We’ve noticed lately that a few NHS trusts have began to reject our requests on IEP (we are a private hospital that has some NHS contracts) because patient consent is required. We’ve been on the HSCN environment for a few years. When we request we always have a documented request process from our consultants so we know the patient is coming to our site for treatment/scans/mdt/etc.
I have to admit it doesn’t feel right that we’re getting rejected? We’re acting in the best interests of the patients care. The trusts in question have outlined that its part of their local policy but this is a real blocker towards patient care in my opinion. I’ve had a look on some RCR guidelines which have said
I was just wondering what peoples views might be on this?
What reasons are trusts giving for rejecting your requests? I would only reject a request from and care organisation, NHS or private, if we didn’t have imaging for the patient.
We’ve been through this @UHS too. a lot of protectiveness over NHS data but an eagerness to benefit from that acquired privately ( yes im NHS, honestly) .
A few years back i was still aware of ‘shenanigan’s’ where consultants would ask for transfers to their private office so that they didn’t have to attend the NHS site as often, this did lead to more thorough checking of requests and ‘we’ did ask for patients to make the request rather than the private institutions themselves. ( im talking 7-8 years ago). With todays integration and the lines between NHS, private supplied NHS, NHS supplied private and truly private work having been so blurred we have to accept that patients are the bottom line and continuity of care is the most important thing regardless of who the care giver is.
Given the granularity of the audit we now have available, unless there are glaring inconsistencies, we now take the sent it first and investigate after approach with IEP. each institution has signed up to the IEP DPA, so know they can be held accountable if there is mischief afoot.
I work for an independent provider of NOUS and we receive approximately 50 IEP requests a month and this has never happened to us. My understanding as this is part of the patient care pathway they have already consented to the sharing of their data for care and treatment, therefore this shouldn’t be needed.
Wow! I would be interested to know which NHS Trusts are being obstructive to continuing patient care! Patient care is absolutely paramount and so this behaviour could potentially have an adverse effect on patient care, management and best outcomes! Shocking!
Should the requestor make it clearer as to the reason for image transfer without making it an onerous task.
Should there be a tick box for ‘Reason for transfer?’
Direct Care/Clinical audit
Other - please specify
It’s up to each individual organisation what mandatory fields they setup for requests and transfers they receive. The requester should complete all mandatory fields they face and should write the reason for their request in the message box
There must be something more to this - is this one particular Trust (no need to name and shame here, just trying to get a feel for how many locations are now taking this approach) or multiple Trusts in a region or…?
I have never heard of this approach before and on face (there may be more to this) it isn’t a sensible approach.
The patients concerned aren’t “well known” are they? That’s the only reason I can think of where extra caution along these lines is needed…
It’s a complex area - it would generally only be the default if it were within reasonable contemplation. If not, the patient has to be explicitly told (and consent). For example: patient was being cared for at Trust A, knows only Trust B has the exam available / quicker waiting list and the consultant has a colleague at Trust C they told the patient they would discuss it with for advice or possible onward referral. Trusts A, B & C can share the data for that particular episode and any clinically relevant priors. If the ‘friend’ at Trust C decides his friend at Trust D could also weigh in, the patient should technically be briefed on this extra sharing and consent to Trust D’s involvement.
It can get a bit messier when you have PP’s or international patients falling under both GDPRs or the US schemes.
XDS makes things a little less cumbersome as it avoids the duplication of data in most cases and maintains the audit trials for all concerned.
In our trust we don’t block transfers to the private sector if the request comes from a legitimate source. I see as continuation of patient care and it’s their choice to receive that ongoing in a private setting & if that institution is connected via IEP they have already fulfilled HSCN/N3 criteria (safer than discs etc.) & fully auditable
As long as the requestor completes all the other mandatory fields we stipulate on IEP we will happily actin ant transfer request
In the Trust I am working in at the moment we setup data sharing agreements with the different providers at the request of our consultants who provide the services. Patient safety is always at the focus of our service delivery.
We’ve seen it with a couple of institutions so far. One of them is a very big NHS trust in London and it’s in their institution notes on IEP stating about “contacting disclosures office or the patient”.
Its not a case of patients being well known or anything as the NHS sites are using this as a blanket statement for all their transactions.
I think i’ll consider an email to them! It’s been great to see everyone’s comments being equally as perplexed as me!
