What is Section 251?

Section 60 of the Health and Social Care Act 2001 as re-enacted by Section 251 of the NHS Act 2006 allows the Secretary of State for Health to make regulations to set aside the common law duty of confidentiality for defined medical purposes.

The Regulations that enable this power are called the Health Service (Control of Patient Information) Regulations 2002. Any references to ‘section 251 support or approval’ actually refers to approval given under the authority of the Regulations.

The HRA (Health Research Authority) took on responsibility for Section 251 in April 2013, establishing the Confidentiality Advisory Group (CAG) function.

Why was Section 251 created?

Section 251 came about because it was recognised that there were essential activities of the NHS, and important medical research, that required the use of identifiable patient information – but, because patient consent had not been obtained to use people’s personal and confidential information for these other purposes, there was no secure basis in law for these uses.

Section 251 was established to enable the common law duty of confidentiality to be overridden to enable disclosure of confidential patient information for medical purposes, where it was not possible to use anonymised information and where seeking consent was not practical, having regard to the cost and technology available.

What can I do if I don’t want my record shared?

If you don’t want to have your information shared, please contact reception.

Further information on the process.

– Formally Hampshire Health Record (HHR).

What is the Care and Health Information Exchange (CHIE)?

The Care and Health Information Exchange (CHIE) is an electronic record containing key information about your medical history from hospital, general practice, community care and social services in Hampshire and Dorset. It is a safe way of sharing information about patients to those treating them. This lets them provide faster and more accurate care. CHIE is a much more detailed version of the SCR.

What information is available in my Care and Health Information Exchange Record?

Your Care and Health Information Exchange records contains information about the medication you are currently taking, your allergies, test results, and other critical medical and care information, such as diseases you have and operations you have had. Health and care staff can access your information if they have your permission to do so.

Who uses the Care and Health Information Exchange Records?

The Care and Health Information Exchange record benefits nearly all clinicians within the local (Hampshire) NHS and is used by a variety of people, from hospital doctors and pharmacists, to community nurses, podiatrists, occupational therapists and physiotherapists, as well as your GP.

Having access to your record allows clinicians to have a much wider view of information than they might otherwise have to hand, which in turn is beneficial to providing your regular health care. In situations where a clinician may not have any history of your previous treatments, for example in Accident & Emergency, access to information about allergies, diagnosis and medication can provide vital details that will help them give you the best care and advice possible.

What can I do if I don’t want my record shared?

If you don’t want to have your information shared, you can opt-out by completing the Data Extraction Opt-Out form and returning it to the practice.

Further information on the system.

Case study Example

You are brought in to A&E at Southampton General Hospital. You are unconscious. The doctor is able to access your coded medical records to check your medication, allergies and significant medical problems to ascertain you don’t have epilepsy or diabetes. Note they are able to access your CHIE record without your consent in an emergency.

All CHIE access is audit trailed. For more information and to request a copy of your record, fill out the appropriate form found here.

A relative or friend accompanying you may remain present during examinations at your own discretion, and with the agreement of your doctor, but the use of suitably trained personnel is more appropriate for the purposes of chaperoning.

If such a member of staff is unavailable we will offer to reschedule your appointment accordingly, as you prefer.

Positive Feedback

We make every effort to give the best service possible to everyone who attends our practices, and are pleased that you have experienced this.

We love to hear your feedback on what has worked well during your interaction with us and pass this on to those involved in your care.

Please use the way you feel most comfortable with to leave your feedback:

• Email us
• Complete our Friends and Family Test
• Leave us a review on Hamble Valley Health- NHS

Complaints

We make every effort to give the best service possible to everyone who attends a Hamble Valley Health site.

However, we are aware that things can go wrong resulting in a patient or their relatives feeling that they have a genuine cause for complaint. If this is so, we would wish for the matter to be settled as quickly, and as amicably, as possible.

To pursue a complaint please contact the Patient Experience Manager, (preferably in writing), who will deal with your concerns appropriately.

For further information regarding the practice’s complaints procedure, please see the following:

• Hamble Valley Health Complaints Procedure

Hard copies of this policies are also available upon request.

The practice complies with data protection and access to medical records legislation. Identifiable information about you will be shared with others in the following circumstances:

• To provide further medical treatment for you e.g. from district nurses, hospital services and any clinics hosted by the local Practice Federation (Eastleigh Southern Practices Network)
• To help you get other services e.g. from the social work department. This requires your consent.
• When we have a duty to others e.g. in child protection cases, or for the prevention and detection of crime

Anonymised patient information will also be used at local and national level to help the Clinical Commissioning Group and Public Health plan services e.g. for diabetic care.

If you do not wish anonymous information about you to be used in such away, please let us know. Reception and administration staff require access to your medical records in order to do their jobs. These members of staff are bound by the same rules of confidentiality as the medical staff.

Freedom of Information

Information about the General Practitioners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager. For more information, please see our Freedom of Information Protocol.

Access to Records

In accordance with the Data Protection Act of 2018 and access to health records act, patients may request to see their medical records. Such requests should be made through the secretaries. No information will be released without the patient consent unless we are legally obliged to do so.

Do I Have A Choice?

Yes. You have the right to prevent confidential information about you from being shared or used for any purpose other than providing your care, except in special circumstances. If you do not want information that identifies you to be shared outside this practice, please contact reception and they will provide you with an opt-out form. This will prevent your confidential information being used other than where necessary by the law.

If you have any concerns about who has access to your medical information, or questions about sharing information with other agencies, please contact the practice.

We increasingly work with other local GP practices to provide a wider range of services. When you book an appointment for these extended services, EMIS Community allows information recorded by your GP to be shared with these services and for your GP to view information recorded by these services.

Purpose: Patients personal confidential data will be extracted and shared with NHS Digital in order to support vital health and care planning and research.

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. For the National Data Opt-Out patients are required to register their preference via: https://www.nhs.uk/your-nhs-data-matters

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

For more information please see NHS Digital’s GPDPR Transparency Notice.

All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.

It should be noted that the prescribed method of calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should not be used for any judgement about GP earnings, nor to make any comparisons with other practices.

Hedge End Medical Centre

The average pay for GPs working in Hedge End Medical Centre in the last financial year (2022-2023) was £75,314 before tax and National Insurance. This is for 13 part time GPs, who worked in the practice for more than six months.

Blackthorn Health Centre

The average pay for GPs working in Blackthorn Health Centre in the last financial year was £124,591 before tax and National Insurance. This is for 3 full time GPs, 6 part time GPs and 1 long term locum GP who worked in the practice for six months or more.

The MIG project enables GPs to see information recorded by the community teams about a patient, and for community staff to see information recorded by the GPs without having to log onto another system or to search for the patient in another system.

Who Uses MIG?

Information will be available between the following organisations within Hampshire:

• GP surgery
• Mental Health
• Children’s Services
• Older People’s Mental Health Inpatients
• Older Person’s Mental Health Community
• Adult Nursing and Therapies

Who can see my Information on MIG?

Of the above, all patients will have a GP record, but not all patients will have one of the other records. The GP record will only be visible to the other service if the other service has a record of their own. Staff will only be able to access MIG with your consent, and access will be audited.

What can I do if I don’t want my record shared?

If you don’t want to have your information shared, please contact the surgery and let us know.

Case Study Example

The Health Visitor for a mum and new baby wants to check that they have had their 8 week check. The Health Visitor can use MIG to check this has been done and no concerns were raised by mum or the GP.

It is the aim of our practice to provide high quality healthcare in a responsive, supportive and courteous manner to all our patients, with a well-trained and motivated primary health care team.

We wish to be an approachable and accessible practice making efficient use of all the health care resources available.

Your rights and responsibilities

We are required to provide all of our patients with a named GP.

Your named GP is the GP who is responsible for handling your paperwork (prescriptions, letters, etc.), and has overall responsibility for the care and support you receive.

This does not prevent you from seeing any GP at the practice.

If you would like to know who your named GP is, please contact reception.

If you have a preference for your named GP, please ask at reception and we will make reasonable efforts to accommodate you.

Fair Processing Notice under the General Data Protection Regulations (GDPR) 2018 (formerly the Data Protection Act 1998) – How we use your personal information

The Privacy Notices below explains why the GP practices collects information about you and how that information may be used.

Hedge End Medical Centre Privacy Notice

Blackthorn Health Centre Privacy Notice

Hedge End Medical Centre and Blackthorn Health Centre actively support clinical research studies within primary care. The NHS Constitution states that Research is a core function of the NHS. Clinical Research is a major driver of innovation and central to NHS practice for maintaining and developing high standards of patient care.

Ultimately, clinical research means patients get access to new treatments, interventions and medicines. Investment in research means better, more cost effective care for patients.

National Data opt-out

The national data opt-out was introduced on 25 May 2018 and replaces the previous ‘type 2’ opt-out.  NHS Digital collects information from a range of places where people receive care, such as hospitals and community services. The new programme provides a facility for individuals to opt-out from the use of their data for research or planning purposes. For anyone who had an existing type 2 opt-out, it will have been automatically converted to a national data opt-out from 25 May 2018 and you will receive a letter giving you more information and a leaflet explaining the new national data opt-out.

To view the patient information leaflet produced by NHS Digital click here; further information is also available here.

The national data opt-out choice can be viewed or changed at any time by using the online service at www.nhs.uk/your-nhs-data-matters.

National Institute for Health Research

In 2006 the Department of Health set up The National Institute for Health Research (NIHR) to improve the health and wealth of the nation through Research.

The NIHR Clinical Research Network (CRN) was introduced to provide the infrastructure to the NHS to allow high quality research to be set up and delivered efficiently and effectively. Hedge End Medical Centre is part of a network of local practices participating in research activities under the banner of CRN Wessex. To find out more about the work of the NIHR Clinical Research Network go to www.crn.nihr.ac.uk.

What is Primary Care Research?

The CRN Primary Care speciality works in collaboration with researchers and primary care practitioners such as GP’s, practice nurses, pharmacists and dentists to promote the successful delivery of research studies in the NHS.

A wide range of research studies are supported which look at:

• Promoting a healthier lifestyle
• Disease diagnosis and prevention
• Management of long-term illnesses such as diabetes or hypertension
• Prevention of future ill-health
• Treating common conditions such as tonsillitis or influenza

What are the benefits of GP practices taking part in Research?

• It offers patients access to new treatments
• It brings new dimension to practice and added skills to those involved
• It provides national gold standard training for research
• It offers mentorship and support to those involved in research within practice

How can you help and take part at Hedge End Medical Centre?

There are many various ways a patient can become involved in studies:

• A doctor or nurse may talk to you about a particular study and ask whether you would be interested in participating
• You may be sent information through the post if we feel you may be a suitable participant
• You may read information about a current study in the patient waiting room or on the surgery website and wish to take part by contacting your GP or the Research Nurse.

You are under no obligation to participate in any research project. Your care and your relationship with your doctor or nurse will not be affected in any way if you decided not to take part in a research study. You will always receive clear information about what taking part in a research study would involve. You will have the opportunity to ask questions and obtain further details about a study. If you do agree to take part in a study you will be asked to sign a consent form. This will clearly state which parts of your notes (if any) may be looked at for the purposes of the research study. Nobody from outside this practice will be given your contact details or have access to your medical records without your prior consent.

Please note: the funding for our research activity is via the CRN so does not come out of the practice’s own budget and therefore does not affect our patients’ services. All clinical research carried out at our practices is thoroughly checked and approved by ethical committees thus ensuring it is appropriate and safe to perform. Your participation is entirely voluntary and can be withdrawn by yourself at any time without any explanation required.

Case Study

Bournemouth University, in conjunction with the National Institute for Health Research, are testing whether participating in Tai Chi slows the progress of mild cognitive impairment. The Practice writes to the patient / carer of anyone with this diagnoses and invites them to take part in the study. The letter from the practice contains information the research team if they wish to participate.

The Health and Social Care Act 2012 (the Act) gives the Health and Social Care Information Centre (HSCIC) statutory powers, under section 259(1), to require data from health or social care bodies or organisations who provide health or adult social care in England, where it has been Directed to establish an information system by the Department of Health (DH) (on behalf of the Secretary of State) or NHS England.

When a direction is received, the HSCIC can issue a Data Provision Notice to the appropriate providers of the required data who are then legally required, under section 259(5) of the Act, to provide the data in the form and manner specified below.

The data collected varies per each data extraction, However as an example, below are the details regarding the Med3 extraction.

The purpose of the anonymised data collection is to provide the Department for Work and Pensions with information derived from computer generated ‘Med3’ forms, known as fit notes, to:

• undertake research analysis to inform policy relating to employment and sickness absence, including evaluation of the new Fit for Work service, which provides an occupational health assessment, and Employment Support Allowance and Universal Credit
• identify geographic, Intergrated Care System (ICS) and GP practice level differences in sickness absence management to inform policy development and continuous improvement, resulting people returning to work sooner
• enable baseline comparisons for the Fit for Work service
• use fit note data to build an understanding of the drivers for benefit claiming
• enable ICSs to self audit their fit note to inform their own policy and commissioning decisions

This collection is formed of anonymous data extracted from fit notes issued in GP practice systems. The data includes:

• How many eMED3 fit notes are issued
• How many patients are recorded as ‘unfit’ or ‘maybe fit’ for work
• Fit note duration
• Gender
• Health condition type aggregated to a high level diagnosis code, for example, paranoid schizophrenia would be classed as a Mental Disorder
• Location, including ICS areas
• Whether workplace adaptations were recommended

What can I do if I don’t want my record shared?

If you don’t want to have your information shared, please contact reception.

What is a Summary Care Record?

The Summary Care Record (SCR) is an electronic record containing information about the medicines you take, allergies you suffer from, and any serious reactions to medicines you have had. Storing this information in one place makes it easier for relevant healthcare staff to treat you in an emergency, or when your GP practice is closed. This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe you. With your consent, additional information can also be added to your record.

Who can see my Summary Care Record?

Only healthcare staff involved in your care can see your Summary Care Record.

Do I have to have a Summary Care Record?

No. It is not compulsory for you to have a Summary Care Record. If you wish to opt out, you will need to complete a form and bring it to the surgery. Click here for the opt-out form.

For further information visit the NHS Care Records web page or view the Summary Care Records patient information sheet.

Case Study Example

You are in an accident at the weekend in Nottingham and don’t have a full list of your medication or allergies. The A&E department ask for your consent to check this information on the SCR.

The practice has the right to remove from their list with immediate effect any patient who behaves in the above manner.

Our Full Zero Tolerance Statement

Introduction

The term ‘visitor’ used below refers to anyone (including patients and their family members, other visitors and contractors making use of the Practice’s premises and services (except employees for whom the Equal Opportunities (Employment) Policy applies).

The Practice:

• Will ensure that all visitors are treated with dignity and respect.
• Will promote equality of opportunities for all.
• Will not tolerate any discrimination or perceived discrimination against or harassment of, any visitor or member of staff on the grounds of age, sex, gender, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief.
• Will provide the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief.
• Will not tolerate verbal or written abuse to staff which prevents them from doing their job or makes them feel unsafe.
• Will not tolerate threats of violence or actual violence to a GP or a member of his or her staff.

Applicability

This Policy applies to the general public, including all patients and their families, visitors and contractors.

Procedure

1. If you feel an act of discrimination by the Practice or visitors/patients against you has occurred:

• You should bring the matter to the attention of the Senior Management Team.
• The Senior Management team will investigate the matter thoroughly and confidentially within 3 working days.
• The Senior Management team will establish the facts and decide whether discrimination has taken place and advise you of the outcome of the investigation within 10 working days.

If you are not satisfied with the outcome, you should raise a formal complaint through the Practice’s Complaint’s Procedure.

2. If you feel an act of discrimination has occurred against another member of Practice staff:

The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against, or harassment of, any member of our staff, may be asked to leave the Practice premises forthwith.

If the visitor is a patient, he/she may be removed from the Practice’s list if any such behaviour occurs on more than one occasion.