Draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023
(1 year, 11 months ago)
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The Chair
Apologies if I croak. I will survive it, but my voice might go and I might choke. But carry on.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
I beg to move,
That the Committee has considered the draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.
It is a pleasure to serve under your chairmanship, Mrs Latham, and I hope that your throat feels better soon.
To make sure that everyone has the right version of the statutory instrument, I draw the Committee’s attention to the correction slip for the SI, which amends two points:
“Page 3, regulation 5(3)(a): omit “annual”
Page 22, regulation 63(a): “paragraph (b)” should read “paragraph (a)”.
The regulations are intended to transfer the statutory functions of the Health and Social Care Information Centre, which operates as NHS Digital, to NHS England, and to wind up NHS Digital. They do that in a relatively straightforward way, using the powers in the Health and Care Act 2022, which allow regulations to transfer the functions of certain bodies to others. Part 1 of the schedule amends primary legislation - chiefly the Health and Social Care Act 2012, which established NHS Digital and set out its statutory functions. Those key functions are transferred to NHS England, unless there is an equivalent function which NHS England already has, or a function is no longer needed, for example, the provisions relating to the board and governance, which will no longer be needed once NHS Digital is abolished.
There are also consequential and transitional provisions, replacing references to the NHS Digital, called the Information Centre, with NHS England in primary legislation, and part 2 of the schedule similarly amends secondary legislation.
The transfer is taking place in response to the recommendations of a November 2021 review entitled “Putting data, digital and tech at the heart of transforming the NHS”. That important review was commissioned by the Government in 2020 and conducted by Laura Wade-Gery, interim chair of NHS Digital and non-executive director of NHS England. The review’s goal was to ensure that the centre of the NHS is able to provide the right leadership and support to integrated care systems to use digital and data more effectively to deliver improved patient outcomes. It called for a realignment of the organisational responsibilities for digital transformation of the NHS, to deliver a new operating model. To achieve that, a specific recommendation was made to consolidate the functions of NHS Digital into NHS England, with an intent to merge legally once legislation enabled that, to help tackle the problem of digital remaining in its own silo and to ensure better alignment with service delivery.
The review’s recommendations were fully accepted by the Government in November 2021. The Secretary of State for Health and Social Care announced on publication of the review that NHS Digital’s functions would be transferred to NHS England as soon as legislation allowed. This SI is the legislation needed to make that happen.
We want to see the excellent work of NHS Digital continue, but we want that to happen within a single central organisation that takes responsibility for all elements of digital transformation and data. As things stand, the functions will transfer unchanged in effect. The transfer, will, however be a critical milestone in making sure our work on digital, data and technology is better aligned with service delivery and patient needs.
We will, of course, be transferring all staff and assets to NHS England at the same time via a separate transfer scheme. The transfer will reduce duplication, bringing the NHS’s national data and technology expertise together into one organisation.
We know that people recognise the value of their data in helping to improve the outcomes from the health service and from social care, but they also want to be reassured, quite rightly, that their personal data is safe. NHS Digital has been an extremely effective guardian of public data, and we will ensure that NHS England, in taking on NHS Digital’s functions, upholds the highest standards of data protection and transparency. The regulations transfer all of the existing safeguards for data, and add to them, by requiring NHS England to have regard to statutory guidance on how it protects people’s data and to report annually specifically on how it has exercised the functions being transferred to it by the SI. Those are new requirements compared with what NHS Digital had to do.
The guidance will recommend NHS England establishes processes and procedures for obtaining independent advice when exercising the transferred data functions. The arrangements for obtaining independent advice should support oversight and scrutiny of the relevant functions of NHS England’s board. NHS England will act transparently, publishing all procedures for when the Secretary of State requests data, or an outside body makes a request, and will publish details of organisations that have been allowed access to data, along with the purpose for that access and the data they have used.
People can have confidence that NHS England will uphold the highest standards of data management, including how it stores, manages, processes and allows access to data. The regulations ensure that by transferring the existing statutory framework of protections and then building on them, and I commend them to the Committee.
Andrew Gwynne (Denton and Reddish) (Lab)
It is a pleasure to serve under your chairmanship, Mrs Latham and good to be speaking on behalf on the shadow health and social care team.
As the Minister has outlined, the regulations effectively abolish the Health and Social Care Information Centre, which we all refer to as NHS Digital, and transfer those functions to NHS England. The SI essentially creates a single statutory body that is responsible for data and digital technology. The clear intention of the merger between NHS Digital and NHS England is to streamline data-sharing processes. It is noteworthy that in their own explanatory note, the Government recognise that
“leadership of digital transformation has been disjointed…the fragmentation of national bodies had made it hard to achieve”
an integrated and accessible digital health system. That view has been informed, of course, by the Laura Wade-Gery review, which was published in 2021. Ensuring that patients can access transparent data easily and effectively is crucial not only to informing patient choice but to monitoring whether relevant standards are adhered to.
The Department of Health and Social Care has said that NHS Digital staff and assets will transfer to NHS England before going through the wider “Creating a new NHS England” change programme. That will ensure that
“the necessary talent and expertise of NHS Digital”
is maintained.
The maintenance of high-level expertise is essential, especially when we consider the concerns that have been raised about the shrinking workforce in NHS England. Can the Minister tell us how long he anticipates the change programme will take? Can he also expand on his assurances that talent and expertise will be retained? As the transfer begins, the Opposition will hold the Government to their assurance that all expected standards governing the protection of patient data are maintained. That is an essential aspect of good data management and I have no doubt that the Minister recognises that.
New duties on NHS England include a requirement for the body to report on how effectively it discharges its relevant data functions, as well as a new duty on the Secretary of State to issue guidance to NHS England about the exercise of its “relevant data functions”. When does the Minister expect that guidance to be published? What expertise has he drawn on to generate that guidance? Can he also take this opportunity to assure Members that the acceleration of the merger, originally planned for April 2023 but now brought forward to January, will not have an adverse effect on IT continuity or staff preparedness? Will he also outline what level of communication current NHS Digital staff have received about the merger, and has that process been impacted by the acceleration?
The Opposition will not oppose the regulations, because we are committed to streamlined data processes, as long as that does not come at the expense of expertise or patient access.
Craig Mackinlay (South Thanet) (Con)
It is a pleasure to serve under your chairmanship, Mrs Latham.
Interoperability of data across different systems in the NHS between GP surgeries and hospitals has always been somewhat of a vexed issue. I note that the regulations relate to NHS England. A number of differences were highlighted during the covid period relating to certification in NHS Scotland—I note that no member of the SNP is present. Are moves afoot to make sure that data fields maintain some degree of regularity across Scotland, Wales and Northern Ireland? If the worst happens to any of us, our constituents or our families when we are in one of the devolved areas, can we expect that there is half a chance of data readability across the systems in different parts of the United Kingdom? Or, as time goes on, are processes getting more and more diverse and more complex? That would be a great sadness in my view.
Nigel Mills (Amber Valley) (Con)
It is a pleasure to serve under your chairmanship, Mrs Latham.
It is tempting to ask whether any of the Lansley reforms from decades ago have survived, and whether we have abandoned them all. We may be considering the last surviving bit to keep. Do the Government now believe that the right structure for the NHS is to have as few organisations as possible and to have them doing everything? We are seeing that with integrated care boards across the country, and now we are bringing stuff into NHS England. What is the Government’s vision for how the NHS should look? Will we see a plan under which we unravel a few more of the trusts that are still stuck around and for which none of us could quite understand the reason? Is that the vision: fewer organisations doing more gives a better outcome than lots of different things doing specialised work?
Neil O'Brien
Some excellent questions have been asked. My hon. Friend the Member for Amber Valley asked about the vision that the proposal is part of. It is certainly the case that there is a process of simplification of organisations, of which the transfer is another major step. The Health and Social Care Act 2022 also gave Ministers powers of direction over NHS England that did not exist before. None the less, that basic operational independence and structure still stands, so there is change but not a wholesale one compared with the 2012 arrangements.
My hon. Friend the Member for South Thanet asked a really important question about interoperability across the UK. As well as trying to promote that in the NHS, a piece of work is being done by the Department for Levelling Up, Housing and Communities and the Cabinet Office about comparability of data not just in health, but across the work of Government. I am sure that my hon. Friend would find that interesting.
The Opposition spokesman, the hon. Member for Denton and Reddish, asked who we have discussed the transfer with, and the answer is that we have discussed it with the devolved Administrations, the Information Commissioner’s Office, the National Data Guardian, medConfidential and, of course, NHS England and NHS Digital. The staff of those latter two organisations have been fully consulted and know all about the plans. In terms of the speed of the merger, the powers in the SI come into effect immediately, so that the merger can take place towards the end of the month.
I am trying to remember the hon. Gentleman’s other question—
Neil O'Brien
Absolutely. All the staff know about what is happening and have been consulted fully about the streamlining.
The SI will bring together NHS Digital and NHS England. It will not only preserve existing safeguards around people’s data but will establish slightly stronger ones. Effectively, it will deliver the preservation of the existing regime governing data protection as we bring the two organisations together and it will create all the efficiencies that that process will enable. I commend the regulations to the Committee.
Question put and agreed to.