

We process prescription requests on a daily basis. This involves our staff accessing information held about you on our computer database, to produce prescription(s) that you, your carer, nominated person, or Pharmacy has requested. Prescriptions can be requested using various methods: by telephone, online via our computer system, Electronic prescriptions, by post, in writing, via fax (if available) or in person. Please refer to our Prescription Procedure for further information. If using the postal service always allow extra time so you do not run out of your medication.

Collection/uplift of prescriptions

We will always ask for your details when a prescription uplift request is received; this could be your name, date of birth and address, medication you requested, or Community Health Index Number (which uniquely identifies you). This ensures that we can produce your prescription(s) efficiently, and reduces the risk of an incorrect prescription being given to you or your nominated person/carer/Pharmacy.

Please allow the allotted time before uplifting your prescription. Prescriptions can be collected/sent via the following methods:

• In person
• Via your nominated choice of person/organisation, this could be your carer, pharmacy, family member or friend (please be aware if you are not uplifting your own prescription we may ask for proof of identification from that person before we issue your Prescription, and we may also require a signature for our own records)
• Post – if using the postal service, please always allow extra time when ordering your medication, as we cannot guarantee postal delivery schedules
• Home delivery service – some Pharmacies may deliver your prescription directly to your home; please check with your local Pharmacist to see if they can provide this service for you

Contract holding GPs in the UK receive payments from their respective governments on a tiered basis. Most of the income is derived from baseline capitation payments made according to the number of patients registered with the practice on quarterly payment days. These amount paid per patient per quarter varies according to the age, sex and other demographic details for each patient. There are also graduated payments made according to the practice’s achievement of certain agreed national quality targets known as the Quality and Outcomes Framework (QUOF), for instance the proportion of diabetic patients who have had an annual review. Practices can also receive payments for participating in agreed national or local enhanced services, for instance opening early in the morning or late at night or at the weekends. Practices can also receive payments for certain national initiatives such as immunisation programs and practices may also receive incomes relating to a variety of non patient related elements such as premises. Finally there are short term initiatives and projects that practices can take part in. Practices or GPs may also receive income for participating in the education of medical students, junior doctors and GPs themselves as well as research.

In order to make patient based payments basic and relevant necessary data about you needs to be sent to the various payment services. The release of this data is required by English laws – NHS England’s powers to commission health services under the NHS Act 2006 or to delegate such powers to CCGs and the GMS regulations 2004 (73)1).