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Confidentiality worries ‘barrier’ to integrated care

by Lalah-Simone Springer
7 June 2013

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Worries over confidentiality governance are currently a huge barrier to integrating health and social care, healthcare leaders have revealed.

Concerns from trusts and clinical commissioning groups on how information can be shared without breaking the Data Protection act, rather than technology issues, are holding up progress.

Andrew Webster, associate director of integrated care at the Local Government Association (LGA) said confidentiality is bound to be a “big issue” when attempting integration.

“Many people will be happy for their information to be shared, and many people think it already is. There are a few people who don’t want that to happen – we have to respect that.”

Webster added: “But at the same time, many organisations are deeply worried about breaching information rules, and rightly so.”

Keith Holden, NHS England’s deputy director said questions over confidentiality are “central” to issues faced by commissioners and GPs at the moment.

He said: “A lot of it is as much about perception or lack of understanding as they are about worry over being disciplined.

“[NHS England] wants to actually clarify what the issue is, what our position is, as well as in some cases going further than that and offering extra guidance.”

Speaking at the NHS Confederation’s Annual Conference, Webster explained the basic guidelines for whether to share information.

He said: “If the duty to support the person outweighs the duty to confidentiality there’s a presumption you can share.

“And if the information is properly anonymised you can use it for population health purposes. We’re waiting for a response on how that can be properly operationalised.”

Best practice ‘pioneers’

According to Webster and Holden, the Pioneer Programme recently launched by Care and Support Minister Norman Lamb could ease the misunderstandings around the sharing of information.

The programme, which calls for best practice ‘pioneers’ working in the primary, community or acute sectors to apply to become funded case studies with support from NHS England and the Department of Health.

Information gathered from the Pioneer Programme would then be shared with other healthcare professionals through seminars, events and newsletters.

Webster said the LGA has spent a lot time trying to work out the right level of information sharing between healthcare and local government.

“Using the pioneer programme, we have the opportunity to test these theories on small groups, then pick up the protocols and use them across the whole country.”

Holden said: “We don’t want this to be an enormous bureaucratic exercise that collapses under its own weight, we want engagement.

“We don’t want a pointy-headed policy person like myself to present this, it must be peer-to-peer learning, from other clinicians.”