NHS #1: What’s happening in England? The new legislation

You’ve probably gathered that a lot of reorganisation is going on within the NHS. The most obvious changes and difficulties have been well-reported, but others are passing pretty much unremarked. In particular changes to the way that patient information in England is collected, passed around and processed fundamentally alter the concept of doctor-patient confidentiality. That isn’t hyperbole.

It’s been quite difficult to write the blogs that follow because it’s so interwoven. Please read all of the blog posts in sequence and bear with us if the story loops back on itself or if we haven’t explained something clearly enough.

For the time being we have switched comments off. When we’ve finished our outline of the current state of play, we will put them back on so that you can leave your views, ask questions and tell us if you think we’ve got something wrong – for which we apologise in advance. The situation is changing all the time and all we can do is set out our current understanding of it. Once we have set out the basic framework, we will discuss some of the elements in greater detail and with a wider range of links.

And now to get down to business. The first step is to look at the legislative framework that allows your medical records to be used in surprising new ways.

The Health and Social Care Act 2012, which came into force on April 1st 2013, made some fundamental changes to the structure of the NHS. The ones that are of particular interest here are:

1)    The creation of the ‘NHS Commissioning Board’

2)    The creation of ‘Clinical Commissioning Groups’

3)    New powers that change the ‘Regulation of health care and associated professions’ into the ‘Regulation of health professions, social workers, other care workers etc’ – in other words, the creation of a new over-arching Health and Social Care Service

4)    And finally, the whole of Part 9 of the Act.  This creates another new body: ‘The Health and Social Care Information Centre’. It also sets out various powers and duties relating to the establishment of information systems (e.g. databases) and the central collection and dissemination of health and social care information about every individual in England.

Tomorrow we’ll explain how this new structure actually works.