Secondary uses pose confidentiality challenge

Meeting the NHS’s need for more information while supporting individuals’ rights to confidentiality is a key challenge for the Secondary Uses Service, according to its leader.

Jeremy Thorp, chair of the Secondary Uses Service project board, told the British Computer Society’s primary healthcare specialist group: “Through the NHS Care Record Service CRS we’ve got the opportunity to take a lot of data, make use of it, combine it and get added value from it.”

He said that though the CRS was very much about the operational care of patients, there were possible secondary uses in a range of areas including: Payment by Results; Access and Choice; meeting the Healthcare Commission’s requirements for regulation; public health; patient safety and research and development.

Potential users were health planners, clinical auditors, statisticians, epidemiologists, researchers and managers.

However he said: “Running throughout has been the whole issue of how we handle confidentiality.”

He described a multi-layered approach to confidentiality and said that Care Record Guarantee provided a context for taking the work forward.

Access controls; pseudonomisation; presentation layers which filter information or provide specific views of information; and work on data quality are being used to safeguard confidentiality.

“Clearly there’s a whole range of work going on in these areas but this is the critical underpinning to any mechanism for being able to share information,” said Thorp.

He said the first release of the SUS was in place and being tested and honed. The initial focus would be on supporting Payment by Results. Further developments planned in stages for 2006 included the replacement of the NHS Wide Clearing Service, pseudonomisation and a move to XML which would enable greater validity checking.