The term 'information governance' could be changed to 'clinical governance' as part of encouraging a cultural shift in the NHS towards more information sharing, Dame Fiona Caldicott has said.
Dame Fiona is leading an independent review of information governance in the health service. Her report is due to go to the health secretary early next year.
She told the audience at EHI Live 2012 that one of the review committee’s recommendations will be that the language used to describe IG needs to be simplified and clarified.
“The expression ‘information governance’ doesn’t immediately fill people with a look of enthusiasm and excitement,” she explained.
She suggested the terminology be changed to ‘clinical governance’ in order to encourage greater understanding and commitment to the need to protect patient privacy and confidentiality while ensuring that clinicians have the necessary information to treat their patients.
“We will recommend some ways in which the language could be clarified,” she said.
She said it has become clear from her public consultation that in the NHS there is an “erring on the side of not sharing” that is not acting in the patients’ interest.
She added that there is support from the population for sharing of identifiable information when it comes to their individual care, but not necessarily for commissioning or research purposes.
Dame Fiona said issues around sharing data are “most pressing” at the interface between health and social care at a time when more patients are receiving care crossing organisational boundaries.
“Anyone thinking of integrating patient pathways can immediately see there are some issues that are going to cause quite a lot of potential tension that need a solution,” she explained.
“One of the areas I’m particularly concerned about is education and training. It’s clear to us that there isn’t the confidence we would like to see in clinicians and professionals about the rules that relate to the use of information, particularly identifiable information.”
“There’s a lot of work to be done in making sure staff who have responsibility in IG are aware of what their responsibilities are and how to get assistance if they are not sure of the answer to questions,” she added.
Dame Fiona said there is “a lot of hiding behind the Data Protection Act and IG rules.”
Much of that fear has developed from confusion around the idea of “need to know” and the large fines being handed down by the Information Commissioners Office for mishandling of patient data.
Dame Fiona said that although her committee is supportive of sanctions, the situation is made complex by the fact that money paid in fines by NHS trusts is then not available for patient care.
She explained that her review will address the necessary change in culture to address the increasing use of technology and the ability to “move data around the system.”
It will also look to clarify when explicit patient consent is required before data is shared.
“There’s a lot of work being done with commissioners about when they need patient identifiable data and how they can have a legal basis for that and when anonymised data can serve the purpose,” she said.
© 2012 EHealth Media.
Wrong on 2 countssaywell 123 weeks ago
Firstly, as previously stated, 'Clinical Governance' already means something else.
Secondly, although 'Caldicott' deals only with patient data, from an organisation's perspective there is a lot of other information that needs governing - so 'Information Governance' is needed as a generic, catch-all term for any data that the ICO would expect us to keep secure.
Clinical GovernanceM Riches 124 weeks ago
Using the word 'clinical' in this context runs the risk of making colleagues in social care feel excluded and that this is all about the NHS and has nothing to do with them or their practice. These are the very people at the interface between health and social care that Dame Fiona is seeking to address.
Clinical Governance - already taken isn't it?stan 10 124 weeks ago
I wasn't present for this but isn't the term "Clinical Governance" already taken? For example on Wikipedia at en.wikipedia.org/wiki/Clinical_governance it defines it as "A framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish". So can see IG being included in Clinical Governance but not actually being it entirely.
Agree with concept strongly but also not sure about the namejwaktare 124 weeks ago
I agree strongly with Dame Fiona Caldicott's concern - Information is too often confused with information security, and information security is used as a mindless excuse for what is actually very poor information governance. However as Stan 10 points out, Clinical Governance already exists, certainly in our hospital and IG is a part of CG.
We need the change in attitude delivered and in change managment, a name change can be a helpful tipping point as a tool to deliver that. My concern is that I don't think that my organisation's IG awareness is strong enough for our Clinical Governce structures to deliver good IG. Our IG committee understands the scope of IG well and are better custodians of "true" IG.
Not generally my approach to pose problems rather than solutions, in in setting I can't see an easy answer...
I agreeGeepsi 124 weeks ago
IG is already within the definition of Clinical Governance and I feel that the name change suggested would actually worsen the situation because many already forget that IG is integral to CG. (e.g. failing to communicate changes in treatment puts the patient at risk in just the same way as failing to change the treatment in the first place)
Perhaps a compromise would achieve more. Calling it Clinical Information Governance could reinforce the importance of IG in clinical care without burying it in the much larger concept of Clinical Governance