Primary care commissioning

Purposes for processing

NHS England is responsible for commissioning high quality primary care services for the population of England. NHS England’s commissioning policy is to move towards more place based, clinically led commissioning and is sharing or delegating commissioning of primary medical care services to Clinical Commissioning Groups (CCGs). NHS England retains responsibility for payment of GPs, Dentists and Opticians. NHS England and delegated CCGS also have responsibility for the assignment of unregistered patients to GP practices, and for the management of list transfers when practices close.

General Practice

GP Payments

NHS England is responsible for paying GP Practices for their services. GP practices are paid on the basis of the number of patients on their list. This is obtained from the registered patient list held by NHS Digital on behalf of NHS England. In addition to this GPs are paid for their performance under the Quality and Outcomes Framework (QOF). NHS Digital collects information under directions from NHS England about General Practice (GP) achievement under QOF. This information is used to calculate GP payments for the current financial year, and to set aspiration payments for the following year. NHS Digital run other QOF reporting collections throughout the year, not related to payment. The QOF data is extracted by NHS Digital from GP Practice systems. The data extracted is in the form of numbers for the QOF indicators and does not include personal data.

Disclosures of personal data to NHS England

NHS England may require access to personal data held by GP practices in circumstances described in the Confidentiality and Disclosure of Information: GMS, PMS and APMS Code of Practice. This is established under directions from the Secretary of State for Health. These circumstances are:

  • Where NHS England is investigating and assuring the quality and provision of clinical care, for example in relation to a complaint.
  • Where it is needed in relation to the management of the contract, for example where remedial action, or termination of the contract/agreement is being considered (e.g. because of poor record keeping)
  • Where NHS England considers there is a serious risk to patient health or safety
  • Investigation of potential fraud or any other potential criminal activity

Patient assignments and list transfers

The process from managing patient assignments is described in the Primary Medical Care Policy and Guidance Manual. NHS England or a CCG will receive the names, addresses and other personal details (not health information) of unregistered patients who have requested registration at a GP Practice. NHS England or a delegated CCG will receive the personal details of patients registered at a GP practice that has closed or is due to close in order to offer alternative registration.

Unregistered patients

NHS England is responsible for the manual records of patients who are not currently registered with a GP Practice, and the deceased. These records are held by Primary Care Support England on our behalf.

GP contracts

GP contracts are held in NHS England’s local offices. The contract includes the name of the contract holder(s).

Community Pharmacy

Payment of pharmacists

Pharmacists are paid for the number of prescriptions that they dispense. Each month Pharmacies send their prescriptions to the NHS Business Services Authority (NHS BSA) for payment, who are acting for the Department of Health and Social Care. These are sent either electronically, or by courier for paper documents. Some prescriptions and other data about vaccinations and immunisations you have received may be shared with NHS England and the NHS BSA where there is a need to investigate possible prescription errors, payment errors or fraud.

Access to pharmaceutical services

Where we have concerns about access to pharmaceutical services, for example in rural areas, we can allow GPs to dispense to their patients. For this to happen, patients who would have serious difficulty in obtaining any necessary drugs or appliances from pharmacy premises by reason of distance or inadequacy of means of communication can submit an application to NHS England for them to receive GP dispensing services. This application includes the patient details, details of the serious difficulty and dispensing practice.

Pharmacy contracts

Pharmacies must be registered on the pharmaceutical list in order to practice. NHS England holds this list, and details of the contractual arrangements in relation to the Community Pharmacy Contractual Framework. This includes details of the pharmacy, superintendents, directors, and for sole traders, the pharmacist. NHS England also receives information about applicants wishing to open new pharmacies from Primary Care Support England.

Dentists

Payment of dentists

Dentists are paid by the NHS Business Services Authority (NHS BSA) acting for the Department of Health and Social Care. NHS England receives service activity figures, which do not include personal data, from NHS BSA for reconciliation and adjustment for under-payments.

Appeals

A patient may appeal to NHS England about any aspect of their dental care.  For example, if a patient is assessed that he or she doesn’t meet criteria for a NHS funded specialist service. The appeal information includes personal details and specific details of clinical condition.

Contracts

Commissioning contracts for dentists are held in NHS England’s local offices, and these may identify the individual responsible for delivery.

Opticians

Payment to opticians

Opticians send payment forms to Primary Care Support England. These include patient name, address, date of birth, whether an eye test was done, and the voucher issued. PCSE produces a statement for each optician which is sent to NHS England for payment. These statements do not contain personal data relating to patients.

Annual checklist

NHS England’s local offices employ optometry advisors checking compliance of premises to delivery optical services. Compliance reports include the name of the practice owner.

Ophthalmic Post Payment Verification Process

Primary Care Support England provide NHS England with a report including name, date of birth and address of patients who have had a test, which is sent to the NHS England local office. The purpose of this is to identify ophthalmic contractor outliers and possible inappropriate claims for payment. Some payment forms and other data about the ophthalmic services you have received may be shared with NHS England and the NHS Business Services Authority where there is a need to investigate possible errors on the forms, payment errors or fraud.

Contracts

NHS England local offices hold contracts with opticians and information about applicants from new opticians. Application documents include correspondence, references, CVs, disclosure and barring checks and financial information.

Legal basis for processing

For GDPR purposes NHS England’s lawful basis for processing is Article 6(1)(e) – ‘…exercise of official authority…’.  For special categories (health) data the basis is Article 9(2)(h) – ‘…health or social care…’.