The start of overseas processing of patient data?

The Sunday Times reports that the NHS is sending millions of patient records and confidential medical notes to India for processing.

The article says that names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments

“The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.”

But in a little-noticed Parliamentary reply in January 2007 Caroline Flint, the then NPfIT health minister, said that some processing of patient data was already carried out overseas.


She said that NPfIT contracts let bythe Department’s NHS Connecting for Health “expressly preclude thetransfer ofpatientinformation outside the United Kingdom”. But she added:
 
“NHSShared BusinessServices Ltd, a50/50 joint venture between the Department and Xansa [now owned by Steria],currently providesfinancial and accounting services to over 100 NHS trusts and other NHSbodies.

“At present, 28.5 per cent. of their work is handledthrough anoutsourcingcontract to Xansa PLC’s India-based operation. The partners have agreedthat nomore than 60 per cent. of work can be offshored through this venture.”


Itappears that a mix of information is being processed overseas.

Aspokesman for NHSShared Business Services told the Sunday Times that information sent toIndia didnot include confidentialclinical records, but only patients’ names, NHS numbers and homeaddresses. Security was very strict in Pune and the company compliedfully with data protection laws, he said.

But the Royal Free, Hampstead, which also sent patient data overseasfor processing, said the information did include clinical history – andexcluded patient names.

Is anyone in the NHS quite sure what UKpatient data is being processed in India? Nope.

**

CarolineFlint’s Parliamentary reply in full:

Mr. Walker: To ask the Secretary of State for Healthwhat NHS (a) patient records services and (b) back officefunctions (i) have been and (ii) are planned to be outsourced to India;and ifshe will make a statement. 


Caroline Flint [11January 2007]:

“Information is not held centrally on thenumber of national health serviceorganisations which currently outsource aspects of patient recordmanagement orthe typing of patient records, or back office functions, to agenciesoverseas.

“Inthe future,each consenting person using the NHS will have a personal electroniccare recordheld within the NHS care records service (NHS CRS).

“The NHSCRS is the lynchpinof the new modern, integrated information technology (IT) infrastructureandsystems and services being implemented through the national programmefor IT.

“Nonational IT systems maintaining patient record services have beenoutsourced toIndia and there is no intention to do so.

“It is known thatiSOFT plc, one of theapplication software subcontractors, is developing software in India.Thissoftware is operated exclusively within England.

“Contractslet bythe Department’s NHS Connecting for Health agency, which is responsiblefordelivering the national programme, expressly preclude the transfer ofpatientinformation outside the United Kingdom.

“NHS Shared BusinessServices Ltd, a50/50 joint venture between the Department and Xansa, currently providesfinancial and accounting services to over 100 NHS trusts and other NHSbodies.

“At present, 28.5 per cent. of their work is handledthrough an outsourcingcontract to Xansa PLC’s India-based operation. The partners have agreedthat nomore than 60 per cent. of work can be offshored through this venture.

“Thesedevelopments are entirely in keeping with the Government’s overallobjective ofmaximising value for money across the NHS, and the public sector as awhole.

**

Update:

One of the comments on the Sunday Times’ article was by Jacqui Murray-Hawkes. She wrote of the potential for serious errors if work coming back to the UK from India is not scrutinised.

She wrote:

“As a fully qualified medical secretarytrained in medical terminology, typing and shorthand with 26 years’experience, a recent year long temping stint at St George’s in Tootinghorrified me.

“All the girls (largely untrained) do is glance overtyping sent to them from India, and press print all day [which sent letters to patients].

“I madecomplaint after complaint about errors to the management, who weren’tinterested.

“I prevented a letter going out to a patient stating, ‘Ihave pleasure in informing you that you do have cancer’ instead of ‘donot have it’.  Management weren’t interested in that either.

“Luckily Iwas only waiting for a different role so didn’t have to stay.”

And Stephen Jones wrote with what seems an unquestionably good idea:

“Instead of relying on foreignworkers, why can’t the government recruit from the thousands of unemployed ordisabled workers who could pass a test of some kind, enabling them to work fromtheir own homes in their own time.

“Surely the cost of providing broadband or acomputer would cost the NHS or the government less than the cost of sendingtheir files abroad …”

Links:

NHSsends confidential patient data to India – Sunday Times

Willpatient data go overseas? – IT Projects Blog (2007)

Healthrecords processed in India – Publicservice.co.uk

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processing data is never going to be an enlightening enough job suitable for us brits.

also the NMW means much cheaper to offshore. its a global market so just live with it - work within it - not against it.

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