PHE warns of 'serious risk' over Home Office data sharing

In correspondence released by the Commons health committee, both organisations said the data sharing between NHS Digital and the Home Office was not transparent, and could erode patient trust in the NHS and deter people from using health services.

HSJ reported in January that NHS Digital – which calls itself a patient data “safe haven” - and the Department of Health had agreed a memorandum of understanding to hand over confidential patient information to the Home Office.

The document allows the Home Office to make a “tracing request” for confidential patient information for suspected illegal immigrants.

In response to a request, NHS Digital will disclose information including a person’s name and last known address, their date of birth, primary care service area code and contact details, as well as the date of registration with the NHS.

Letters published on the health committee’s website today reveal that, in March, PHE – the government’s national public health body – warned the arrangement was “concerning from a public health and personal healthcare perspective”.

There was evidence migrants who feared deportation were less likely to access healthcare, PHE said.

“Anything which exacerbates existing mistrust among some migrants of health services and professional would compound other well documented barriers to access.”

This in turn could weaken population health as whole, particularly in detecting and preventing communicable diseases, presenting a “serious risk to public health”, it said.

Meanwhile in a letter to health committee on 18 April, national data guardian Dame Fiona Caldicott said she was disappointed not to have been consulted earlier, and had several outstanding concerning the data sharing.

“I believe that trust would have been better maintained had there been more public debate about where the balance should be struck between the public interest in maintaining an effective immigration service.”

Dame Fiona said the approach NHS Digital had taken in testing the “public interest” of sharing the data differed from standard in the NHS Code of Practice and General Medical Council guidelines, and lacked clinical input.

She was also concerned about a lack of transparency, particularly around governance.

“Notwithstanding these suggestions, my panel members and I continue to have reservations about data which has been collected by the NHS, and is owed a duty of confidence, being used for the purposes of immigration control.”

The DH, NHS Digital and health minister Nicola Blackwood have made submissions to the committee defending the sharing.

NHS Digital chair Noel Gordon said the MoU only formalised and streamlined a weaker existing arrangement with the Home Office, and provided more transparency.

A recent review of “tracer requests” to NHS Digital from other government agencies, including the Home Office, found there was “sound legal basis to release to the Home Office non-clinical information subject to consideration of public interests and after ensuring agreed safeguards are met”.

In a letter to the committee in March, Ms Blackwood said patient data was only request when other avenue had been exhausted and with “strong safeguards in place”.

“The MoU makes clear that NHSD retains the right to seek more information from HO should it need to and without limitation. NHSD may refuse a request for information from the HO ifit is not satisfied that the request is in the public interest.”

An internal NHS Digital review has been carried out into the MoU arrangement. HSJ understands this has now been completed but won’t be published until after the general election.