Safe data, safe care

Review by Care and Quality Commission looking at whether personal health and care information is being used safely and is appropriately protected in the NHS. | CQC

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This CQC review focused on patient data in the NHS.

In the NHS organisations reviewed, the CQC found:

  • There was evident widespread commitment to data security, but staff at all levels faced significant challenges in translating their commitment into reliable practice.
  • Where patient data incidents occurred they were taken seriously. However, staff did not feel that lessons were always learned or shared across their organisations.
  • The quality of staff training on data security was very varied at all levels, right up to Senior Information Risk Owners (SIROs) and Caldicott Guardians.
  • Data security policies and procedures were in place at many sites, but day-to-day practice did not necessarily reflect them.
  • Benchmarking with other organisations was all but absent. There was no consistent culture of learning from others, and we found little evidence of external checking or validation of data security arrangements.
  • The use of technology for recording and storing patient information away from paper-based records is growing. This is solving many data security issues but, if left unimproved, increases the risk of more serious, large-scale data losses.
  • Data security systems and protocols were not always designed around the needs of frontline staff. This leads to staff developing potentially insecure workarounds in order to deliver good timely care to patients – this issue was especially evident in emergency medicine settings.
  • As integrated patient care develops, improvements must be made to the ease and safety of sharing data between services.

The report makes  six recommendations:

1. Leadership

The leadership of every organisation should demonstrate clear ownership and responsibility for data security, just as it does for clinical and financial management and accountability.

2. Information, tools and training

All staff should be provided with the right information, tools, training and support to allow them to do their jobs effectively while still being able to meet their responsibilities for handling and sharing data safely.

3. IT systems

IT systems and all data security protocols should be designed around the needs of patient care and frontline staff to remove the need for workarounds, which in turn introduce risks into the system.

4. Outdated technology

Computer hardware and software that can no longer be supported should be replaced as a matter of urgency.

5. Audit and validation

Arrangements for internal data security audit and external validation should be reviewed and strengthened to a level similar to those assuring financial integrity and accountability.

6. CQC assessment

We’ll amend our assessment framework and inspection approach to include assurance that appropriate validation against the new data security standards have been carried out, and make sure inspectors are appropriately trained.

55 million patients to access their GP record online

Patients in England will be able to view test results as they come in and keep track of their glucose levels and cholesterol on their smart phones, enabling them to take greater control of their care and better manage their health. 

image source: Lea Latumahina – Flickr // CC BY-SA 2.0

Official figures reveal that over 95% of GP practices are now set up to offer online access to detailed GP records including test results and diagnoses as well as referrals, immunisations, procedures and medications history.  This is up from just 3% of practices in January this year.

Greater use of technology to enhance patient care and experience and reduce the administrative burden on GP practices is a key commitment of the General Practice Forward View, launched by NHS England in April 2016.  These figures reveals significant progress has been made on the ambition to support practices to reduce their workload and achieve a paper-free NHS by 2020.

The impact on NHS finances of the UK leaving the EU

Health Foundation analysis

Leading economists are almost unanimous in concluding that leaving the EU will have a negative effect on the UK economy, which in turn will impact on public spending.

A new report from the Health Foundation, NHS finances outside the EU, concludes that it is difficult to see how the NHS can escape the consequences.

The report looks at how different decisions following the UK vote to leave the EU might affect funding of the NHS in England, the current state of finances for NHS providers in 2015/16, what this implies for the total Department of Health budget, and the scale of the financial challenge facing the health service for the near future.

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Google DeepMind pairs with NHS to use machine learning to fight blindness

Hern, A. The Guardian. Published online: 5 July 2016

‘Deep learning’ research company will use 1m anonymised eye scans to train a neural network to identify early signs of degenerative eye conditions

N0037850 Human eye with blue iris
Image source: Macroscopic Solutions – Wellcome Images // CC BY-NC-ND 4.0 

Google DeepMind has announced its second collaboration with the NHS, working with Moorfields Eye Hospital in east London to build a machine learning system which will eventually be able to recognise sight-threatening conditions from just a digital scan of the eye.

The collaboration is the second between the NHS and DeepMind, which is the artificial intelligence research arm of Google, but Deepmind’s co-founder, Mustafa Suleyman, says this is the first time the company is embarking purely on medical research. An earlier, ongoing, collaboration, with the Royal Free hospital in north London, is focused on direct patient care, using a smartphone app called Streams to monitor kidney function of patients.

The Moorfields collaboration is also the first time DeepMind has used machine learning in a healthcare project. At the heart of the research is the sharing of a million anonymous eye scans, which the DeepMind researchers will use to train an algorithm to better spot the early signs of eye conditions such as wet age-related macular degeneration and diabetic retinopathy.

Read the full news story here

British Social Attitudes Survey – NHS Chapter

British Social Attitudes. Published online: July 2016

Trends in dissatisfaction and attitudes to funding


Low levels of dissatisfaction 

Levels of dissatisfaction with the NHS are comparatively low and remain relatively stable, despite reductions in funding since 2010.

Image source: BSA
  • 23% are dissatisfied with the NHS. This proportion declined from 50% in 1997 and levelled off between 2010 and 2015.
  • 16% are dissatisfied with GPs, 18% with dentists and 33% with social care.


Dissatisfaction with the NHS linked to views on NHS funding 

Many of the reasons people are dissatisfied with the NHS relate to the resources it has available and those who are dissatisfied are more likely to think the NHS is facing a “severe” funding problem – yet they are no more likely to favour policy options directed at addressing this problem.

Image source: BSA
  • 84% of those who are dissatisfied select a reason for this which relates to resources.
  • 45% of those who are dissatisfied think the NHS has a “severe” funding problem compared with just 26% of those who are satisfied.

Similar proportions of those who are dissatisfied and satisfied would be willing to pay more directly for the NHS through a separate tax; however 11% of those who are dissatisfied are prepared to pay more through the current taxes they pay, compared with 19% of those who are satisfied.

Read the full chapter here

Improving teen mental health outside of traditional settings

Fenton, K. PHE Public Health Matters Blog. Published online: 4 July 2016
Image source: Plum leaves – Flickr // CC BY 2.0

Childhood and teenage years are a time of rapid change and development and coping with the pressures of growing up can be tough.

Young people can experience a range of mental health problems, and as part of our work to improve the public’s mental health we can help by identifying and encouraging approaches that adapt to and meet the changing needs of young people.

We have a key role in helping to make this vision a reality, and we have an important opportunity to drive action to improve children and young people’s mental health beyond health and social care services.

Reading for good mental health 

The Reading Well for Young People scheme was launched in April by The Reading Agency, Society of Chief Librarians (SCL) and the Association of Senior Children’s and Education Librarians (ASCEL), with funding from the Wellcome Trust and Arts Council England.

With the tagline ’Find shelf help in your local library’, the scheme has been co-produced with young people alongside leading health organisations including PHE.

The importance of a good night’s sleep

MindEd at the Royal College of Psychiatrists and the University of Northumbria have published a new ‘sleep in adolescence’ resource, supported by PHE.

This follows a recent report from the Royal Society for Public Health and the University of Oxford stated that poor sleep is linked to a wide range of physical, mental, behavioural and performance issues. It warned that four in ten people aren’t getting enough sleep, while one in five sleep poorly most nights, and called for sleep to become a key priority for the public’s health.

Read the full blog here

Database of pharmaceutical industry payments to doctors goes live via @onmedicanews

Torjesen, I. OnMedica. Published online: 1 July 2016

B0007020 Science research
Image source: Marina Caruso – Wellcome Images // CC BY-NC-ND 4.0

Details of payments and benefits in kind received by doctors, nurses and pharmacists have been published for first time by the Association of the British Pharmaceutical Industry. The ABPI estimates that 70% of health professionals receiving the payments have consented for their details to be disclosed.

The database reveals that the pharmaceutical spent £340.3 million working with UK health professionals and organisations. On average, companies spent £3.1 million and Astra Zeneca spent the most – £41.7 million.

Most of the money (£229.3 million) went on research and development activities, details of which are already disclosed through clinical trial registries and other transparency policies. The remaining third (£111 million) went to individual healthcare professionals and healthcare organisations for other activities.

Almost half of the money not spent on research and development (£46 million) was paid to healthcare professionals in fees for service and consultancy work, such as participating on advisory boards, speaking at or chairing meetings, and developing support materials for patients or other healthcare professionals. Healthcare professionals also received another £14.8 million from industry in registration fees for meetings and conferences and associated travel and accommodation costs.

Read the full news article here