Commissioners have no right to check where the users of their local acute trust’s genito-urinary medicine service are resident for billing purposes, according to a recent arbitration.
Strategic health authority NHS London ruled that one of its primary care trusts, NHS Hounslow, was not entitled to know how many patients at West Middlesex University Hospital Trust’s GUM clinic were from the borough, because it was potentially embarrassing “patient identifiable data”.
The PCT had contested the £500,000 bill from the acute trust, saying the patients could have come from neighbouring Richmond, which the hospital also serves.
This and other issues between the PCT and the trust went to arbitration in January. The judgment was revealed under the Freedom of Information Act.
A spokes man for the PCT said: “The NHS Hounslow view was it was unable to verify the activity billed for GUM as there was insufficient patient identifiable data. Hence NHS Hounslow could not verify if the patients were Hounslow residents.”
But the arbitration panel chair for the case, Terry Hanafin, wrote that the National Information Governance Board for Health and Social Care “states that GUM patient identifiable data (including NHS number, postcode, etc) should not be shared for contracting and commissioning purposes”.
This and the nine other issues adjudicated on by the panel resulted in NHS London charging the other organisations a fee of £50,000, with West Middlesex ordered to pay £20,000 and NHS Hounslow £30,000.
The other issues looked at by the panel resulted in it finding in favour of the trust after it confirmed it did not bill for patients who were in a critical care bed but fit to be discharged.
Another issue surrounded a 37 per cent rise in consultant to consultant referrals within the trust, which the panel ruled was “clear evidence of a change in coding and counting” and found in favour of the PCT.