1. www.england.nhs.uk Development of Information Sharing Guidance Richard Sewart Data Sharing and Privacy Specialist 3 rd June 2015

2. www.england.nhs.uk Concerns expressed about uncertainty over legal basis for information sharing in integrated shared record environments Consequent potential obstacles to information sharing Need for guidance in addition to exemplar materials Need for consistent interpretation and application of the law Rationale

3. www.england.nhs.uk “bottom up” approach to identify gaps and real world problems Facilitated by a series of consultation webex sessions with integration pioneers Identification of generally applicable good practice Practical application of legal requirements expressed through “perspectives” Identification of clinical scenarios involving information sharing across organisations in integrated environments Approach

4. www.england.nhs.uk Clinical scenarios giving practical application of legal requirements “Perspectives” to present the same issues as experienced by organisations, care professionals and citizens Complements and references exemplar materials in IGA Information Sharing Toolkit References to other published good practice guidance The product

5. www.england.nhs.uk Cross-organisational multi-disciplinary teams e.g. diabetic retinopathy Acute hospital discharge liaison – role of the hospital based social worker and support staff E-Ambulance – mobile shared records and referrals Access on receipt of referrals Centralised consent management Integration of patient held records Availability of mental health information Clinical Scenarios – for example:

6. www.england.nhs.uk I have confidence that my information sharing practice is lawful All the information I need is available when I need it I can collaborate with professionals in partner organisations with no unnecessary obstacles I can work with my colleagues to provide the best care for my patients Perspectives: the Care Professional

7. www.england.nhs.uk I don’t necessarily understand the complexity of the NHS and how it works with partners – but want them to work together for me When I give my permission for you to share my information I want to understand who will see it and why If I want to I can stop someone seeing some or all of my information Because I trust the system I get the best care from people working together for me – because they have all the information they need Perspectives: the Citizen

8. www.england.nhs.uk We achieve our Vision, Values and Objectives Our investment in the integrated care programme is well spent We are compliant with legal and regulatory requirements Data controller / data processor responsibilities We manage risk We collaborate with partner organisations to deliver the best care Perspectives: the Organisation

9. www.england.nhs.uk Confidence in the legal basis for sharing Need for a consistent approach to information sharing and ISAs Holistic care: care teams operate across organisations including health and social care Access control and consent: need to balance availability against need to know, proportionality and necessity Pros and cons of implied vs explicit consent Communications and fair processing Trust Common themes

10. www.england.nhs.uk Common law duty of confidence Data Protection Act 1998 Human Rights Act 1998 Health and Social Care (Quality and Safety) Act 2015 The law

11. www.england.nhs.uk Gives statutory weight to the 7 th Caldicott Principle Duty on health and social care providers and commissioners to disclose information to professionals and other organisations providing or commissioning care For the provision of direct care Objections to be respected Needs a regulation to bring into force Health and Social Care (Quality and Safety) Act 2015

12. www.england.nhs.uk Implied consent for availability / explicit consent at point of care With amended H&SC Act – statutory requirement to share with objections respected For both – quality of patient comms is key Consent model

13. www.england.nhs.uk Layered and collaborative approach to patient comms / fair processing Objections management Access by non-regulated / non-registered professionals Application of amended H&SC Act Granularity of access control Issues – for example:

14. www.england.nhs.uk Continue to work with Pioneers, or anyone to refine requirements and document scenarios Distribute draft to consultation group and IGA for review Contributions very welcome…. What next?

15. www.england.nhs.uk Questions?