Clinical commissioners have written to NHS England saying they cannot carry out their statutory duties because of issues around processing patient confidential data.

Primary care trusts had a section 251 exemption to process patient confidential data, but this was not automatically transferred to their successors, clinical commissioning groups and commissioning support units, when they came into being this April.

New guidance issued by NHS England last month says PCD can only be used for ‘direct patient care’. But this does not include many functions of commissioners such as risk stratification of the population.

In a letter to NHS England’s director of intelligence and strategy Christine Outram, NHS Clinical Commissioners – an independent CCG membership group – say there is a “very real concern amongst CCGs that the impact of this will be to stop them fulfilling their statutory functions”.

“CCGs have a fundamental need to access and process PCD, without which CCGs will be unable to carry out their commissioning responsibilities and support their member practices,” it says.

The letter describes three significant issues impacting on CCGs.

It says that risk stratification tools, which currently rely on access to PCD, are central to delivering patient care such as identify high-risk patients for admission to a virtual ward.

Also, lack of clarity around the guidance means there is a real risk that CCGs may be acting unlawfully.

Lack of access to PCD also impacts on how CCGs can manage their finances as they cannot validate invoices from providers.

“While this problem impacts beyond CCGs, current thinking at the centre appears not to be taking the new role of CCGs sufficiently into account,” the letter says.

According to new guidance, PCD can only be processed in Accredited Safe Havens. The only current ASH is the Health and Social Care Information Centre, which has nine regional outposts in the form of Data Management Integration Centres.

These centres have been developed by CSUs, but not all CCGs have a local CSU and others want to do their data processing inhouse. The letter says the new arrangements may therefore mean significant additional cost for some groups.

It goes on to say that guidance issued so far by the HSCIC is, “contradictory and appears to some extent to be founded on opinion rather than a position of legal clarity.

“It is essential that we have a clear and consistent legal position for all CCGs that we know has the support of the Information Commissioner,” the letter says.

“We fully recognise that finding a successful resolution to these issues is in the interest of all of us and we would welcome the opportunity to work with NHS England and the HSCIC to achieve this.”