Lords to examine NHS identity bill

A bill proposing to mandate the use of a common patient identifier across the health and social care system will be discussed in the House of Lords tomorrow.

The Health and Social Care (Safety and Quality) Bill, sponsored by Conservative MP Jeremy Lefroy and former Royal College of Surgeons president Lord Ribeiro, includes several proposed amendments to the Health and Social Care Act 2012 to improve the safety and quality of care offered by NHS and social care services.

Provisions include a duty for the health secretary to specify a “consistent identifier” that can track an individual across all health and social care services, including hospitals, GP surgeries and care homes.

Lefroy told EHI News that this identifier would likely be the current NHS Number, but added that it “doesn’t have to be”, citing previous suggestions of using the National Insurance Number.

The ten-digit NHS Number was introduced in 1996 and made mandatory for all NHS trusts in 2014, despite the failure of previous attempts to mandate its adoption. Its use is only voluntary for other health and social care services.

Lefroy said the introduction of a common identifier used across all care settings would be one of the “building blocks” to join up health and social care. All organisations that used the number would be required to share information to support patient care.

“This is something we should have done years ago,” said Lefroy, adding that his constituents had expressed problems with the poor coordination between health and social care.

The identifier provisions of the bill are in line with the National Information Board’s proposal to expand the use of the NHS Number as part of its Personalised Health and Care 2020 IT framework.

The framework states: “NHS England with Department of Health and the Health and Social Care Information Centre will work with commissioners and providers across the care system, including local authorities, to agree how the NHS number can be universally adopted.”

Mark Davies, the DH’s director of health inequalities and partnership, mentioned the Lefroy bill while discussing progress on the framework at the NIB’s second board meeting.

Lefroy said the bill has nothing to do with NHS England’s plans for secondary uses of data such as the care.data programme, and is intended to stand on its own merits.

“This is not about harvesting data, we are not there to create a database – this is to ensure quality of patient care and safety.”

The bill’s first iteration was developed by life sciences minister George Freeman but adopted by Lefroy as his constituency is Stafford, the home of Mid Staffordshire NHS Foundation Trust where serious breaches in care were reported several years ago.

The bill has reached the committee stage, where it will be examined in detail with any potential amendments discussed before moving through the final stages to reach royal assent.

Its passage through the houses has been relatively smooth, although in June last year Phil Booth of healthcare privacy campaign group medConfidential described the bill as “a rather heavy-handed way to treat health and care professionals who already have a duty of care”.

Commenting on the plans for a consistent identifier, Booth said: “What is significant is that use of the NHS Number in information that is shared will make it much more readily available for uses other than patients’ direct care.

“[I]t is secondary uses – and the conflation of them – that undermines public trust. Quite clearly, mandating the use of the NHS Number is not just for patients’ direct care or the purpose of maintaining a record.”

The bill is set for a third reading in the House of Lords on 25 March.