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Caldicott appointed first 'national data guardian' for NHS

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A new health data watchdog has been announced for patients’ medical information as part of plans to improve the use of technology across the NHS.

Dame Fiona Caldicott has been appointed as the National Data Guardian, with the power to intervene if she has concerns about the way sensitive personal information is used.

Health secretary Jeremy Hunt said organisations that fail to act on her recommendations could face being fined or banned from using shared personal data.

Dame Fiona and her Independent Information Governance Oversight Panel currently provide advice to the government on healthcare information sharing, but the latest announcement strengthens her powers.

In a speech to the King’s Fund health think-tank, Mr Hunt said Dame Fiona’s role was “to be the patient’s champion when it comes to the security of personal medical information”.

“It will be her responsibility to raise concerns publicly about improper data use”

Jeremy Hunt

He said: “She has agreed that it will be her responsibility to raise concerns publicly about improper data use. And organisations that fail to act on her recommendations will face sanctions, either through the Information Commissioner’s Office (ICO) or the Care Quality Commission (CQC), including potentially both fines and the removal of the right to use shared personal data.”

The health secretary added: “I intend to put the National Data Guardian on a legal footing at the earliest opportunity, but the CQC and ICO have decided to sanction organisations that do not comply with her recommendations even before that legislation is passed so patients will benefit immediately from the security of a much tougher and more transparent regime.

Dame Fiona is already advising the government on the troubled care data project and Mr Hunt said no data will be extracted from GP practice systems in England until she is satisfied with the programme’s safeguards.

She said: “Everyone should feel confident that their healthcare information is shared safely.

Fiona CaldicottFiona Caldicott

“As the first National Data Guardian I am committed to holding the health and social care system to account and acting on behalf of patients and care users,” she added.

As part of the drive to improve data use, Mr Hunt said NHS England will ask clinical commissioning groups to collect and analyse expenditure on a per-patient basis to “pinpoint more clearly where there is the greatest potential to improve patient outcomes whilst reducing avoidable costs through more innovative use of preventative measures”.

Mr Hunt set out a range of measures aimed at slashing up to £10bn a year from the cost of running the NHS and delivering a personalised system.

From next spring patients will have online access to a summary of their GP record, with access to full medical records by 2016, he said.

By 2018, patients will be able to record their own comments on the records.

“I am committed to holding the health and social care system to account and acting on behalf of patients and care users”

Fiona Caldicott

By 2020, the details of those who consent will be shared right across the health system, cutting duplication after a study found 66% of junior clinician’s time was spent finding, accessing and updating patient notes.

Drawing inspiration from the world of online technology giants, Mr Hunt said “if we are to be truly financially sustainable we need to rethink how we spend money in a much more fundamental way”.

He said: “A more personalised service that helps people stay healthier is not just what people want: it also reduces cost. The banks have persuaded more than half of us to bank online. And in doing so cut their costs by an impressive 20%.

“By embracing the lower costs of virtual shopping, websites such as Amazon deliver products not just conveniently but more cheaply too,” he said. “Skype is not just handy – it means international calls are free. Higher quality and reduced cost at the same time.

“Likewise in healthcare, where in the US the Veterans Association estimates that a fully integrated, digital system incorporating accessible electronic health records, remote monitoring, and online consultations has benefited patients and saved three billion dollars (£1.9bn) over six years,” said Mr Hunt.

“It is of course difficult to predict exactly what the savings might be for the NHS – but to give you one example, if better care at home reduced emergency admissions by 30%, we could save £5bn by 2020,” he said.

Jeremy Hunt

Jeremy Hunt

“A one year delay in the onset of dementia would save £1.5bn. Which is money that can be reinvested in more front line staff and more preventative care, creating a win-win for patients and staff alike.

“But there is also a lose-lose we are grappling with, the fact that every pound racked up in deficits is a pound taken away from patient care, so maintaining financial balance is vital,” he added.

Other potential cost-savings promoted by Mr Hunt include cutting the £2.5m a year cost of “avoidable harm”, £551m in prescription errors, £1.5bn of procurement costs, £2.5bn spent on agency staff and £150m on drugs that are never taken.

Selling off surplus land and facilities – valued at £1.5bn in the capital alone – reducing administrative costs and recovering £500m a year from migrants and visitors for NHS care are also on his hit list.

Among the innovations to have caught his imagination is simple one-button access to advice for the elderly through their televisions which is said to have reduced emergency admissions at one Yorkshire hospital by 14%.




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