department of health and social care · department of health and social care ... quest under the...

Department of Health and Social Care

Rheynn Slaynt as Kiarail y Theay

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Chief Executive: Malcolm Couch

By email:

Freedom of Information Team Department of Health & Social Care

Chief Executive’s Office Crookall House Demesne Road

Douglas Isle of Man, IM1 3QA

Tel: Email:

Website:

Date: FOI Reference:

(01624) 642621 [email protected]

www.gov.im/dhsc

01 September 2017 IM97-965i

Dear

REQUEST UNDER THE FREEDOM OF INFORMATION ACT 2015 (“the Act”)

Thank you for your request to the Department of Health and Social Care, dated 03 August 2017

Your request

You asked for:

Question 01: “How many records (in whatever format) are currently held by your department that are beyond their retention schedule date?”

Question 02: “Re: Mediviewer at Nobles Hospital, you state in a previous FOI response that no paper medical records will be destroyed until MediViewer is compliant with BS10008 - provide any audit reports of MediViewer in reference to BS10008.”

Question 03: “Provide all project management reports regarding MediViewer (digital health records, new project) from start of the project to current date.”

Question 04: “Provide a full budget report to date of the cost of implementation of MediViewer. I want this in excel format, broken down into different categories of what these public funds have been spent on i.e. training, installation, staff costs/wages, etc, further broken down by expenditure per month.”

Question 05: “Provide all MediViewer staff training manuals.”

Question 06: “Provide the procedure if a patient wishes to opt out of their health record to be stored on MediViewer.”

Question 07: “Which wards / departments of nobles have now transitioned across to MediViewer”

Question 08: “Prove the total number of staff who have complete MediViewer training to current date.”

mailto:[email protected]

http://www.gov.im/dhsc

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Revised response to your request

Upon review of the disclosure made 31 Aug 2017, it became apparent that the original response to Question 01 was incorrect; this was due to a misunderstanding by the Freedom of Information Team of the response provided by the Mental Health Directorate. This was of no fault of the Mental Health Directorate.

The Department fully adheres to the principles of Freedom of Information, public accountability, openness and transparency, therefore the actual response for the Mental Health Directorate is now disclosed for your kind reference*

On behalf of the Department of Health and Social Care, please accept our sincere apologies for not providing you with this information as part of our original response and for any inconvenience caused.

Response to your request

We are pleased to be able to provide a response to your request with answers to some of your questions; while our aim is to provide information whenever possible, in this instance we are unable to provide some of the information you have requested. The reasons and statutory exemption sections and reasons are shown as part of the corresponding answers below.

Question 01: How many records (in whatever format) are currently held by your department that are beyond their retention schedule date

In response to Question 01 the Service Areas were requested to provide a snapshot of records held outside their retention period on the date this request was received. In addition they were also asked to detail any destruction regimes, relevant projects and implementation plans in order to provide you with as much information and help as possible:

• Adult Services Care Homes There is a difference in the number of records held and therefore the retention periods reached across the Adult Services Care Homes. Of those able to ascertain the information requested:

o Adult Social Care Home Care Team hold 80 service user records due to be destroyed this month in line with their destruction schedule

o Cummal Mooar holds no records outside their retention period o Southlands hold no records outside their retention period

• Children and Families Social Care

Children and Families commenced a project in February 2017 to identify and destroy historic files past their retention schedule. To date 28,680 files have been identified as beyond their retention date, 23,568 were destroyed on 25 August 2017 as part of planned work under that project. The remainder need a final check before they can be approved for destruction. To be clear these are electronic ‘files’ containing only basic demographic information on the client and reason for referral that were brought forward from a legacy computer system. A further 3,377 historic children’s files have been identified where the retention date was unclear - these are being meticulously gone through to identify what the correct retention period is. 1,160 have been assessed to date and of those 512 have been marked for destruction. 559 current children’s files have reached their retention period in this calendar year and will be purged with our next batch by the end of this year.

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• Family Practitioners Service

Due to the volume of records held by Family Practitioners it is most cost and time effective to destroy records in batches at scheduled intervals throughout the year. As a snapshot this Service currently has the following records outside their retention period that are due to be destroyed at their next scheduled destruction date:

o 37 boxes of GP records o 60 boxes of Service forms and contact sheets and accounts relating to

their various operations

• *Mental Health Directorate - revised MHS introduced a new Retention Policy in January 2017 with a 2 ½ year implementation plan to meet requirements. Therefore we are unable to identify at the present time if there any records which are held outside of their retention period.

• Noble’s Hospital Medical Records Due to the volume of records held by Noble’s Hospital Medical Records destroy records in batches at scheduled intervals throughout the year. As a snapshot this Service Area currently has the following records outside their retention period that are due to be destroyed at their next scheduled destruction date:

o Approximately 689 General Health records of deceased patients o Approximately 460 General Health records o Approximately 5,800 Maternity records o Approximately 3,500 Emergency Department cards

• Occupational Health

Occupational Health are holding no records past their retention period. The nature of their work, including the investigation of workplace exposures, requires the majority of their records to be kept for a minimum of 40 years. The Service has not yet been in operation for that length of time and so the majority of their records have not yet reached their retention period

• Public Health Directorate The Public Health Directorate have one file held past their retention period that will be destroyed at their next scheduled destruction date

While our aim is to provide information whenever possible, in this instance those Service Areas listed above do not hold or cannot, after taking reasonable steps to do so, find the information that you have requested (section 11(3)(a) of the Act).

Question 02: Re: Mediviewer at Nobles Hospital, you state in a previous FOI response that no paper medical records will be destroyed until MediViewer is compliant with BS10008 - provide any audit reports of MediViewer in reference to BS10008

In response to Question 02, please find the latest audit report and certificate of compliance in Appendix 01.

Question 03: Provide all project management reports regarding MediViewer (digital health records, new project) from start of the project to current date

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In response to Question 03, please find the Digital Health Record (DHR) Project Status Summaries in Appendix 02. Those “missing” Summaries indicate dates when Project Board meetings were not held; this either due to holidays or other meetings that effecting the attendance of the Project Board.

Question 04: Provide a full budget report to date of the cost of implementation of MediViewer. I want this in excel format, broken down into different categories of what these public funds have been spent on i.e. training, installation, staff costs/wages, etc., further broken down by expenditure per month

While our aim is to provide information wherever possible, in this instance the information requested in Question 04 is exempt under section 30(2)(b) of the Act as it constitutes as its disclosure would prejudice the commercial interest of IMMJ Systems (the supplier of the MediViewer system).

As section 30(2)(b) is a qualified exemption, it is subject to a public interest test. The public interest must be something that is of serious concern and benefit to the public at large.

Factors in favour of disclosing the information include:

• Disclosure would show where public money is being spent, how much public money is being spent and how IMMJ Systems arrived at the process

• Disclosure would hold the Department to account for their stewardship of public resources

• Disclosure would ensure that commercial activities, including the procurement process, are conducted in an open and honest way

• Disclosure would mean competing business could respond better to future public sector opportunities.

Factors in favour of maintaining the exemption include:

• Disclosure of the information would affect a company’s ability to participate competitively in a commercial activity (directly or indirectly)?

• Disclosure of would be revealing commercially sensitive information. • Prejudice would be likely to occur as having a detrimental impact on commercial

revenue or the ability to obtain supplies or secure finance. Prejudice would also be likely to occur has weakening their position in a competitive environment by revealing market sensitive information or information of potential usefulness to competitors.

In assessing the weight to be attributed to each of the factors in favour of disclosing the information and maintaining the exemption, the Department has taken the following into consideration

• The severity of the impact of the prejudice has been considered and it has been determined that disclosure would have a substantial impact upon the commercial interests of the company, the Department and the relationship between them

• The age of the information has been considered and as this is a current and ongoing arrangement, it would not be appropriate to disclose the information

• How far disclosure would further the public interests identified above has been considered and it has been identified that there would be little if not no public interest in the breakdown of this information. With this, the availability of any similar information in the public domain has been considered and the requester is

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directed to: https://www.gov.im/media/1357071/cost-of-digital-health-record-scanning-and-cost-of-misl-use.pdf, where the total amount of for this project has been published in a previous Freedom of Information response (reference IM87-863i), although is not broken down as requested

• There likelihood of disclosure correcting any misinformation has been considered and it is unlikely that disclosure of a breakdown of this information, in addition to the link provided above would rectify any misinformation

• As the information requested has been received from confidential sources there is a strong likelihood that the relationship between the Department and IMMJ Systems would be damaged by disclosure and reduce the likelihood of information or services being made available in the future

• There is a need to protect the commercial interests of the private sector, which plays an important role in the general health of the economy.

• There must be consideration of matters such as the maintenance of intellectual property and the need to protect the flow of commercial secrets to public authorities

In taking all of these factors into account the Department determines that the factors in favour of maintaining the exemption outweigh the factors in favour of disclosing the information.

Question 05: Provide all MediViewer staff training manuals

In response to Question 05, While our aim is to provide information wherever possible, in this instance the information is exempt from disclosure under section 30(2)(a) of the Act as it constitutes a trade secret.

As section 30(2)(a) is a qualified exemption, it is subject to a public interest test. The public interest must be something that is of serious concern and benefit to the public at large.

Factors in favour of disclosing the information include:

It would inform the public of the training activities being undertaken and provide reassurance

It would enable the public to better scrutinise the public monies spent and the resources dedicated to training

Factors in favour of maintaining the exemption include:

There is a strong public interest in protecting the information because of the level of investment involved

There is a strong public interest in maintaining the exemption due to the extent to which disclosure would undermine IMMJ Systems competitive advantage as well as their ability to generate income; therefore the information is of commercial value.

There is a public interest in maintaining the exemption in order to protect the training techniques of IMMJ Systems as well as protecting the technical knowledge of how their system works which would be harmful in the hands of a competitor

How far disclosure would further the public interests identified above has been considered and it has been identified that there would be no current public interest in having access to these training documents, rather there is a public interest in knowing training has and will continue to take place to provide the services related to MediViewer

https://www.gov.im/media/1357071/cost-of-digital-health-record-scanning-and-cost-of-misl-use.pdf

https://www.gov.im/media/1357071/cost-of-digital-health-record-scanning-and-cost-of-misl-use.pdf

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The specific information requested constitutes a trade secret and intellectual property in line with the contact in place with IMMJ Systems and the Department

In assessing the weight to be attributed to each of the factors in favour of disclosing the information and maintaining the exemption, the Department has taken the following into consideration

As the information in question is current and in use by not just Noble’s but other organisations that use Mediviewer disclosure would prejudice the working practices of IMMJ Systems and potentially their other customers

In taking all of these factors into account the Department determines that the factors in favour of maintaining the exemption outweigh the factors in favour of disclosing the information.

Question 06: Provide the procedure if a patient wishes to opt out of their health record to be stored on MediViewer

In response to Question 06, The Department has a legal obligation to keep medical records, they are essential for the continuity of care, as well as ensuring they are sufficiently comprehensive for legal use (if having to defend a claim). When a patient accesses our services and provides information, they are consenting to the Department to record/retain the information not specific to form of media. Specific pieces of the health record are currently electronic, for example, blood results, x-rays, referrals, Audiology, Dietetics notes and Emergency Dept records. Therefore, the digitalisation of the health record is not an opt-in, opt-out process.

Question 07: Which wards / departments of nobles have now transitioned across to MediViewer?

Please find the Department’s response to Question 07 listed in out-patient specialities below:

Breast Surgery Colorectal Surgery Colposcopy ENT Fertility General Surgery Gestational Diabetes Gynaecology Maternity Ophthalmology Oral Surgery

Orthodontics Orthotics Orthoptist Paediatric T&O Paediatrics Pain Management Plastic Surgery Trauma and Orthopaedics Urogynae Urology

While this list indicates those out-patient specialities that now use MediViewer, all out-patient and in-patient areas are able to use MediViewer; this means if any patients under the out-patient specialities above were to become in-patients, their in-patient area would be able to use Mediviewer.

Question 08: Prove the total number of staff who have complete MediViewer training to current date

Please find the Department’s response to Question 08 in Appendix 04.

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Your right to request a review

If you are unhappy with this response to your Freedom of Information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post to the FOI Co-ordinator, Department of Health & Social Care, Chief Executive’s Officer, Crookall House, Demesne Road, Douglas, Isle of Man, IM1 3QA. An electronic version and paper version of our complaint form can be found by going to our website www.gov.im/about-the-government/freedom-of-information/how-to-make-a-freedom-of-information-request/ . Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on:

01. Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act; or

02. Whether we are justified in refusing to give you the information requested.

In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision.

Further information about Freedom of Information requests can be found on the Information Commissioner’s website at: www.inforights.im/information-centre/freedom-of-information. Should you have any queries concerning this letter, please do not hesitate to contact us.

Yours Sincerely

Freedom of Information Team Department of Health and Social Care

http://www.gov.im/about-the-government/freedom-of-information/how-to-make-a-freedom-of-information-request/

http://www.gov.im/about-the-government/freedom-of-information/how-to-make-a-freedom-of-information-request/

http://www.inforights.im/information-centre/freedom-of-information

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Appendix 01: BS10008 Compliance Report and Certificate of Compliance

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Back to Question 02


Appendix 02: Digital Health Record (DHR) Project Status Summaries


Back to Question 03

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Appendix 04: Training Report week ending 4th August 2017 Over the week a total of 23 staff have been trained on MediViewer. We have now been advised of 994 staff whom need training. Of the 994, 737 people have already been booked in to attend training with all 714 people having been trained so far – see table below for breakdown of staff across the various services.

This breaks down as follows:

Area Total no of staff to train

Total no of staff booked onto training

Total no of staff trained w/s 31/07/17

Total no. of staff trained

Admin 1 1 0 1

Anaesthetists 9 9 0 9

Breast Unit 2 2 0 2

Cancer Multidisciplinary Team 4 3 0 3

Cancer Services 4 4 0 4

Cardio Respiratory 11 10 0 10

Community Nurses 1 1 0 1

Consultants / Doctors 45 45 0 45

Core Medical Trainees 4 4 4 4

Day Assessment Treatment Unit 14 14 0 14

Dental Nurses 3 3 0 3

Dietetics 11 10 0 10

Ear Nose and Throat 1 1 0 1

Emergency Department 31 30 0 30

Endoscopy 3 3 0 3

Foundation 1 Doctors 21 21 0 21

Foundation 2 Doctors 11 8 0 8

GPs with Special Interest 1 1 0 1

Intensive Care Unit 18 18 0 18

Locum Consultants 7 7 2 7

Medical Coding 6 5 0 5

Medical Records 1 1 0 1

Medical Secretaries 60 59 0 59

MHS 62 17 0 17

Middle Grade Doctors 3 3 0 3

Obstetrics and Gynaecology Medical Consultants 7 7 0 7

Obstetrics and Gynaecology Medical Secretaries 3 3 0 3

Occupational Therapy 6 4 0 4

Oral Surgery Out Patients Department 7 7 0 7

Out-patient Department 32 31 0 31

PAC 1 1 0 1

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Paediatric Outpatients 7 3 0 3

Paediatricians 9 2 0 2

Pathology 16 14 0 14

Patient Safety and Governance 6 4 0 4

Pharmacists 6 6 5 6

Physiotherapy 53 26 0 26

Podiatrists 5 5 4 5

Private Patients 19 19 0 19

Radiology 10 7 0 7

Ramsey and District Cottage Hospital 49 47 0 47

Ramsey GPs 8 8 0 8

Renal Unit 2 2 0 2

Senior Nurses 1 1 0 1

Social Workers 6 6 0 6

Specialty Doctors 5 5 0 5

Specialty Nurses 11 8 0 8

Speech and Language Therapists 7 4 0 4

Theatres 67 34 0 34

Ward 1 32 18 0 18

Ward 10 58 20 0 20

Ward 11/12 44 24 0 24

Ward 14 DPS 29 16 0 16

Ward 16 Special Care Baby Unit 16 9 2 9

Ward 18 Coronary Care Unit 4 4 1 4

Ward 2 26 15 0 15

Ward 20 Oncology 7 4 0 4

Ward 3 24 16 1 16

Ward 4 17 17 0 17

Ward 5 33 33 0 33

Ward 6 7 7 0 7

Ward 7 6 6 1 6

Ward 8 4 4 3 4

Ward 9 2 2 0 2

Other 8 8 0 8

Total 994 737 23 737

Back to Question 08

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