CDS, CMDS and HES

IMPORTANT SECURITY ISSUES AND OTHER NOTES

    A. Removal of name and address where the NHS Number is present
  1. From 1 April 1999, PATIENT NAME and PATIENT USUAL ADDRESS (not POSTCODE OF USUAL ADDRESS) must be removed from all commissioning data sets where a valid NHS NUMBER is present. This applies to all nationally defined Commissioning Data Sets Types (CDS) and any additional locally agreed flows from service providers to commissioning bodies.

  2. A valid NHS NUMBER is one that has passed the check digit calculation on entry into the source system. If an NHS NUMBER is not valid (i.e. does not conform with the check digit algorithm) then PATIENT NAMES and PATIENT USUAL ADDRESS should not be removed, as the reliability of the NHS NUMBER will not be known.

  3. The NHS NUMBER STATUS INDICATOR is a mandatory part of the CDS. PATIENT NAMES and PATIENT USUAL ADDRESS should be removed when a valid NHS NUMBER is present, even if the NHS Number Status Indicator does not have a status of 01, Number present and verified.

  4. B. Marital Status
  5. Following the recommendations of the Data Protection Registrar, Providers should not record MARITAL STATUS in any CDS Type, except in respect of the psychiatric specialities in the Admitted Patient Care CDS Types, where it will continue to be recorded.

  6. C. Sensitive data
  7. The Human Fertilisation and Embryology Act 1990 as amended by the Human Fertilisation and Embryology (Disclosure of Information) Act 1992 imposes statutory restrictions on the disclosure of information about identifiable individuals in connection with certain infertility treatments. A list of the relevant codes is given in Table 1. In these cases the NHS NUMBER, LOCAL PATIENT IDENTIFIER, PATIENT NAMES, POSTCODE OF USUAL ADDRESS and BIRTH DATE should be omitted from the CDS Types.

  8. Other statutory restrictions on the disclosure of patient information do not prohibit the disclosure to individuals involved with the treatment and prevention of certain specific diseases (HIV/AIDS and venereal diseases) in the population.

  9. TABLE 1: TREATMENTS PROVIDED UNDER THE LICENCE OF THE HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY

    Description OPCS-4 ICD-10
    Standard In Vitro Fertilisation (IVF) Q13.-1 Introduction of gamete into uterine cavity, or
    Q38.3 Endoscopic intrafallopian transfer of gamete
    Z31.2 In vitro fertilization
    IVF with donor sperm Q13.- 1 Introduction of gamete into uterine cavity, or
    Q38.3 Endoscopic intrafallopian transfer of gamete
    Z31.2 In vitro fertilization
    IVF with donor eggs Q13.-1 Introduction of gamete into uterine cavity, or
    Q38.3 Endoscopic intrafallopian transfer of gamete
    Z31.2 In vitro fertilization
    Donor insemination (DI) Q13.3 Intrauterine artificial insemination, or
    Q13.2 Intracervical artificial insemination
    Z31.1 Artificial insemination
    Gamete intrafallopian transfer (GIFT) with donor sperm Q38.3 Endoscopic intrafallopian transfer of gamete Z31.3 Other assisted fertilization methods
    Gamete intrafallopian transfer (GIFT) with donor eggs Q38.3 Endoscopic intrafallopian transfer of gamete Z31.3 Other assisted fertilization methods
    Intracytoplasmic sperm injection (ICSI)    
    Sub-zonal insemination (SUZI)    
    Zygote intrafallopian transfer (ZIFT) Q38.3 Endoscopic intrafallopian transfer of gamete Z31.2 In vitro fertilization
    Partial Zona Dissection (PZD)    
    Zona drilling    
    Hamster- egg penetration test    
    Assisted hatching    
    Pre-implantation Genetic Diagnosis (PGD)    
    Storage of sperm    
    Storage of embryos    
    Use and storage of testicular tissue    
    Transport/satellite IVF/ICSI    
    Embryo donation   Z31.8 Other procreative management
    Research    

    1.- means all fourth characters of this rubric should be included.

  10. All records containing patient identifiable information, other than those covered by the Human Fertilisation & Embryology Acts, as outlined in the Table above, should be treated as sensitive. Organisations may continue to exchange records containing NHS NUMBER, POSTCODE OF USUAL ADDRESS and BIRTH DATE in these cases, but receiving organisations must ensure that only those staff with legitimate need have access to this information, e.g. public health departments, and strictly on a need to know basis. No-one should have unrestricted access unless fully justified in accordance with the principles of the Caldicott Committee Report.

  11. Where patient level data is required for other purposes within an organisation, it should be anonymised/aggregated prior to disclosure by someone with legitimate access. If this is not practicable, local protocols defining which CDS Types are particularly sensitive (including, but not necessarily restricted to HIV/AIDS and venereal disease) agreed by the organisation Caldicott Guardian, should be put in place and identifiers stripped from these records.

  12. Your Caldicott Guardian will be able to advise you further on all issues relating to patient confidentiality.

  13. Where appropriate, further information about confidentiality is contained within the notes for individual data items.