Purpose

To ensure people are not in hospital if they would be better looked after in the community.  The ICB collects information about people with;

 - a learning disability, autism or both,

 - who are getting care in hospitals for their mental health or

 - because they have displayed behaviour that can be challenging. 

This is called Assuring Transformation Data.  This information tells us:

• How many people with a learning disability and/or autism registered with a The Norfolk and Waveney GP Practice are in hospital
• How long they have been in hospital
• When their care and treatment has been checked
• What kind of hospital they are in.

Legal Basis

NHS Act 2006 and Health and Social Care act 2012 https://www.england.nhs.uk/learning-disabilities/care/atd/

Processing Activities

Every month NHS Norfolk and Waveney ICB securely submits this information to NHS Digital who publish a report on a monthly basis. No personal information is included in this report.

If you are in hospital but do not want the ICB to use your data for the above purpose, you can let us know by contacting us either in writing, via email or by telephone. An “Assuring Transformation Easy Read Leaflet” is available from the ICB which explains the process in more detail. This can be obtained from our website.

Purpose

If you make an application for CHC funding the ICB will use the information you provide, and where needed request further information from care providers, to identify eligibility for funding. If agreed, arrangements will be put in place to arrange and pay for the

agreed funding packages with appointed care providers.

Legal Basis

Direct Care Provision – NHS Act 2006, Health and Social Care Act 2012, National Framework for NHS continuing Healthcare and NHS funded Nursing Care July 2022

Processing Activities

The clinical professional who first sees the patient to discuss their needs will explain what information will be collected and how this will be used to assess and commission a package of care. As information will be required from a variety of sources (i.e., GP, care home, hospital) the assessor will obtain your permission under the common law duty of confidentiality, to contact these organisations to gain the information required to inform the assessment.

The ICB has commissioned the services of Liaison Group to conduct CHC reviews. This will enable the ICB to manage its current backlog of reviews and ensure that patients receive appropriate CHC funding to meet their current needs. Liaison Group will act as a Data Processor on behalf of NWICB, processing personal data to our written instructions in accordance with the DPA and UK GDPR.

Purpose

The ICB also offers a service to retrospectively assess CHC eligibility if the individual was not assessed at all in the past. This is known as a “previously unassessed periods of care”.

Legal Basis

NHS Act 2006, Health and Social Care Act 2012 and National Framework for NHS continuing Healthcare and NHS funded Nursing Care July 2022

Under common law duty of confidentiality, we will seek consent. Your consent will also be requested to access any new health and social

care information that may impact on your eligibility status.

Processing Activities

Limited and authorised clinical members of the CHC Team will contact health and social care providers who have been engaged in your care, and request copies of information that are needed to inform an assessment. This will be done with your consent.

The ICB has commissioned the services of Liaison Group to conduct CHC reviews. This will enable the ICB to manage its current backlog of reviews and ensure that patients receive appropriate CHC funding to meet their current needs. Liaison Group will act as a Data Processor on behalf of NWICB, processing personal data to our written instructions in accordance with the DPA and UK GDPR.

Purpose

The Continuing Healthcare Team provides a “local resolution” service for individuals who wish to appeal against an eligibility decision. The team will use data obtained as part of the application process to check that the original assessment was conducted in accordance with the National Framework for Continuing Healthcare.

Legal Basis

NHS Act 2006, Health and Social Care Act 2012 and National Framework for NHS continuing Healthcare and NHS funded Nursing Care July 2022

Under common law duty of confidentiality, we will seek consent. Your consent will also be requested to access any new health and social care information that may impact on your eligibility status.

Processing Activities

Limited and authorised members of the CHC Team will access information already provided as part of the assessment process. This information will be available from our administration system, Broadcare.

If insufficient information is available to determine eligibility based on the grounds for appeal, the CHC Team will contact other providers engaged in your care to request further information. Only the minimum information needed to inform the appeal will be requested.

All new data and the outcome of the appeal will be recorded within your electronic patient record in Broadcare.

The ICB has commissioned the services of Liaison Group to conduct CHC reviews. This will enable the ICB to manage its current backlog of reviews and ensure that patients receive appropriate CHC funding to meet their current needs. Liaison Group will act as a Data Processor on behalf of NWICB, processing personal data to our written instructions in accordance with the DPA and UK GDPR.

Purpose

Patients that are in receipt of fully funded continuing health care are appropriately safeguarded via authorisation from the court of protection.

A deprivation of liberty is defined as being not free to leave and under continuous supervision and control. Anyone experiencing a deprivation of liberty (DOLS) and lacks capacity to make a decision about their care arrangements must be safeguarded via the appropriate routes. Where people live in their own home or supported living and are in receipt of fully funded continuing health care the responsibility for seeking authorisation of care arrangements which amount to a DOLS is the ICBs responsibility.

Decisions on capacity and best interest are made by continuing health care practitioner where the patient is fully funded for NHS continuing health care.

In order to make applications to the court of protection information relating to the patient will be shared with legal advice and organisation contracted to provide a community deprivation of liberty services on behalf of the ICB

Legal Basis

Article 5 of the human rights act 1998 describes the right to liberty and security which protects an individual’s freedom from unreasonable detention. There are three means of restricting the persons liberty: -

• mental health act, 2005, schedule (A) 1
• criminal justice processes, and
• mental capacity act. 2022 see section 14Z31

Processing Activities

The CHC Team hold information on a recording system called Broadcare, which is collected, stored and processed by the ICBs for the purposes of assessment and administering CHC packages of care this includes DOLS

The ICB has identified a third-party data processor NHS Midlands and Lancashire CSU who is under contract to assist the ICB with reviewing the Broadcare records for patients who are potentially eligible for a DOLS applications for court of protection. They will be responsible for completing the all the necessary paperwork for applications for the court of protection and updating the Broadcare system

Purpose

Personal information is processed to facilitate Individual Funding Requests (IFR). 

These can be to fund specialist drugs, Mental Health support, or rare treatments, including dental care, diabetic technology, MyAirVo2 – for the treatment of chronic obstructive pulmonary disease.

Legal Basis

NHS Act 2006 and Health and Social Care Act 2012

Processing Activities

The clinical professional who first identifies that you may need the treatment, will explain to you what information will need to be shared with the ICB and the process in order for us to assess your needs and commission your care.

The ICB will use the information you provide and, where needed, request further information from care providers to identify eligibility for funding.

This includes the processing of information such as travel expenses and sourcing alternate provides for treatment.

Information can be shared with specific companies who will be able to provide the specific product or service requested in the funding application.

Mental Health Individual funding requests are discussed at the Clinical Reference Group, redacted information is shared with external health organisations to support decision making.

If agreed, arrangements will be put in place to arrange and pay for the agreed funding packages with appointed care providers.

Information may be stored within the Blueteq system to facilitate panels and manager records in line with the Records Management Code of Practice.

Purpose

Legal Basis

Direct Care Provision – NHS Act 2006 and Health and Social Care Act 2012

Explicit Consent under Common Law Duty of Confidentiality.

Processing Activities

We receive information from: NHS and Private Independent Hospitals. NHS  Trusts.  Local Authorities.  GP Practices. Individual patients, family members and carers and the individual's support staff.   

As the coordination of care can involve liaising and sharing your personal data with many organisations. Such as:

• NHS and Private Independent Hospitals, NHS Trusts,
• Local Authorities,
• GP Practices,
• You, your family members and carers and,
• Your care and support staff, Care Education and Treatment Review and Scrutiny Panel members

The IPP Team will also seek your permission to do so under the common law duty of confidentiality.  This will enable the team to fulfil the following functions:

• Clinical management and oversight of patients on an IPP pathway, including conducting regular care reviews and discharge planning processes
• Sourcing appropriate placements
• Negotiating Patient Care Agreements (PCAs) with care providers
• Monitor the appropriateness and effectiveness of provider contracts

Limited and authorised members of the IPP Team will use your personal information to contact care providers who are able to deliver specialised care.  This information will be used to establish a patient care agreement.

The IPP Team will record all information within our administration system.

The IPP team also manage oversight of the Dynamic Support Register (DSR) and the Non Dynamic Support Register

This is managed by explicit consent, information is shared with NHS England and the LDPB Learning and Disabilities Partnership Board. This information does not contain personal details.  

NHS England » Dynamic support registers and Care (Education) and Treatment Review code of practice

Purpose

The NHS Long Term Plan pledges that children and young people with a learning disability, autism or both with the most complex needs will have a designated keyworker (also known as a Navigator).   On the success of this service funding was received to provide a Mental Health Care Navigator Service.

The aim of the service is to prevent problems from escalating to the point of crisis and to prevent hospital admission or readmission and ensure services ‘wrap around’ the young person and their family so they are able to access the care and treatment they need at home, or as close to home as possible. Navigators will work closely with children, young people and their families to improve their quality of life, ability to cope and to put in place the confidence, skills and knowledge to sustain a safe and happy home.

Legal Basis

NHS Act 2006 and Health and Social Care Act 2012

Processing Activities

Referrals are made to the Navigators service by Norfolk County Council, Suffolk County Council, Norfolk & Suffolk Foundation Trust (NSFT), Norfolk Community Health & Care (NCH&C), Norfolk & Norwich University Hospital (NNUH), James Paget University Hospital (JPUH), Queen Elizabeth Hospital Kings Lynn (QEHKL) and Hertfordshire Partnership University NHS Foundation Trust (HPFT), East of England Provider Collaborative.

The organisations working with families are Family Partnerships, Family Action, SENsational families, Family Voice and Norfolk Parent Carer Network.

The ICB will not be sharing any clinical or social care notes with these providers. Families will be sharing their information directly with these organisations.

The child/young person or their parent/carer is asked to sign a Consent Form to agree to be added to the Dynamic Support Register (DSR) or the Mental Health Dynamic Support Register (MHDSR) and provided with an information leaflet to explain what the DSR is. Service users choose their most preferred method of communication with the Care Navigators; this can sometimes be message / Whatsapp. The method is documented by the team. 

The consent form also allows appropriate information to be shared between Health, Education & Social Care to enable the child/young person to be safely supported. - Norfolk & Waveney Integrated Care System (ICS (improvinglivesnw.org.uk)

NHS England » Dynamic support registers and Care (Education) and Treatment Review code of practice

The ICB is required to report progress to NHS England on a quarterly basis. This does not include any Personal Identifiable Data.

Purpose

A Personal Health Budget is an amount of money to support the identified healthcare and wellbeing needs of an individual, which is planned and agreed between the individual, or their representative, and the ICB. To support this process, the ICB will process personal confidential data including special category / sensitive data to evaluate, agree and monitor any personal health budgets.

Legal Basis

NHS Act 2006, Health and Social Care Act 2012 and under NHS (Direct Payments) Regulations 2013

Processing Activities

Limited and authorised members of the CHC Team will use your personal information to contact care providers, where you have asked the ICB to support you to arrange your care. We will also process your information to ensure that your care needs are being met in accordance with your care plan and that your budget is appropriate and sufficient to meet your needs.

Purpose

Legal Basis

NHS Act 2006 and Health and Social Care Act 2012

Processing Activities

Data processing is carried out with agreement from the data controller – usually the GP practice.  Access to the system is controlled by the GP practice.  Your medical record may be accessed in full or Summary Care Record to process certain requests made to us by the GP practice.

For the purposes of auditing, only NHS numbers are documented for data collection where necessary.  This information is destroyed once the audit is completed and the results are recorded.

Data is shared within the Medicines Optimisation team using MedOptimise recording system (CoordinateRx is now the new name for MedOptimise) and the ICB for the purposes of financial and quality monitoring, commissioning and supply of services.  Individual patient level data is never shared for these purposes.

Purpose

To support the hospitals patient discharge process from hospital wards to the appropriate setting. 

The ICB has a responsibility outlined in the Government’s ‘Hospital Discharge Service: Policy and Operating Model’ first published in March 2020 and Hospital discharge and community support guidance - GOV.UK (www.gov.uk)

Legal Basis

Public Task - Section 82 of the NHS Act 2006Section 82 of the NHS Act 2006 requires NHS bodies and local authorities to cooperate with one another to secure and advance the health and welfare of their local population. NHS bodies and local authorities must also comply with duties in the Care Act 2014, which requires them to co-operate with each other in the exercise of their respective care and support functions, including those relating to carers and young carers (section 6 and 7).

Processing Activities

The ICB facilitates multi-disciplinary meetings with organisations across the Integrated Care System. Data is processed to enable the health and care system to:

• Determine how best to support the individuals who are ready for discharge in an appropriate and proportionate way in the community.
• Monitor performance at key points for the purposes of:
  • maintaining system operational flow and Provider performance
  • learning lessons from the data to continuously improve services, and
  • identifying opportunities to use system capacity and Provider resources in different ways.

Teams involved in this support are The Central Norfolk UEC and Quality & Care Team, the Home First team, and the Integrated Transfer of Care Team East

These teams support the ’Discharge to Assessment’ process and manage a referral hubs to signpost referrals to the most appropriate services/teams/beds and monitor the system.

Purpose

To support the transition from paediatric to adult services for young people and families with profound learning and physical disabilities and young people who are autistic and display complex behaviours which challenge

To manage the multiple transitions, through multiple services to support improved outcomes we have adopted a support register model to help case managers work collaboratively and coordinate these complex transitions.

The need for improvement has been seen in LeDeR (Learning from Lives and Deaths: People with A Learning Disability and Autistic People), to support the most complex transitions for young people with SEND (Special Educational Needs and Disabilities), whose circumstances posed a significant risk or created significant complexity to their transition. This will be called The Norfolk and Waveney Children and Young People’s Complex Transition Support Register (CYPTSR).

Legal Basis

NHS Act 2006 and Health and Social Care Act 2012

Processing Activities

Referrals to place a young person on the register could be received from:

• Norfolk County Council,
• Suffolk County Council,
• Norfolk & Suffolk Foundation Trust (NSFT),
• Norfolk Community Health & Care (NCH&C),
• Norfolk & Norwich University Hospital (NNUH),
• James Paget University Hospital (JPUH),
• Queen Elizabeth Hospital Kings Lynn (QEHKL) or
• Norfolk and Waveney ICB.

The referrer will remain that person’s case manager and be responsible for them and actioning agreed next steps from the group. They will document updates on their own patient management systems and continue to hold responsibility for the young persons care and support.

This process will be open to all young people with complex health needs and/or complex behavioural needs who have a learning disability, autism or fall into the SEND criteria. This process would exclude young people held on the Norfolk and Waveney Dynamic Support Register (DSR)

Information will be used purely to help the wider group discuss and advise on suitable actions for the case manager to take to coordinate the transition.

The support register will contain an agreed minimum dataset to allow the group to meet the aims and objectives. This will include:

• Name
• Date of Birth
• NHS Number
• Locality
• Case Manager/Referrer
• Diagnosis
• Transition Concerns
• Agreed actions and Updates

The information will be shared across organisations as necessary and agreement to this forms part of the consent form.

The child/young person or their parent/carer is asked to sign a Consent Form to agree to be added to the Register

Purpose

The ICB supports national vaccine programmes under instruction from NHS England.   Currently the remit of the team is Covid, Flu and Monkeypox, but this may expand dependant on instruction from NHS England.

Legal Basis

Regulation 3(1), (5) & (7) of the Health Service (Control of Patient Information) Regulations 2002 (“the COPI Regulations”) to support the response to Covid-19.

Data Protection Act 2018 – Schedule 1, Part 1, 2(a) preventative or occupational medicine, (b) provision of healthcare of treatment (f) the management of healthcare systems or services or social care systems or services.

Processing Activities

This involves working with Acute Trusts, Local Authorities, Vaccination Centres, PCN Primary Care Vaccination Hubs to coordinate and deliver vaccination programmes across Norfolk & Waveney. This work will be ongoing due to the updates to JCVI (Joint Committee for Vaccination & Immunisation) guidance regarding patient cohorts and eligibility criteria.

In line with NHS England direction in relation to programmes of vaccination, the ICB is required to process personal confidential information such as – vaccination status, demographics (e.g., name, address, date of birth, contact number), cohort, any relevant conditions or circumstances which may affect vaccination and dates of any previous vaccination doses given.

Purpose

To give patient choice for those waiting over 40 weeks without an appointment or an admission data to be invited to move to another provider for quicker treatment via the PIDMAS system.

Legal Basis

NHS E Directive - NHS England » Patient choice

NHSE are required to use this information through the Health and Social Care Act 2022 – section 3I Duty as to patient choice.

The Board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

From the statutory duties list:

To promote a comprehensive health service

To arrange the provision of health services in England as well as having regard to impact of services in certain areas and performance of functions outside England.

Processing Activities

When you sign up to the PIDMAS System your information will be shared with the ICB for the purpose of facilitating the transfer. 

The ICB receive waiters information from local hospitals this is shared with our virtual support team so they can contact you and advise of offers to transfer to other hospitals to enable reduced wait times.  The outcome of this contact will be shared back to the provider to update your records.  Patient Initiated Digital Mutual Aid System (PIDMAS) - Norfolk & Waveney Integrated Care System (ICS (improvinglivesnw.org.uk).

Information will only be held for the purpose of contact and transfer and once the work is complete, the hospitals will be updated and the ICB copies of information will be destroyed.