Summary of Amendment to the Cost Recovery Collection, Processing and Dissemination of overseas visitor and UK Patient-Level Data Directions 2021 issued to NHS England by the Secretary of State on 9 June 2023

Agenda item: 10.3 (Public session)
Report by: Jackie Gray, Director of Privacy, Transparency and Ethics
Paper type: For information
27 July 2023

Organisation objective

  • Statutory item
  • Governance

Executive summary

This paper is for the Board’s information only to provide an overview of the Amendment to the Cost Recovery Collection, Processing and Dissemination of overseas visitor and UK Patient-Level Data Directions 2021 issued to NHS England (NHSE) in June 2023 by the Secretary of State for Health and Social Care (SoS). The Directions (Amendment Directions) amend the Cost Recovery Collection, Processing and Dissemination of overseas visitor and UK Patient-Level Data Directions 2021 (Original Directions) issued under section 254 of the Health and Social Care Act 2012 (2012 Act), section 13ZC and 272(7) and (8) of the National Health Service Act 2006 (the 2006 Act) and regulation 32 of the National Institute for Health and Care Excellence (Constitution and Functions) and NHS England (Information Functions) Regulations 2013.

The purpose of the Amendment Directions (Purpose) is to amend the Original Directions to enable NHS England to process data it receives from the Home Office for the purposes of remedying and reporting on known errors with data provided by the Home Office, and aiding relevant bodies in exercising their functions and complying with their obligations under the National Health Service (Charges to Overseas Visitors) Regulations 2015 (as amended) (Charging Regulations).

Action required

The Board is asked to note these Amendment Directions and the information provided in this Paper regarding their purpose, effect, and requirements.

Background

1. Under section 254 of the 2012 Act, the SoS may direct NHSE to establish and operate a system for the collection or analysis of information. These are functions exercisable in relation to the development or operation of information systems in connection with the provision of health services or of adult social care in England. Under section 13ZC of the 2006 Act, the SoS may give NHSE directions as to the exercise of any of its functions. The Amendment Directions are issued by the SoS to NHSE under these provisions and involve the discharge of functions which have been transferred to NHSE from NHSD under the Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.

Purpose of the Direction

2. The purpose of the Amendment Directions is to amend the Original Directions which established the Cost Recovery Collection, Processing and Dissemination of overseas visitor and UK Patient-Level Data Information System (Cost Recovery System). The Cost Recovery System supports the Government in ensuring that the NHS remains free at the point of use, for those that are entitled to use it, and supports any relevant body to comply with their obligations under to comply with their obligations under the Charging Regulations, to make and recover charges for any relevant services it provides to an overseas visitors.

3. The Amendment Directions will enable the Home Office to share data with NHSE on known errors in data it has previously shared for the purposes of operating the Cost Recovery System and to permit NHSE to process that data, including linking it with Hospital Episode Statistics (HES) and Personal Demographic Services (PDS) data and any other datasets as necessary or expedient for the purposes of:

  • Investigating and correcting errors;
  • Reporting and informing on errors;
  • Updating relevant systems to resolve errors;
  • Aiding relevant bodies in exercising their functions and complying with their obligations under the Charging Regulations.

4. The Home Office shares data with NHSE for the purpose of operating the Cost Recovery System under a Memorandum of Understanding which has been updated to reflect this additional data to be shared with NHSE and purposes of processing by NHSE set out in the Amendment Directions.

5. NHSE is required to disseminate the information collected pursuant to the Amendment Directions to relevant bodies for the purpose of enabling them to exercise their functions where directed to do so by the Secretary of State.

Effect and Requirements of the Direction

6. From the date of signature of the Amendment Directions, NHSE has a legal duty to comply with the Original Directions as amended by the Amendment Directions (the Amended Directions).

7. These functions are to be exercised in accordance with the service levels, support and monitoring requirements, and the reporting and governance requirements notified by the SoS in writing to NHSE. The exercise by NHSE of the functions set out in the Amended Directions is also subject to the statutory guidance issued by the SoS to NHSE under section 274A of the 2012 Act: NHS England’s protection of patient data, 23 May 2023 which is guidance that NHSE has a duty to have regard to when discharing its functions under the Amended Directions.

Approval of acceptance of Directions and publication

8. The National Director of Transformation and National Medical Director approved acceptance of the Amendment Directions on behalf of the Accounting Officer as set out in the NHSE Scheme of Delegation.  The Amendment Directions amendment letter has been published on the NHSE website alongside the Original Directions

Annex 1

Amendment to the Cost Recovery Collection, Processing and Dissemination of overseas visitor and UK Patient-Level Data Directions 2021 (as amended)