This privacy notice explains why we collect information about you, how that information will be used, how we keep it safe and confidential and what your rights are in relation to this.

It follows on from our Fair Processing Notice and tells you in more depth why Mythe Medical Practice collects information about you, who we may share it with and how that information may be used.

The health care professionals who provide you with care also maintain records about your health and any treatment or care that you have received previously.  This may include your GP Surgery, the NHS Trust, Walk-In Clinics and Out of Hours care).  The reason for sharing this information is to provide you with the best possible joined up healthcare.

Our Commitment to Data Privacy and Confidentiality Issues

As a GP practice, all of our GPs, staff and associated practitioners are committed to protecting your privacy and will only process data in accordance with the Data Protection Legislation. This includes the General Data Protection Regulation (EU) 2016/679  (GDPR), the Data Protection Act (DPA) 2018, the Law Enforcement Directive (Directive (EU) 2016/680) (LED) and any applicable national Laws implementing them as amended from time to time. The legislation requires us to process personal data only if there is a legitimate basis for doing so and that any processing must be fair and lawful.

In addition, consideration will also be given to all applicable Law concerning privacy, confidentiality, the processing and sharing of personal data including the Human Rights Act 1998, the Health and Social Care Act 2012 as amended by the Health and Social Care (Safety and Quality) Act 2015, the common law duty of confidentiality and the Privacy and Electronic Communications (EC Directive) Regulations.

What sort of records about me do you hold?

Your Data Controller:  Mythe Medical Practice

Records may be held in both electronic or manual (written down) formats and may include the following important information:

• Personal Data – means any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.
• Special Categories of Personal Data – this term describes personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.
• Confidential Patient Information – this term describes information or data relating to their health and other matters disclosed to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. Including both information ‘given in confidence’ and ‘that which is owed a duty of confidence’. As described in the Confidentiality: NHS code of Practice: Department of Health guidance on confidentiality 2003.
• Pseudonymised – The process of distinguishing individuals in a dataset by using a unique identifier which does not reveal their ‘real world’ identity.
• Anonymised –  Data in a form that does not identify individuals and where identification through its combination with other data is not likely to take place
• Aggregated – Statistical data about several individuals that has been combined to show general trends or values without identifying individuals within the data.

Apart from my own healthcare why might you hold these records?

Information held about you may:

• be used to help protect the health of the public and to help us manage the NHS
• for clinical audit to monitor the quality of service provided
• be held centrally and used for statistical purposes
• for research purposes

In all cases you can expect that that we will ensure that individual patients cannot be identified and consent will be obtained where research work is carried out.

How we keep your information confidential and safe

• Everyone working for the NHS is subject to the Common Law Duty of Confidence.
• Information provided in confidence will only be used for the purposes advised with consent given by the patient, unless there are other circumstances covered by the law.
• The NHS Digital Code of Practice on Confidential Information applies to all our staff and they are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared.
• All our staff are expected to make sure information is kept confidential and receive annual training on how to do this.
• NHS health 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.
• Your records are backed up securely in line with NHS standard procedures.
• We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access is restricted to authorised personnel.
• We also make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed.
• We are committed to protecting your privacy and will only use information collected lawfully in accordance with:
  • General Data Protection Regulation 2018
  • Human Rights Act
  • Common Law Duty of Confidentiality
  • NHS Codes of Confidentiality and Information Security
  • Health and Social Care Act 2015
• We maintain our duty of confidentiality to you at all times.
• 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), or where the law requires information to be passed on.

How we use your information

Improvements in information technology are also making it possible for us to share data with other healthcare organisations for the purpose of providing you, your family and your community with better care. For example it is possible for healthcare professionals in other services to access your record with your permission when the practice is closed. This is explained further in the Local Information Sharing at Appendix A.

Whenever you use a health or care service, such as attending Accident & Emergency or using Community Care services, important information about you is collected in a patient record for that service. Collecting this information helps to ensure you get the best possible care and treatment. The information collected about you when you use these services can also be used and provided to other organisations for purposes beyond your individual care, for instance to help with:

• improving the quality and standards of care provided
• research into the development of new treatments
• preventing illness and diseases
• monitoring safety
• planning services

This may only take place when there is a clear legal basis to use this information. All these uses help to provide better health and care for you, your family and future generations. Confidential patient information about your health and care is only used like this where allowed by law.

Most of the time, anonymised data is used for research and planning so that you cannot be identified in which case your confidential patient information isn’t needed.

A full list of details including the legal basis, any Data Processor involvement and the purposes for processing information can be found in Appendix A.

How long do we hold information for?

All records held by the Practice will be kept for the duration specified by national guidance from NHS Digital, Health and Social Care Records Code of Practice. Once information that we hold has been identified for destruction it will be disposed of in the most appropriate way for the type of information it is. Personal confidential and commercially confidential information will be disposed of by approved and secure confidential waste procedures. We keep a record of retention schedules within our information asset registers, in line with the Records Management Code of Practice for Health and Social Care 2016.

Individuals Rights under GDPR

Under GDPR 2016 the Law provides the following rights for individuals. The NHS uphold these rights in a number of ways.

• The right to be informed
• The right of access
• The right to rectification
• The right to erasure (not an absolute right) only applies in certain circumstances
• The right to restrict processing
• The right to data portability
• The right to object
• Rights in relation to automated decision making and profiling.

Your right to opt out of data sharing and processing

The NHS Constitution states ‘You have a right to request that your personal and confidential information is not used beyond your own care and treatment and to have your objections considered’. For further information please visit: The NHS Constitution

Type 1 Opt Out

This is an objection that prevents an individual’s personal confidential information from being shared outside of their general practice except when it is being used for the purposes of direct care, or in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease. If you wish to apply a Type 1 Opt Out to their record they should make their wishes know to the practice manager.

National data opt-out

The national data opt-out was introduced on 25 May 2018, enabling patients to opt-out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.

By 2020 all health and care organisations are required to apply national data opt-outs where confidential patient information is used for research and planning purposes. NHS Digital has been applying national data opt-outs since 25 May 2018. Public Health England has been applying national data opt-outs since September 2018.

The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to share a patient’s confidential patient information for purposes beyond their individual care. Any patient that had a type 2 opt-out recorded on or before 11 October 2018 has had it automatically converted to a national data opt-out. Those aged 13 or over were sent a letter giving them more information and a leaflet explaining the national data opt-out. For more information go to National data opt out programme

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters.

On this web page you will:

• See what is meant by confidential patient information
• Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care
• Find out more about the benefits of sharing data
• Understand more about who uses the data
• Find out how your data is protected
• Be able to access the system to view, set or change your opt-out setting
• Find the contact telephone number if you want to know any more or to set/change your opt-out by phone
• See the situations where the opt-out will not apply

Right of Access to your information (Subject Access Request)

Under Data Protection Legislation everybody has the right have access to, or request a copy of, information we hold that can identify you, this includes your medical record, there are some safeguards regarding what you will have access and you may find information has been redacted or removed for the following reasons;

• It may be deemed to risk causing harm to the patien to others
• The information within the record may relate to third parties who are entitled to their confidentiality, or who have not given their permission for the information to be shared.

You do not need to give a reason to see your data. And requests can be made verbally or in writing. Although we may ask you to complete a form in order that we can ensure that you have the correct information you require.

Where multiple copies of the same information is requested the surgery may charge a reasonable fee for the extra copies.

You will need to provide proof of identity to receive this information. We will not share information relating to you with other individuals without your explicit instruction or without sight of a legal document.

Patients may also request to have online access to their data, they may do this via the NHSAPP or via the practice’s system. If you would like to access your GP record online visit www.mythemedical.co.uk.

Change of Detail

It is important that you tell the surgery if any of your contact details such as your name or address have changed especially if any of your other contacts details are incorrect. It is important that we are made aware of any changes immediately in order that no information is shared in error.

Mobile telephone number

If you provide us with your mobile phone number, we may use this to send you text reminders about your appointments or other health screening information. Please let us know if you do not wish to receive text reminders on your mobile.

Email address

Where you have provided us with your email address, with your consent we will use this to send you information relating to your health and the services we provide. If you do not wish to receive communications by email please let us know.

Notification

Data Protection Legislation requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.

We are registered as a Data Controller and our registration can be viewed online in the public register at: www.ico.org.uk/what_we_cover/register_of_data_controllers

Any changes to this notice will be published on our website and in a prominent area at the Practice.

Data Protection Officer

Should you have any data protection questions or concerns, please contact our Data Protection Officer via the surgery at: mythec.c.@nhs.net

What is the right to know?

The Freedom of Information Act 2000 (FOIA) gives people a general right of access to information held by or on behalf of public authorities, promoting a culture of openness and accountability across the public sector. You can request any non-personal information that the GP Practice holds, that does not fall under an exemption. You may not ask for information that is covered by the Data Protection Legislation under FOIA. However you can request this under a right of access request – see section above ‘Access to your information’.

Right to Complain

If you have concerns or are unhappy about any of our services, please contact the Practice Manager. For independent advice about data protection, privacy and data-sharing issues, you can contact:

The Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Phone: 0303 123 1113
Website: www.ico.org.uk/global/contact-us

The NHS Care Record Guarantee

The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS, what control the patient can have over this, the rights individuals have to request copies of their data and how data is protected under Data Protection Legislation.

The NHS Constitution

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

www.gov.uk – NHS Constitution for England

Appendix A

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

Who are our information sharing partners?

As mentioned above, we share information with a variety of organisations for different reasons.

See below for more details of our sharing partners.

ACR Testing (Urine albumin to creatinine ratio testing)

• Purpose: to ensure appropriate adherence with the urinary albumin test for people living with conditions that make them at risk of chronic kidney disease.
  We work with Health.IO to contact patients and provide home ACR test kits.
  Patients will be contacted by the Practice and be able to opt out of this service.
• Legal Basis : Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Processors/Recipients: Healthy.IO

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: The legal basis for this activity under UK GDPR is
• Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated below
• Processors/Recipients :  INRStar

Cabinet Office

The use of data by the Cabinet Office for data matching is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014.  It does not require the consent of the individuals concerned under the Data Protection Act 1998.  Data matching by the Cabinet Office is subject to a Code of Practice. Information on the Cabinet Office’s legal powers and reasons why it matches particular information.   www.gov.uk – Code of Data Matching Practice for the National Fraud Initiative.

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 GDPR) and their privacy statement is available on our website: https://www.cqc.org.uk/about-us/our-policies/privacy-statement
• Legal Basis – Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.” And Article 9(2) (h) as stated below
• Processors – Care Quality Commission

Child Health Information Service

• Purpose – We wish to make sure that your child has the opportunity to have immunisations and health checks when they are due. We share information about childhood immunisations, the 6-8 week new baby check and breast-feeding status with health visitors and school nurses.
• Legal Basis – Direct Care
• Data Processor – Health Intelligence, on behalf of NHS England

Clinical Audit (including Primary Care Data Extraction Process (PCDES))

• Purpose – Information will be used by the ICB for clinical audit to monitor the quality of the service provided to patients with long terms conditions. When required, information will be held centrally and used for statistical purposes (e.g. the National Diabetes Audit). When this happens, strict measures are taken to ensure that individual patients cannot be identified from the data.
• Legal Basis – Article 9(2)(h) ‘necessary for the purposes of preventative 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 – Gloucestershire ICB; Sollis

Clinical Research

• Purpose – We may share personal confidential or anonymous information with research companies. Where you have opted out of having your identifiable information shared for this purpose your information will be removed.
• Legal Basis – consent is required to share confidential patient information for research, unless there is have support under the Health Service (Control of Patient Information Regulations) 2002 (‘section 251 support’) applying via the Confidentiality Advisory Group in England and Wales.
• Processor – The Practice is involved with ResearchOne via our TPP Systmone clinical system. ResearchOne is a unique, not for profit, non-identifiable database (in conjuction with the University of Leeds) with the potential to unlock more than 26 million patient records across the country for important research purposes. ResearchOne holds data from many care settings (including our own) in a completely de-identified way to help with vital primary care research. Whilst any data drawn from our system is completely non-identifiable please let us know if you would like any data from your record excluded from the scheme.

Coroners

• Purpose – A Coroner’s office may request copies of information in relation to a deceased individual. The practice will share relevant information in relation to the request
• Legal Basis – Coroners and Justice Act 2009
• Processor – Coroner

Data Retention

We will approach the management of patient records in line with the Records Management NHS Code of Practice for Health and Social Care which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England, based on current legal requirements and professional best practice.

Department for Work and Pensions

• Purpose – Our practice is legally required to provide limited data to the Department for Work and Pensions for the management of the social care system and fraud prevention.
• Legal Basis – Article 9(2)(b) ‘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..’
• Processor – Department for Work & Pensions

Diabetic Eye Screening Programme

• Purpose – The practice provides NHS numbers and demographic data of diabetic patients so that they can be invited for screening via the GPES extraction service for GP2DRS. Additionally, via access to risk factor data held in primary care records, they will work out a risk stratified approach to screening based on certain criteria allowing prioritisation of invites. Information that does not identify individual patients is used to enable focussed discussions to take place at practice-led local diabetes review meetings between health care professionals. This enables the professionals to improve the management and support of these patients.
• Legal Basis – Anonymised information
• Processor – Gloucestershire Diabetic Eye Screening Service.

General Practice Extraction Service (GPES)

• Purpose: GP practices are required to provide data extraction of their patients 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 criteria, in order to monitor and either provide direct care, or prevent serious harm to those patients. The following link provides details of the data extractions and how your information will be used to inform this essential work:  Data Provision Notices (DPNs) – NHS Digital
• 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.  enquiries@nhsdigital.nhs.uk
• Processor: NHS Digital or NHS X

General Practice Data for Planning and Research (GPDPR)

• Purpose: Patients personal confidential data will be extracted and shared with NHS Digital in order to support vital health and care planning and research. Further information can be found here
• Patients may opt out of having their information shared for Planning or Research by applying a National Data Opt Out or a Type 1 Opt Out (see above).
• Legal Basis : The legal basis for this activity can be found at this link : General Practice Data for Planning and Research: NHS Digital Transparency Notice – NHS Digital
• Processor: NHS Digital

Healthy io Diabetes (ACR Testing – urine albumin to creatinine ratio testing)

• Purpose: To ensure appropriate adherence with the urinary albumin test for people living with conditions that make them at risk of chronic kidney disease.  We work with Health.IO to contact patients and provide home ACR test kits.  Patients will be contacted by the Practice and be able to opt out of this service.
• Legal Basis : Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Processor: Healthy.IO

iGPR

• Purpose – Your medical record will be shared in order that a report can be provided to agencies such as insurance companies or solicitors
• Legal Basis – Your consent will be required to share your record for this purpose
• Processor – iGPR

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 contracts.
• Legal Basis – 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
• Data processor – Gloucestershire Integrated Care Board.

ICB (NHS Gloucestershire Integrated Care Board)

• Purpose – Anonymous data is used by the ICB for planning and performance as directed in the practice’s contract.
• Legal Basis – Contractual
• Processor – Gloucestershire Integrated Care Board (ICB)

Like all other Practices in Gloucestershire, Mythe Medical Practice works with NHS Gloucestershire ICB to receive support in providing the best possible treatment and care to patients. This is achieved through sharing data with the ICB from our GP system:

• To enable regular clinical audits of the care we deliver to our patients
• For support with identifying patients at risk
• For support with medicines use and management
• To support commissioners in understanding the care needs of our patients
• To evaluate current care programmes and design new care pathways and services that reflect the specific needs of our patients

From April 2018 rather than manually extracting and providing data to the NHS separately, multiple times for different purposes across the year, which take a lot of staff time and effort at the practice, we are working with the ICB to set up a single, secure automated routine process to extract and share only the required information from our practice system, as done previously. The new automated process we are designing will require less time and effort and will be easier for ius to manage, freeing our time to focus on the most important duty which is to provide the best care to our patients.

In line with clear NHS England guidance and Data Protection laws, Personal or Confidential information about you is never shared with anyone other than doctors, nurses or clinicians involved in caring for you. Only non-identifiable health and care related information such as the below are shared to allow the above mentioned important work to take place:

• Health conditions patients suffer in the local area
• The types and frequency of appointments and care delivered to patients
• Medicines prescribed and dispensed for treatment of different conditions
• How well a new or existing service has been accessed and used by patients

NHS numbers are instead used to enable GPs and clinicians to identify patients under their care.

NHS Gloucestershire ICB with whom the data is shared, follows strict NHS England governed guidelines to ensure that the information about patients it receives is anonymised and analysed securely and confidentially in line with the latest Data Protection laws and Information Security guidance issued by the government. This means personal or confidential details such as your name and address are never shared.

Can I Opt-out of this?

If you wish to Opt Out of this programme you can do so in the following ways :

• Online at https://your-data-matters.service.nhs.uk/
• By phone – Speak to the NHS Digital Contact Centre. They can help you use the online service or make or change a choice on your behalf. 0300 303 5678 Monday to Friday, 9am to 5pm (excluding bank holidays)
• By post – Fill in a Manage Your Choice form and send to NHS PO Box 884 Leeds LS1 9TZ

Please note that you must be aged 13 years or over to Opt Out.

JUYI – Joining Up Your Information

• Purpose – JUYI is the secure online system for sharing information in Gloucestershire, giving local health and social care professionals directly involved in your care instant access to your health and social care records.  Sharing your electronic records with the people who look after you gives them the most up-to-date information about you and makes your care safer and more efficient and cost effective. For information about the county’s JUYI shared care record and fair processing notice please visit www.juyigloucestershire.org.
• Legal Basis – Direct Care.
  Please be aware that if you choose to opt-out of SCR, NHS healthcare staff caring for you outside of this surgery may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency. Your records will stay as they are now with information being shared by letter, email, phone. If you wish to opt-out of having an SCR please return a completed opt-out form to the practice.
• Processor – NHS England and NHS Digital.

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 with 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 who fit within a certain criteria.
• Processors/Recipients – ICB, NHS England

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… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated below
• Processors/Recipients – Direct Care providers

Medical Reports

• Purpose – Personal information will be shared with Insurance companies, or potential or active employers at the patients request.
• Legal Basis – Consented
• Processor – Patients and or their representatives – e.g. Insurance companies, RAF, Navy, DVLA, Capita etc.

Medical Student placements

• Process – Our practice is involved in the training of medical students. As part of this programme medical students will work in the practice and may be involved in your care. It is usual for GPs to discuss patient case histories as part of their continuing medical education or for the purpose of training GPs and/or medical students. In these situations the identity of the patient concerned will not be revealed.
• Legal Basis – If clinicians would like a student to be present they will always ask for your permission before the start of the consultation. The treatment or care you receive will not be affected if you refuse to have a student present during your appointment.
• Processor – Mythe Medical Practice/Student (University of Bristol)

Medicines Management

• Purpose – your medical record is shared with the medicines management team, in order that your medication can be kept up to date and any changes can be implemented.
  ICBs operate pharmacist and prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. These pharmacists work with your usual GP to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your needs, safe and cost-effective. Where specialist prescribing support is required, the ICB medicines optimisation team may order medications on behalf of your GP Practice to support your care
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Processor – Gloucestershire ICB and Gloucestershire Hospitals NHS Foundation Trust

Medicines Optimisation in Care Homes (MOCH)

• Purpose – your medical record is shared with the medicines management team, in order that your medication can be kept up to date and any changes can be implemented.
  ICBs operate pharmacist and prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. These pharmacists work with your usual GP to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your needs, safe and cost-effective. Where specialist prescribing support is required, the ICB medicines optimisation team may order medications on behalf of your GP Practice to support your care
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Processor – Gloucestershire Clinical Commissiong Group and Gloucestershire Hospitals NHS Foundation Trust.

Medication/Prescribing

• Purpose – Prescriptions containing personal identifiable and health data will be shared with chemists/pharmacies, in order to provide patients with essential medication or treatment as their health needs dictate. This process is achieved either by face to face contact with the patient or electronically. Where patients have specified a nominated pharmacy they may wish their repeat or acute prescriptions to be  ordered and sent directly to the pharmacy making a more efficient process. Arrangements can also be made with the pharmacy to deliver medication
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below. Patients will be required to nominate a preferred pharmacy.
• Processor – Pharmacy of choice

Mental Health Provider

• Purpose – For the provision of mental health services
• Legal Basis – Direct Care
• Processor – 2gether NHS Foundation Trust

Messaging Services – AccuRx/Mjog

• Purpose – Personal identifiable information 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 – – UK GDPR Article 6 1 (b) Contract, Article 6 1 (e) Public task, Article 9 2 (h) Health data
• Processor – AccuRx, Mjog.

National Fraud Initiative – Cabinet Office

• Purpose – The use of data by the Cabinet Office for data matching is carried out with statutory authority. It does not require the consent of the individuals concerned under Data Protection legislation. Data matching by the Cabinet Office is subject to a Code of Practice. For further information see: https://www.gov.uk/government/publications/code-of-data-matching-practice-for-national-fraud-initiative
• Legal Basis – Part 6 of the Local Audit and Accountability Act 2014
• Processors/Recipients – Cabinet Office/ Local Fraud Team

National Registries

• Purpose – National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.
• Legal Basis – Section 251

NHS Trusts, Community Providers, Direct Care, Pharmacies, Enhanced Care Providers, Nursing Homes and other Care Providers

• Purpose – Personal information is shared with other secondary care trusts in order to provide you with 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 and 9 conditions as stated below:
• Processors – Gloucestershire Hospitals NHS Foundation Trust; Gloucestershire Care Services NHS Trust; 2gether NHS Foundation Trust; South Western Ambulance Service NHS Foundation Trust.

Other GPs

• Purpose: If you are on holiday elsewhere in the country you may need to register as a temporary resident for urgent treatment. The GP looking after you may contact the surgery for specific information regarding an existing condition, history of vaccinations or medication to enable them to treat you appropriately.
• Legal Basis – Consented.
• Processor – Alternative NHS healthcare provider.

Patient Record data base

• Purpose – Your medical record will be shared, in order that a data base can be maintained and managed in a secure way
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Processor – TPP – SystmOne and PCSE

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 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.
• Legal Basis – Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.” And Article 9(2)(h) ‘as stated below
• Data Processors – NHS England, ICB, Public Health

Police

• Purpose – The police may request information in relation to on-going enquiries, all requests are reviewed and only appropriate information will be shared under legislation.
• Legal Basis –  GDPR – 6 1 (c) Legal Obligation. Article 6 1 (f) legitimate interest
  9(2) (c) Vital Interests; 9(2) (f) Legal claims or judicial acts; 9(2) (g) Reasons of substantial public interest (with a basis in law)
• Processor – Police

Population Health Management

• Purpose – Health and care services work together as ‘Integrated Care Systems’ (ICS) and are sharing data in order to:
  • Understand the health and care needs of the care system’s population, including health inequalities
  • Provide support to where it will have the most impact
  • Identify early actions to keep people well, not only focusing on people in direct contact with services, but looking to join up care across different partners.
    (NB this links to the Risk Stratification activity identified above)
• Type of Data – Identifiable/Pseudonymised/Anonymised/Aggregate Data.  NB only organisations that provide your direct care will see your identifiable data.
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h)
• Data Processors – Gloucestershire ICB, Optum.

Private Healthcare Providers

• Purpose – Personal information 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) and 9 2 (h) Consented under contract between the patient and the provider.
• Processors/Recipients – As directed by patient.

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 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 – 6 1 (a) consent, patients will be asked if they wish to take part in training sessions.
  9 2 (a) – explicit consent will be required when making recordings of consultations.
  Recordings remain the control of the GP practice and they will delete all recordings from the secure site once they are no longer required.
• Processors/Recipients – RCGP, HEE, iConnect, Fourteen Fish

Public Health Screening programmes (identifiable)

Notifiable disease information (identifiable)

Smoking cessation (anonymous)

Sexual health (anonymous)

• 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. The law allows us to share your contact information with Public Health England so that you can be invited to the relevant screening programme.
  More information can be found at: https://www.gov.uk/topic/population-screeningprogrammes or speak to the practice
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) as stated below
• Data Processors – Gloucestershire County Council

Remote Consultation including Video Consultation and Clinical Photography

• Purpose – Personal information including images may be processed, stored and with the patients consent shared, in order to provide the patient with urgent medical advice.
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated below
• Processors/Recipients –AccuRx, PANDO.

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 – GDPR Art. 6(1) (e) and Art.9 (2) (h). The use of identifiable data by ICBs and GPs for risk stratification has been approved by the Secretary of State, through the Confidentiality Advisory Group of the Health Research Authority (approval reference (CAG 7-04)(a)/2013)) and this approval has been extended to the end of September 2020 NHS England Risk Stratification  which gives us a statutory legal basis under Section 251 of the NHS Act 2006 to process data for risk stratification purposes which sets aside the duty of confidentiality. We are committed to conducting risk stratification effectively, in ways that are consistent with the laws that protect your confidentiality.
• Processors – Sollis; South, West and Central Commissioning Support Unit; Gloucestershire Integrated Care Board.

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.
• Legal Basis – Because of public Interest issues, e.g. to protect the safety and welfare of vulnerable adults, we will rely on a statutory basis rather than consent to process information for this use.
• Data Processor – May include Gloucestershire ICB, local Police, Care Agencies, Ambulance Service, Paramedics, Social Prescriber, Hospital Consultants.

Safeguarding – Children

• Purpose – We will share children’s personal information where there is a need to assess and evaluate any safeguarding concerns.
• Legal Basis – Because of public Interest issues, e.g. to protect the safety and welfare of Safeguarding we will rely on a statutory basis rather than consent to share information for this use.
• Data Processor – May include Gloucestershire ICB, local Police, Care Agencies, Ambulance, Paramedics, Social Services, Health Visitors, Hospital Consultants.

Smoking Cessation

• Purpose – personal information is shared in order for the smoking cessation service to be provided.
• Legal Basis – consented
• Processor – Gloucestershire County Council.

Social Prescribing

• Purpose – At Mythe Medical Practice we work closely with a Social Prescriber who puts patients in touch with local organisations which may benefit their health and wellbeing.  A GP or Nurse at the Practice will talk to you about the kind of support or help that you need and make a referral with your consent.  We will not directly refer you to an organisation or give your details out to anyone except the Social Prescriber.
• Legal Basis – Consented.
• Processor – Our Social Prescriber is employed by our Primary Care Network on behalf of the Practice.

Subject Access Requests (SARs)

• Purpose – Personal information will be shared with the person or their representative at their request
• Legal Basis – Contractual agreement with the patient – and consented
• Processor – Patients and or their representatives – e.g. family members, solicitors, insurance companies

Summary Care Record (SCR)

• 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
  Please be aware that if you choose to opt-out of SCR, NHS healthcare staff caring for you outside of this surgery may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency. Your records will stay as they are now with information being shared by letter, email, phone. If you wish to opt-out of having an SCR please return a completed opt-out form to the practice.
• Processor – NHS England and NHS Digital

Supporting Locally Commissioned Services

• Purpose – ICBs support GP practices by auditing anonymised data to monitor locally commissioned services, measure prevalence and support data quality.  The data does not include identifiable information and is used to support patient care and ensure providers are correctly paid for the services they provide.
• Legal Basis – Anonymised Data
• Processor – Gloucestershire ICB

Technical Solution Pseudonymisation

• Purpose: Personal confidential and special category data in the form of medical record, is extracted under contract for the purpose of pseudonymisation. This will allow no patient to be identified within the data set that is created. SCWCSU has been commissioned to provide a data processing service for the GPs, no other processing will be undertaken under this contract.
• Legal Basis: Under UK GDPR the legitimate purpose for this activity is under contract to provide assistance.
  Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated below
• Processors/Recipients: SCW CSU

Telephony

• Purpose – The practice use 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 –There is a robust contract in place with the Processor, and the surgery has undertaken this service to assist with the direct care of patients in a more efficient way.
  Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h) Health data as stated below
• Processors/Recipients – NewDocs Ltd., MINT

TWNS (Tewkesbury, West Cheltenham Medical, Newent & Staunton Primary Care Network)

• Purpose – Your medical record will be shared with the practices of the above PCN in order that they can provide direct care services to the patient population.
• Legal Basis – Article 6(1)(e); “necessary… in the exercise of official authority vested in the controller’ And Article 9(2)(h). The Practices provide services across the PCN and offer appointments to patients from Mythe Medical Practice.
• Processor – Church Street Medical, West Cheltenham Medical, Newent Doctors Surgery and Staunton & Corse Surgery.

Reviews of and Changes to our Privacy Notice

We will keep our Privacy Notice under regular review. This notice was reviewed and updated in line with the recommended by Data Protection Governance Services, NHS South, Central & West in September 2022.

Lawful basis for processing:

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 and 9 conditions of the 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…’; and
• Article 9(2)(h) ‘necessary for the purposes of preventative 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…”

Policy Written by: Bridget Derrett (Practice Manager)

Date: April 2018

• Updated : November 2019 (new Care.Data Project Opt Out update)
• Updated : September 2020 (Medicines Optimisation in Care Homes)
• Updated : September 2020 (Diabetic Eye Screening)
• Updated : November 2020 (COVID-19 Section)
• Updated : June 2021 (Complete Revision in line with recommended NHS Template)
• Updated : September 2021 (Healthy io Diabetes added)
• Updated : March 2022 (Removal of reference to Data Protection Act 1998)
• Updated: September 2022 (Removal of COVID Regulations; Change from CCG to ICB; updates to various sections and additions in line with recommendations from GP Data Protection Officer, Gloucestershire)