Scrapping NHS Digital and folding it into NHS England will probably be a “vital retrograde step” in relation to safeguarding affected person privateness rights, significantly within the wake of ongoing considerations over information gathering of affected person data, a former well being service official has warned.
The overhaul of NHS IT, announced in November 2021, will see each NHS Digital and NHSX come beneath the management of NHS England and Enchancment (NHSE/I) in a transfer the Division of Well being and Social Care (DHSC) claims will enhance care, centralise the NHS workforce, and speed up total digitisation.
The reforms will see NHS Digital turn into the well being providers CIO directorate, and NHSX will serve the transformation directorate’s technique operate. Well being Schooling England can also be to be merged into NHSE/I.
In a letter to the British Medical Journal (BMJ), Kingsley Manning, who stepped down from the chair in 2016, mentioned the plans would endanger the rights of residents in regard to how their information is collected and utilized by the well being service.
Manning, who give up after a disagreement over the publication of statutory statistics, argued that the Well being and Social Care Act of 20212 had already given NHS England an excessive amount of oversight of NHS Digital, and that since 2016 its affect over the physique had grown.
“This is a crucial and retrograde step not least within the context of this authorities’s clear intent to weaken the constraints on using patent information, as set out in the consultation document, Data: A new direction,” wrote Manning.
“Disposing of an impartial statutory physique in NHS Digital, charged with defending affected person rights, is itself unlucky. However handing that physique and its powers to NHS England, is a grave error.
“In impact, NHS England will be capable to determine that its respectable curiosity[s] override these of the citizen and the affected person, with little or no exterior constraint or scrutiny. With no requirement for transparency and with further boundaries to residents asking for details about using their information, people might by no means know what NHS England chooses to do with their information,” he wrote.
Manning mentioned that this was significantly necessary in mild of the debacle that unfolded final yr across the proposed General Practice for Data Planning and Research (GPDPR) scheme, during which the mass “information scrape” of GP information was closely criticised.
The programme was mentioned to be poorly bought to most people, with the outcome that large numbers chose to opt out amid confusion over the programme’s scope. It was finally placed on maintain, with no firm date for its introduction.
He accused NHS England of getting taken the method that present steering and laws with regard to its use of affected person information was “seen as pointless”, and urged that it had failed to contemplate that a lot of its inner priorities could also be at odds with these of people or teams when it comes to useful resource allocation and repair entry. Throughout the board, he mentioned, permitting decision-making to be pushed by opaque use of knowledge would finally undermine affected person belief within the NHS.
Manning known as for “strong, exterior, impartial scrutiny” of NHS England to be put in place, proposing that the National Data Guardian be awarded a more practical oversight remit. He additionally known as for a statutory requirement of transparency to pressure NHS England to permit sufferers to seek out out what information the NHS holds them, who can entry it, and what they’ll do with it.
“The demise of NHS Digital will go unnoticed by the overwhelming majority of the inhabitants. However its absorption into NHS England is a step within the fallacious route, signalling a coverage method which not solely difficult the fundamental proper of sufferers with respect to their very own information, however may additionally, finally, show self-defeating,” he warned.
NHS England declined to touch upon Manning’s letter, saying that the final word choice to carry NHS Digital beneath its purview was right down to the federal government. The Division for Well being and Social Care had not responded to a request for remark on the time of publication.