Patient confidentiality in a time of care.data

The NHS is in the midst of an information revolution. Powers introduced by the Health and Social Care Act will enable the Health and Social Care Information Centre to extract large amounts of personal confidential data from GP medical records. These powers override the common law duty of confidentiality and the ordinary requirement to seek consent for disclosure, although patients have a right to object to their data being disclosed.

Any large scale use of sensitive personal data inevitably raises ethical concerns, and, unsurprisingly, the new powers have sparked controversy. Public confidence in large publicly held databases, and in the politicians who commission and control them, is scant. Trust between doctors and patients and consequently in the wider health service is predicated on the belief that, in all but exceptional circumstances, confidentiality will be respected. But the potential benefits arising from the proper use of medical data are too important to be ignored without exceptional reason. We therefore must be clear about what the changes involve and what the benefits might be.

The first use of the new powers is the care.data initiative, commissioned by NHS England. …