Caldicott expected to raise legal doubts over CSU data services

There is a growing expectation that CSUs will not be allowed to store or work with data that can identify individual patients, HSJ has learned. It raises doubts over whether they will be able to set up “data management and integration centres” to provide some core business intelligence services to commissioners.

Senior sources believe Dame Fiona Caldicott’s review into information governance for the Department of Health, which is expected to report in the first quarter of 2013, will find that patient identifiable data should not be passed from NHS commissioners or providers to other organisations, including CSUs.

As CSUs would not be able to receive, store or integrate sensitive data, they would not be allowed to carry out business intelligence services. In August the NHS Commissioning Board designated nine CSUs or groups of CSUs to provide those services “at scale” across the country. It is not clear what the implications would be for these CSUs’ business plans. Some business intelligence CSU functions, such as analysis of encrypted data, would not be affected and could still be carried out by CSUs.

New legislation would be required to enable CSUs to receive patient identifiable data. It is thought likely the issue will come up again by 2016, when CSUs are to be floated off into the private or voluntary sectors, as this would change their legal status.

However, the information centre already has special legal status enabling it to work with confidential information.

One possible solution under discussion is that the information centre takes over the data management functions of CSUs, storing the information itself

and then making it available to CSUs in a “pseudonymised” or encrypted form. Another possibility is that the information centre could “host” those CSU functions, bringing them under its legal permissions.

The centre expects to be asked to provide data management and integration services to support commissioners, and is buying extra hardware that would increase its data storage capacity and enable it to carry out this function. Information centre bosses are moving early because if they wait for the Caldicott review to report they will have little time to scale up ahead of the new NHS commissioning system going live in April.

HSJ understands the information centre also believes that through economies of scale it can provide services more cheaply, and with lower start-up costs, than the CSUs would.

The organisation and CSUs are also still waiting for details on how business intelligence services will be funded.

The commissioning board declined to comment.