Can a private hospital access NHS records?

I've asked the question of Ms. RM, she used to work for NHS Digital and did a rather large piece of work around patient data. She now works for EMIS doing similar things.

I'm not 100% sure. From what I have read they can't directly access nhs records. They will have access to whatever they have been sent if it was a referral.

Asked a friend who works in a patient record team in a local trust and they say no. Might be an error?

Edit: Even the NHS own website says no.

Depends on the Private Hospital, but they should* be able to see some minimal data on the Spine - the stuff you can see in the NHS mobile app, usually allergies, medications, immunisations. Depending on how much you (via your GP Practice) have opted to share that might include specific conditions data and test results.

If you have the NHS App, have a look and see whether there's a test result visible in it, or query with your GP Practice.

(* Massive source of debate, but a big purpose of the Spine minimum data set was to reduce incidents where people are given stuff they're allergic to or have a current medicine which might have an adverse interaction with. Health Providers having access to that data shouldn't be a bad thing)

In my experience the NHS accessed a private scan carried out in a private hospital that I paid for. How does that work cos it flippin' well shouldn't. Would suggest you request a copy of all of your medical records from your GP practice, they can make interesting reading.

Who has referred you to the private hospital? If it's through your GP, they might've sent those blood tests. Some Private hospitals have workers who can access NHS Spine, your blood test data may be there. The insurance company may have asked your GP for that information, and they may have passed it to the hospital.

In short, there's quite a few ways how that info could get to the hospital.

Yes.

It used to be that there was a hard wall between private and NHS but this has been eroded.  I had a private consultant consultation yesterday and they have access to TRAK so had my full record in front of them.  I did watch her access it and she went thru a portal that made it clear it was being accessed from the private hospital.  She checked my NHS scans and x rays

this was a consultant with both NHS and private practice but she was not accessing it via her NHS login but clearly thru a portal for the private hospital to access TRAK

this was in Scotland where the setup is different to England

Edit - when I signed up for the private consultation I did sign for record sharing

@nickc I should have followed up with that, as a rule the NHS doesn't 'share' I believe unless given direction by the patient. But other entities can if often unbeknownst to us we've agreed in some T&C's somewhere I believe?

@tj I think if that's the case, the NHS needs to update its statement on that fact! A cursory google contradicts your post at a national and local level, but unsurprising it would be out of date and innacurate. 😂

Edit: I forget you lot have different rule, the googling was England, obvs.

Mrs Pondo had an MRI on her back last year through the NHS, then surgery done privately - private had to request the scans and I'm sure all of that was done electronically, but they did not by default have access to her records.

Would suggest you request a copy of all of your medical records from your GP practice, they can make interesting reading

My personal view is that the NHS has more than enough to be getting on with without fielding spurious requests for copy records, just for giggles.

RM - Trak has very good security - it knows where anything is accessed from so the NHS would know about that access request

as a rule the NHS doesn’t ‘share’ I believe unless given direction by the patient.

Mostly. There can be 'implied consent' in some cases. i.e. you've agreed a referral via your GP, and the GP sends data about you to that hospital. You may not be asked about specific data, and they may even follow that up with other records about you.

RM – Trak has very good security – it knows where anything is accessed from so the NHS would know about that access request

Be good if they could create a similar bridge between defence and the NHS like that.

Mostly. There can be ‘implied consent’ in some cases. i.e. you’ve agreed a referral via your GP, and the GP sends data about you to that hospital. You may not be asked about specific data, and they may even follow that up with other records about you.

Of course, makes sense.

RM – Trak has very good security – it knows where anything is accessed from so the NHS would know about that access request

Same in England, I can audit any system that has pt data on it, and see who has accessed it, and what they did. Part of our auditing processes at practice level is doing random checks of reception/admin staff to see who's pt. records they're accessing and why. We also do the same random audits of referrals and tele convos.

Yes, but you have to give permission.  I am also going through work insurance and was asked to authorise access to my records / GP.  It may be that this is tucked away on a form or email somewhere, but makes complete sense to me so they know what has been going on.  They are much more efficient than the other way round, where it has taken over a month for the consultants findings to be added to my GP records (and only after me chasing for this to be done). 

My personal view is that the NHS has more than enough to be getting on with without fielding spurious requests for copy records, just for giggles.

You're wrong.

Yes, of course.

I just paid for a private CT because the consultant couldn't access my NHS one 🙁

Slightly off-topic but when a relative last year was struggling to get information on their own health through the NHS, they went through the MacMillan nurse and got it that way immediately.

I was very surprised that MacMillan could access it (but very happy at the time).

I'm just amazed they could, because when I was in hospital not so long ago for cardiac issues the NHS were struggling access my NHS records because previous consultant records were with a different NHS trust. I was told they (Tayside) would have to specifically request access from Grampian, neighbouring trusts and it would take some time.

Yes, but you have to give permission.

Really? I was contacted by a private clinic for a scan, as this was a service used by my NHS trust. I gave no such permission. In fact I was annoyed, as such a scan wasn't necessary (I'd already had one), and I hadn't been informed my supposedly confidential details had been given to a private company without my express consent.

Mostly. There can be ‘implied consent’ in some cases. i.e. you’ve agreed a referral via your GP, and the GP sends data about you to that hospital. You may not be asked about specific data, and they may even follow that up with other records about you.

In my case, there was no implication from anybody that my details would be sent to a private company. Nobody informed me this might or would happen.

Some doctors/consultant working for the NHS also have private work out side of this. This isn't a secret obviously. But they are not allowed to 'tout' for business for any private healthcare company they have any connection to. One doctor recommended me to a physical therapy service, and was very enthusiastic about it. I researched the company, and found out he was one of the directors. I made a complaint and he was disciplined accordingly. He hadn't been at all open about this, and I don't believe such behaviour is permissable. But I suspect such things happen a lot.

EDIT - apologies - just re read your post and i had mis-interpreted it. You meant that they were marketing to you after you had the original scan?

 as this was a service used by my NHS trust. I gave no such permission.

They don't need your permission.

We'd need written permission from the patient and consultant before being able to release data. That data would be minimal info from the test report.

I've had to refuse quite a few requests from Pvt healthcare as they either haven't followed the correct procedure by mistake or in some cases are just fishing for info.

It also applies to NHS consultants who call for historic results from say their mobile phone who we also refuse. Most then pull the "don't you know who I am" card which is great because you can say "no, actually I don't, you could be any tom dick or harry" we ask them to email from a verified .NHS email address with copies of the correct permissions.

Of course, live blood results when you are on the operating table are different but that is a different dept to mine.

Did you sign anything during your private consultation? You should have been made aware and frankly asked if you have had any previous tests. If it's a blood test only and it was months ago TBH it's going to be of little value now. You'll need an up to date test carried out. They may if course be using your previous result to justify charging your medical insurance for your care/further tests. As now you are private the company will be trying to extract the maximum amount of £ from your insurer. Obviously the side effect will hopefully be swifter treatment.

Slightly off-topic but when a relative last year was struggling to get information on their own health through the NHS

We have quite a few patients ring for results (not blood tests) and have to refuse. You have to go via your consultant/gp, again using a .NHS email.

It's all to protect patient confidentiality

You have to go via your consultant/gp, again using a .NHS email.

or just ask the Macmillan nurse and they'll give you the info!

From the best of my knowledge no, NHS records are not shared with private hospitals.

You can ask for your medical record and then share it with the private hospital. If you go privately you will ask if you want to consent for your private record to be shared with your GP.

As to Op why not just ring the hospital and ask where the data came from ?

Interesting, thank you. The test results do show up in the NHS app. Probably have given permission for wider de-identified data sharing in the past for research purposes.

The referral was through AXA’s own GP service.

Will enquire the next time I’m in the hospital.

NHS can't view medical records (full medical records) between the different trusts let alone to private hospitals.

or just ask the Macmillan nurse and they’ll give you theinfo

unless you want them to get into a LOT of trouble I'd stop mentioning it on the internet 

Given NHS institutions struggle to access even their own records at times I’d expect not.

Perhaps they wrote to your GP following your initial referral?

Perhaps they wrote to your GP following your initial referral?

Don’t think so, it’s only been a couple of days since the initial referral.

Would suggest you request a copy of all of your medical records from your GP practice, they can make interesting reading.

I spend quite a bit of time reconciling NHS patient paper records to their electronic record for a GP surgery. It is currently part of the GP contract that this continues. It is surprising how many electronic records even post 2005 when consultations went electronic in most surgeries are incomplete.
When patients move from surgery to surgery sometimes the GP to GP record doesn’t transfer, especially if it is between Wales and England or Scotland and England as there is some element of lack of interoperability of their systems, but can be from those just down the road.
If this happens then a new electronic record has to be manually constructed, usually from the paper records that exist  or are printed/ emailed from their previous surgery and they are  only as good as the person imputing the data and what protocols their surgery follow.
tldr: don’t expect your record to be as complete as you might expect, and it’s not usually the current surgeries fault

@flaperon - looks like it varies from trust to trust then.

At my trust the answer is yes, they have access. We have local agreements with various private hospitals and clinics local to us. They have to go through rigorous IG process but they get access to the same system the trust uses. It's accepted that the private clinics need access to pathology reports and that only verified individuals will be accessing that data, i.e a registered professional... the receptionist won't be rooting through the patient database but the GMC registered consultant you see will look you up to find what is relevant.

Got the answer: came from my GP's records.

Sharing of data varies on a trust by trust basis. There's lots of ways to access/share data, most require you to be on the Health and Social Care Network (HSCN), VPN that runs on the internet nowadays.

At a guess I'd assume your private health provider has accessed the records via Sunquest ICE or similar. To reiterate, access control is very much defined by each trust.

Typical example here, first Google result.

https://mft.nhs.uk/the-trust/other-departments/laboratory-medicine/information-for-gps/using-the-ice-system/

Its all very murky. Many people are now treated on the NHS in private hospitals by surgeon working in either a private capacity or as one of their NHS session depending on the agreement between the local Trust and the hospital. This was very common duing Covid and has remained a popular solution in many areas. There was a big debate when I was at a private hospital about who controlled the notes for private paitents. Many consultants said they were theres and they could take them wherevet they like. The other view was that because they were created at the private hospital then GDPR required them to retain ownership and responsibility for them. As with much in private healthcare in the UK its all a bit murkey and not as clear as it should be

We had a proper laugh about this thread title chez BWD given that er indoors has recently found that the NHS seems to have serious issues with sharing NHS patient data within the NHS let alone outside it, 'I'm afraid you'll have to have another MRI /blood test / consultation as we have no way of accessing the stuff you had done a couple of months ago at another NHS hospital less than ten miles away'.  When she tentatively looked into going private, she was told all the redone tests would have to be redone, again.

Moreover, when I dropped into a local A&E department in 2020, the details they held for me were still from the mid 90s when my GP was Harold Shipman.

I know this is anecdotal, but from our experience at least, NHS records and IT seem to be in something of a state, which extends to an appointment system which has cancelled consultations via text message to appointments which we were notified of several days after they were cancelled, which was a bit surreal.

I'm sure there are good reasons for all this, but it's perplexing from a patient point of view and I can imagine that someone 'confused' and without internet / mobile phone access would be even more baffled.

BWD is seems very much to be a postcode lottery thing this and worse in England.  I know I have accessed full  records belonging to folk in other hospitals even outside the area with no problem including results and tests.  You need to know how to operate the system tho which too many folk do not which was an issue someone else had whereby they were told records from St Johns were not available at Sick kids which is not that the records were not available because they are.  It was because no one there knew how to do it 🙂

Sort of an aside, but it might give some context to a few comments on here, especially about how poor sharing of records between bit of 'The NHS' is (and I put that in inverted commas for a reason...):

People believe that 'The NHS' is a single entity - because that's how it's referred to and how it's put forward - but it isn't. It's lots of little organisations - Primary Care (GPs), Secondary Care (hospitals), Community Trusts, and the various other allied health professionals, plus Commissioning Organisations (formerly PCTs, then CCGs, now ICBs/ICSs: These are where I work) and assorted other hangers on that do the Admin side rather than the actual trying-to-make-people-better side. There's precious little that links those organisations, and precious little interaction between them, except when they're forced to. For us here South of Gretna, NHS England mainly just shout orders - sometimes comprehensible, sometimes half-baked - from on high, which we ad everyone else have to obey, because they're the ones who have the money from the Department of Health & Social Care, and if we don't do what they say we don't get funded.

When it comes to Patient Records, the main issue is that there's no single national repository, because the data storage requirement and cost would be astronomical (especially given the retention schedule on health data), so everyone has their own. Even where there are Shared Care Records (we have one in Leeds), there's arguments about the data on it, who is the Data Controller, etc etc, so in our case GPs feed into it, Leeds Hospitals feed into it, but at the last shout Community Healthcare still don't, because... Regardless of this all being a Patient's data, each individual organisation is legally responsible, and they don't necessarily want to share because of the Governance implications. And the security implications to prevent a breach. And the repercussions if/when there's a breach...

The reason a lot of Hospital Trusts can't share records between them - or even internally between departments - is historic. In the infancy of computers, departments in hospitals got their own internal systems, because all records were on paper so why should we ever need systems that talk to each other? As long as they can talk to a printer, we're fine. As technology moved on, a lot of these systems were incrementally updated, but because centralised storage was costly and records were still predominantly paper, interoperability wasn't a priority  - and even if it had been, a lot of these systems were so bespoke, there would have to have been the development of a common language for them to talk. Even GP electronic records were for a very long time in  two different Code sets - Read V2 or CTV3 - depending on which Clinical System your GP used. They were only updated to use a single code set - SNOMED - from about 2016, and the Read codesets were only retired in about 2020. Add into the mix that Hospitals mainly get funded specifically for the operations they provide - usually by Block Contract from the Commissioning organisations - so there isn't a lot of spare cash floating around, and you start to see why a hospital might not be able to afford the project to bring together 50+ different bespoke departmental systems which all speak different languages, plus create enough server or cloud capacity to store all that data, plus make it talk to the various GP Practice systems, ideally? Unless DHSC suddenly decided that they could chuck a few month's-worth of Bus Money (£350 million a week, wasn't it? Six month's worth might get a good start on it) at the problem, then by now, a single centralised National Shared Record is a technical pipedream - before you even start talking about the legal and ethical implications.

Also in terms of a single National record, schemes like the ill-fated Care.Data programme didn't help matters - that could have vastly improved healthcare data sharing between NHS organisations for all the right reasons and for the betterment of healthcare - but DHSC wouldn't remove the clause about also being allowed to sell data - albeit anonymised - to other companies, which rightly had people worried and meant people started opting out of any potential sharing of their health record. Understandably, to be honest...

So - TL;DR version: Why is health record sharing so poor in 'The NHS'? Because everything's in different languages, no-one's got any money, it would be so huge and so heavily fortified it would cost astronomical amounts, and people would probably still object to its existence.

( < /rant > )

Oh, and just to prove a point on 'different languages':<br /><br />We funded a project to get remaining paper records at our GP Practices, the Lloyd George notes, scanned into the electronic record systems. We started with the handful of our Practices who use the EMIS Clinical system, and spent a lot of money paying a company to scan rooms and rooms full of Patient notes to create electronic records that could be pulled up in the GP system if needed. Seemed successful, job done.

One of those Practices recently changed Clinical System, migrating from EMIS to TPP SystmOne. Those scanned records, in a format that was necessary for them to be openable and readable in EMIS, won't open in SystmOne...

You'd have to consent them accessing your public records, surely?

Over here we have MyHealthRecord which you're automatically opted in, and visits to hospitals / health care etc gets uploaded to one place. You have to opt out if you don't want to be part of this. And you have to opt out individually for each place (not one opt out to rule them all). Ultimately it'll probably be used to void your medical insurance cos they can track back and say "oh, in 2012 you had an anti depressant" or some crap like that. Get-out clauses to avoid that annoying insurance claim.

So – TL;DR version: Why is health record sharing so poor in ‘The NHS’? Because everything’s in different languages, no-one’s got any money, it would be so huge and so heavily fortified it would cost astronomical amounts, and people would probably still object to its existence.

Thanks for the detailed explanation, which is largely as I thought it would be. I suppose in an era when so much stuff does seem to be joined up, our expectations are higher. Fwiw, anyone living where I do - High Peak - will be all too familiar with the incoherence of the NHS beyond a local level. We're technically part of Derbyshire, but our nearest hospitals tend to be Stockport or even Manchester, or Tameside.

I moved five miles to a different town, but kept my original GP, which means/meant/who knows that I'm technically living in a different trust area, but treatment is accessed based on my GP, I think, rather than my address. Or something like that. The end result is that people here bounce around between random hospitals that could anywhere between Salford and Derby. It's sometimes quite frustrating and public transport links to some of the hospitals are appalling. 

Perhaps one of Boris Johnson's 'new hospitals' will pop up nearby some time soon... meanwhile our local MP is more interested in trying to claim credit for a road-building project that's been in an ongoing process of not happening since at least the early '90s and probably well before.