Privacy Notice Appendix A

The Practice will share your information with these organisations where there is a legal basis to do so.

Commissioning and Contractual Purposes

• Invoice Validation
• Planning
• Quality and Performance

Purpose – Anonymous data is used by the Integrated Care Board (ICB) for planning, performance, and commissioning purposes, as directed in the practice's contract, to provide services as a public authority.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Patients may opt out of having their personal confidential data used for planning or research. Please contact the practice in writing to request a Type 1 Opt-out or log into the NHS website to apply a National Data Opt-out

Processor – Buckinghamshire, Oxfordshire and Berkshire West ICB

Summary Care Record

• Including additional information

Purpose – The NHS in England uses a national electronic record called the Summary Care Record (SCR) to support patient care. It contains key information from your GP record. Your SCR provides authorised healthcare staff with faster, secure access to essential information about you in an emergency or when you need unplanned care, where such information would otherwise be unavailable.

Legal Basis – Direct Care under UK GDPR:

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Patients have the right to opt out of having their information shared with the SCR by completion of the form. Please note that by opting out of having your information shared with the Summary Care Record could result in a delay to care that may be required in an emergency.

Processor – NHS England and NHS Digital

Research

Purpose - We may share anonymous patient information with research companies for the purpose of exploring new ways of providing healthcare and treatment for patients with certain conditions. This data will not be used for any other purpose.

Where personal confidential data is shared, your consent will be required.

When you have opted out of having your identifiable information shared for this planning or research, your information will not be shared.

Legal Basis -

• Articles 6(1)(a) and 9(1)(a) – explicit consent; or
• Article 6(1)(c) (where we are legally obligated to share your personal data) for your standard personal data and Article 9(2)(j) (scientific research) for your health data.

Where identifiable data is required for research, patient consent will be needed, unless there is a legitimate reason under law to do so or there is support under the Health Service (Control of Patient Information Regulations) 2002 (‘section 251 support’) applying via the Confidentiality Advisory Group in England and Wales.

Sharing of aggregated non-identifiable data is permitted.

Patients may opt out of having their personal confidential data used for planning or research. Please contact the practice in writing to request a Type 1 Opt-out or log into the NHS website to apply a National Data Opt-out

Processor - NIHR Clinical Research Network - Thames Valley and South Midlands area

Individual Funding Requests

Purpose – We may need to process your personal information where we are required to fund specific treatment for you for a particular condition that is not already covered in our standard NHS contract.

The clinical professional who first identifies that you may need the treatment will explain to you the information that is needed to be collected and processed in order to assess your needs and commission your care; they will gain your explicit consent to share this. You have the right to withdraw your consent at any time but this may affect the decision to provide individual funding.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Data Processor – Datix

Safeguarding Adults

Purpose – We will share personal confidential information with the safeguarding team where there is a need to assess and evaluate any safeguarding concerns and to protect the safety of individuals.

Consent is not required to share information for this purpose.

Legal Basis – Direct Care under UK GDPR:

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Data Processor – Oxfordshire Safeguarding Adults Board

Safeguarding Children

Purpose – We will share children’s personal information where there is a need to assess and evaluate any safeguarding concerns and to protect the safety of children.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Consent may not be required to share this information.

Data Processor – Oxfordshire Safeguarding Children Board

Risk Stratification - Preventative Care

Purpose – ‘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.

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.

Type of Data – Identifiable/Pseudonymised/Anonymised/Aggregate Data

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processors – Buckinghamshire, Oxfordshire, and Berkshire West ICB

Public Health Screening Programmes (Identifiable)

• Notifiable disease information (identifiable)
• Smoking cessation (anonymous)
• Sexual health (anonymous)
• Vaccination Programmes

Purpose – Personal identifiable and anonymous data is shared. The NHS provides national screening programmes so that certain diseases can be detected at an early stage. These currently apply to bowel cancer, breast cancer, aortic aneurysms, and diabetic retinal screening service to name a few.

The law allows us to share your contact information, and certain aspects of information relating to the screening with Public Health England so that you can be appropriately invited to the relevant screening programme.

More information can be found on the government website or by speaking to the practice.

Patients may not opt out of having their personal information shared for Public Health reasons. Patients may opt out of being screened at the time of receiving an invitation.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Data Processors – Oxfordshire County Council

Direct Care

• NHS Trusts
• Community Providers
• Pharmacies
• Enhanced care providers
• Nursing Homes
• Other Care Providers

Purpose – Personal information is shared with other secondary care trusts and providers in order to provide you with individual direct care services. This could be hospitals or community providers for a range of services, including treatment, operations, physio, and community nursing, ambulance service.

Legal Basis – The processing of personal data in the delivery of direct care and for providers’ administrative purposes in this surgery and in support of direct care elsewhere is supported under the following:

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processors – Oxford University Hospitals, Oxford Health NHS Foundation Trust, Buckinghamshire Healthcare NHS Trust, Berkshire Healthcare NHS Foundation Trust

Care Quality Commission

Purpose – The CQC is the regulator for the English Health and Social Care services to ensure that safe care is provided. They will inspect and produce reports back to the GP practice on a regular basis. The law allows the CQC to access identifiable data.

More detail on how they ensure compliance with data protection law (including UK GDPR) and the Care Quality Commission Privacy Statement is available on their website.

Legal Basis –

• Article 6(1)(e) ‘…processing is necessary for compliance with a legal obligation’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processors – Care Quality Commission

Payments, Invoice Validation

Purpose – 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 amounts paid per patient per quarter vary 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 (QOF), 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, 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.

Legal Basis –

• Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.”
• Article 9(2)(h) as stated below.

Data Processors – NHS England, ICB, Public Health

Patient Record Database

Purpose – Your medical record will be processed in order that a database can be maintained. This is managed in a secure way, and there are robust processes in place to ensure your medical record is kept accurate and up to date. Your record will follow you as you change surgeries throughout your life. Closed records will be archived by NHS England.

Legal Basis –

• Article 6(1)(c) ‘processing is necessary for compliance with a legal obligation to which the controller is subject’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – EMIS and PCSE

Medical Reports & Subject Access Requests

Purpose – Your medical record may be shared in order that:

• Solicitors/persons acting on your behalf can conduct certain actions as instructed by you.
• Insurance companies seeking medical reports where you have applied for services offered by them can have a copy of your medical history for a specific purpose.
• An outside company will compile medical reports and Subject Access Requests on our behalf - this will be Medi2Data.

Legal Basis –

• Article 6(1)(a) – consent for personal data; and
• Article 9(2)(a) – explicit consent for special-category data.

Processor – Medi2Data, Solicitors, Insurance Organisations

GP Federation

• Primary Care Visiting Service
• Hospital at Home
• Urgent Care Centre
• Community Gynaecology Service

Purpose – Your medical record will be shared with PML Services in order that they can provide direct care services to the patient population. This could be in the form of video consultations, Minor injuries clinics, GP extended access clinics. The Federation will be acting on behalf of the GP practice.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – Principle Medical (PML)

Primary Care Network (PCN)

Purpose – Your medical record will be shared with the Bicester PCN in order that they can provide direct care services to the patient population.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – Alchester Medical Group, Bicester Health Centre, Montgomery-House Surgery

Smoking Cessation

Purpose – Personal information is shared in order for the smoking cessation service to be provided. Only those patients who wish to be party to this service will have their data shared.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – Stop for Life Oxon

Social Prescribers

Purpose – Access to medical records is provided to social prescribers to undertake a full service to patients dependent on their health social care needs. Only those patients who wish to be party to this service will have their data shared.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – Bicester PCN

Police

Purpose – Personal confidential information may be shared with the Police authority for certain purposes. The level of sharing and purpose for sharing may vary. Where there is a legal basis for this information to be shared, consent will not always be required.

The Police will require the correct documentation in order to make a request. This could include, but is not limited to, DS 2, Court order, s137, the prevention and detection of a crime, or where the information is necessary to protect a person or community.

Legal Basis – UK GDPR

• Article 6(1)(c) – to comply with a legal obligation;
• Article 9(2)(j) – ‘for reasons of substantial public interest’.

Processor – Police Constabulary

Coroner

Purpose – Personal health records or information relating to a deceased patient may be shared with the coroner.

Legal Basis – UK GDPR

• Article 6(1)(c) – to comply with a legal obligation;
• Article 9(2)(h) – ‘necessary for the purposes of preventative or occupational medicine’.

Processor – The Coroner

Medical Examiner - Buckinghamshire, Oxfordshire and Berkshire West ICB

Purpose – Medical records associated with deceased patients are outside the scope of the UK GDPR. However, next of kin details are within the scope of the UK GDPR. We will share specified deceased patient records of next of kin details with the Medical Examiners within BOB ICB.

Legal Basis –

• Article 6(1)(c) – necessary under a legal obligation to which the controller is subject;
• 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.”

Processor – Medical Examiners service - Buckinghamshire, Oxfordshire and Berkshire West ICB

Non-commissioned, Private Healthcare Providers

Purpose – Personal information is shared with private healthcare providers in order to deliver direct care to patients at the patient’s request. Consent from the patient will be required to share data with Private Providers.

Legal Basis –

• Article 6(1)(a) – consented and under contract between the patient and the provider;
• Article 9(2)(h) – necessary for the purposes of preventative or occupational medicine.

Provider – Private Healthcare Provider of choice

Messaging Service

Purpose – Personal identifiable information is shared with the messaging service in order that messages including; appointment reminders; results; campaign messages related to specific patients' health needs; and direct messages to patients, can be transferred to the patient in a safe way.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Provider – AccuRX, eConsult, NHSAPP

Remote Consultation

• Including - Video Consultation, Clinical Photography

Purpose – Personal information, including images, may be processed, stored, and with the patient's consent, shared to provide the patient with urgent medical advice.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Patients may be videoed or asked to provide photographs with consent. There are restrictions on what the practice can accept photographs of:

• No photographs of the full face.
• No intimate areas.
• No pictures of patients who cannot consent to the process.
• No pictures of children.

Processor – e-Consult, AccuRX

MDT Meetings

Purpose – For some long-term conditions, the practice participates in meetings with staff from other agencies involved in providing care, to help plan the best way to provide care to patients with these conditions. Personal data will be shared with other agencies in order that mutual care packages can be decided.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – District Nurses, Health Visitors, via MS Teams

General Practice Extraction Service (GPES)

Purpose – GP practices are required to provide data extraction of their patient’s personal confidential information for various purposes to NHS Digital. The objective of this data collection is on an ongoing basis to identify patients registered at General Practices who fit within a certain criterion, in order to monitor and either provide direct care, or prevent serious harm to those patients.

Below is a list of the purposes for the data extraction, by using the link you can find out the detail behind each data extraction and how your information will be used to inform this essential work:

• At risk patients including severely clinically vulnerable
• NHS England has directed NHS Digital to collect and analyse data in connection with Cardiovascular Disease Prevention Audit
• GPES Physical Health Checks for people with Severe Mental Illness (PHSMI) data collection
• National Obesity Audit

Legal Basis – All GP Practices in England are legally required to share data with NHS Digital for this purpose under section 259(1)(a) and (5) of the 2012 Act. Further detailed legal basis can be found in each link. Any objections to this data collection should be made directly to NHS Digital at enquiries@nhsdigital.nhs.uk.

Processor – NHS England

Medication/Prescribing

Purpose – Prescriptions containing personal identifiable and health data will be shared with organisations who provide medicines management, including chemists/pharmacies, in order to provide patients with essential medication regime management, medicines, and/or treatment as their health needs dictate.

This process is achieved either by face-to-face contact with the patient or electronically. Pharmacists may be employed to review medication. Patients may be referred to pharmacists to assist with diagnosis and care for minor treatment. Patients may have specified a nominated pharmacy where they wish their repeat or acute prescriptions to be ordered and sent directly, making the process more efficient. Arrangements can also be made with the pharmacy to deliver care and medication.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Processor – Pharmacy of choice

Online Consultation Provider (Triage)

Purpose – Provides the online booking service for Montgomery-House Surgery. Their data is hosted on Amazon Web Services (AWS) servers in the UK. All data sent is encrypted when in transit (when it is sent) and at rest (when it is stored). Patient data is kept in line with the NHS Records Management Code of Practice and stored on the practice system. Rapid Health will retain a copy of the data for a period of 6 months after it is collected, for technical support purposes, before being deleted.

Rapid Health has completed all stages of NHS-required assurance to interact with the practice patient record system and is fully GDPR compliant.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Data Processor – Rapid Health

Registration Automation

Purpose – The aim of the Healthtech-1’s service is to reduce the time practice staff spend on administration and improve the patient’s experience of engaging with the practice. For Healthtech-1 to complete an automated patient registration, the primary data source is from the patient who will manually enter their personal details using their digital device onto the website.

Additional special category data points are collected from the patient for the purpose of increasing quality of care for that patient at the relevant GP surgery.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Data Processor – Healthtech-1

Professional Training

Purpose – We are a training surgery. Our clinical team are required to be exposed to on-the-job clinical experience, as well as continual professional development. On occasion, you may be asked if you are happy to be seen by one of our GP registrars, pharmacists, or other clinical team members to assist with their training as a clinical professional.

You may also be asked if you would be happy to have a consultation recorded for training purposes. These recordings will be shared and discussed with training GPs at the surgery and also with moderators at the RCGP and HEE.

Legal Basis –

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Recordings remain the control of the GP practice and they will delete all recordings from the secure site once they are no longer required.

Processor – RCGP, HEE, iConnect, Fourteen Fish

Telephony

Purpose – The practice uses an internet-based telephony system that records telephone calls for their own purpose and to assist with patient consultations. The telephone system has been commissioned to assist with the high volume and management of calls into the surgery, which in turn will enable a better service to patients.

Legal Basis – While there is a robust contract in place with the processor, the surgery has undertaken this service to assist with the direct care of patients in a more efficient way.

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’;
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’.

Provider – Surgery Connect – X-ON

Learning Disability Mortality Programme (LeDeR)

Purpose – The Learning Disability Mortality Review (LeDeR) programme was commissioned by NHS England to investigate the death of patients with learning difficulties and Autism to assist with processes to improve the standard and quality of care for people living with a learning disability and Autism. Records of deceased patients who meet this criteria will be shared with NHS England.

Legal Basis – It has approval from the Secretary of State under section 251 of the NHS Act 2006 to process patient identifiable information for those who fit within a certain criteria.

Processor – Buckinghamshire, Oxfordshire and Berkshire West ICB, NHS England

Shared Care Record

Purpose - In order for the practice to have access to a shared record, the Integrated Care Service has commissioned a number of systems including GP connect, which is managed by NHS Digital, to enable a shared care record, which will assist in patient information to be used for a number of care related services. These may include Population Health Management, Direct Care, and analytics to assist with planning services for the use of the local health population. Where data is used for secondary uses no personal identifiable data will be used. Where personal confidential data is used for Research explicit consent will be required.

Legal Basis -

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’; and
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’

Processor - NHS England

Local share care record

• The Thames Valley & Surrey (TVS)
• Care Records
• Health Information Exchange (HIE)

Purpose - Health and social care services are developing shared systems to share data efficiently and quickly. It is important for anyone treating you to be able to access your shared record so that they have all the information they need to care for you. This will be during your routine appointments and in urgent situations such as going to A&E, calling 111 or going to an Out of Hours appointment. It is also quicker for staff to access a shared record than to try to contact other staff by phone or email.

Only authorised staff can access the systems and the information they see is carefully checked so that it relates to their job. Systems do not share all your data, just data which services have agreed is necessary to include.

For more information on the TVS Shared Care Record and HIE

If you wish to opt out from this data sharing, you will need to let the practice know so they can change your record sharing settings. Please contact the surgery and ask us to record that you have refused consent for upload to local shared electronic record

Legal Basis -

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’; and
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’

Processors - Graphnet, Cerner

Anticoagulation Monitoring

Purpose - Personal Confidential data is shared with LumiraDX in order to provide an anticoagulation clinic to patients who are on anticoagulation medication. This will only affect patients who are within this criteria.

Legal Basis -

• Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’; and
• Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine’

Processors - LumiraDX. INRStar

Digitisation of paper medical records -

• Iron Mountain UK

Purpose -  The NHS Long Term plan published in 2019 requires the digitisation of all primary care paper medical records, commonly known as ‘Lloyd George’ records or ‘A4 medical records’. Having paper based medical records restricts the use of technology to provide ‘joined up’ services and therefore the current paper records will be transferred to a digital format and then destroyed. This will involve the current patient paper medical records being scanned and then entered directly into a patient’s electronic medical record. This work will be completed by a third-party supplier, Iron Mountain UK plc, whose security standards have been reviewed by BOB ICB.

Legal Basis -

• Article 6(1)(e) – “processing is necessary…in the exercise of official authority vested in the controller...’’ and
• Article 9(2)(h) – “processing is necessary for the purpose of preventative…medicine…the provision of health or social care or treatment or the management of health or social care systems and services...”

Processors - Iron Mountain UK plc