Southend Clinical Commissioning Group has made a crucial submission to the Confidentiality Advisory Group which NHS England hopes will help overcome a major barrier to integrating health and social care.

The CAG, which oversees requests to access identifiable patient information without consent, was due to consider the application last week, according to NHS England’s national director of commissioning strategy Ian Dodge.

While the application was submitted by Southend CCG, the issue was identified during discussions with the other 13 “integration pioneers”. These were appointed by government to identify and overcome obstacles to joining up health and social care services.

The application was revealed by Mr Dodge last month at a conference run by the think tank Reform.

Ian Dodge

Accessing patient identifiable data is one of the biggest barriers for CCGs, Ian Dodge said

“There is a problem for CCGs in getting hold of the [patient identifiable] data that they need. It’s one of the biggest barriers they are experiencing,” he said.

“One of the pioneers is doing a piece of work on behalf of all of them to try and sort this out by way of an application to the CAG,” he added.

“If there is a successful outcome, then we hope it can be rolled out across the other pioneers.”

Any decisions made by the CAG are put forward as recommendations to health secretary Jeremy Hunt with whom the final decision rests.

He has the right to set aside the common law duty of confidentiality “for defined medical purposes” under section 251 of the NHS Act 2006.    

Southend CCG told HSJ it was not able to discuss the contents of the application until after it had been considered by the committee.

Access to identifiable patient data has been an issue for CCGs since their conception.

While primary care trusts had blanket access to identifiable patient information under a section 251 decision, this power was not transferred to CCGs when they were created under the Health and Social Care Act 2012.

The news comes as Monitor published plans to introduce “single patient level cost collection” that is based on “patient level information and costing systems”.

The paper, Reforming the payment system for NHS services: supporting the Five Year Forward View, said: “This collection would identify separately the costs of patient care at the patient level, education and training, and research and development and commercial activities.”

The paper proposes introducing the single cost collection in acute and ambulance trusts in 2018-19, followed by mental health trusts in 2019-20, and community service providers by 2020-21.

While the new “patient level” cost data will be introduced gradually, Monitor will have to be in a position to generate reference costs for individual trusts at this level before the transition can begin.