Ratification date:

project or process name:

DPIA summaries:

Recommendation and conclusions:

This DPIA will cover:

Home working

Use of services from the private healthcare sector

Expansion of functionality in existing systems utilised by the Trust

Virtual meetings and file sharing via web/cloud services

Other data processing required for a COVID-19 purpose (as defined the Control of Patient Information Regulation (COPI) notice issued on behalf of Secretary of State for Health and Social Care on 20/03/20.

The Trust will operate in accordance with the COPI notice, which is time limited until 30th September 2020 (but may be reviewed or extended).

Recommendation and conclusion:

Each individual proposal for service change will be assessed and risks identified and mitigated as far as practicable whilst enabling the continued delivery of healthcare to individuals

Patients following Total Hip replacement (THR), Total Knee Replacement (TKR) and Anterior Cruciate Ligament (ACL) repair surgery lead busy lives and require post-operative clinic follow ups to their symptoms to be monitored.. A mobile application to allow patients to provide day to day information about their condition will

A. allow timely advice and action from their clinician

B. capture clinical data to support remote management of these patients

C. incentivise patients to use self-management plans as recommended by Arthritis Research UK

D. Allow health and quality of life measures to be audited for a common disease

Recommendation and conclusion:

Nil Known risk

The aim of the project is to improve communications between healthcare staff and patients to improve outcomes and productivity.

The need for a DPIA is the processing on a large scale of special categories of data for the use of the AccuRx Fleming to: perform video consultations (which are not recorded or stored) between healthcare staff and their patients.

Recommendation and conclusion:

Low/medium risk

We need to send our internal newsletters in a high quality, accessible digital format to all staff and externally to stakeholders.

The internal newsletter needs to be moved from a PDF document attached to an email, which looks dated and is difficult to read. We want to send out the newsletter using email marketing software rather than NHS mail so that:

1. We can design an engaging, clear easy-to-read newsletter where staff / stakeholders can see at a glance what stories are included.

2. Critically that we can measure / monitor / analyse open and click through rates. This will allow us to gauge how successful our email communications are, what stories are most popular and therefore enable us to gain insight so that we can make improvements to our digital communications / staff engagement / staff understanding of key messages / improved awareness of MTW among stakeholders / promotion of reputation.

Recommendation and conclusion:

Low risk

The website will help to deliver the strategic objectives of increased visibility and awareness, supporter accessibility and ultimately, generate increased income potential from both one-off and regular donors. From a user perspective, the site will make it simple for supporters to thank us for the care they have received. It will also enable supporters to donate to their chosen speciality with ease and to see the impact that their donations are having on patient care and staff welfare.

As part of the service offered by The Access Group, the site will be mapped to simplify page navigation and optimise mobile accessibility. Valley Hospital Charity view their website as like an additional member of their team, reducing the administrative burden and answering supporter queries, a valuable resource when current resources are stretched.

The project is pivotal to growing charitable fundraising potential and increasing the visibility of the charity both inside and outside of the trust.

Recommendation and conclusion:

No risk found

An outsourcing company will be used to undertake the typing of clinician’s dictations. The dictations are sent as Olympus DS2 files and returned into the Kent Oncology Management System via a HL7 interface. There is a need for a DPIA because patient data including name and hospital number will be sent outside of the Trust to a private company. Diagnosis, treatment plans and other clinical information will also be shared. The demographic interface would return KOMS patient demographic detail to DScribe, on request. The document interface would return the transcribed dictation from DScribe to KOMS via an HL7 message, an accepted standard.  The HL7 message would be associated to a specific patient. The interface would eliminate some or all of the current need for copy-pasting transcription content into KOMS clinical letters.  The interface would also require and hence enforce better discipline in associating each transcription to the correct patient.

Recommendation and conclusion:

High/low risk

In response to the global COVID-19 pandemic the Trust has set up new COVID -19 swabbing services. Two of these services are on Trust premises, one was originally set up in the car park of the Hop Farm, Paddock Wood (a local entertainment venue) but has now been relocated to a college campus in Maidstone. This site is known as the Oakwood Park

When the service was at the Hop Farm, the staff used an iPad to view emailed information about patient attendances using a mobile phone as a hotspot to access WIFI.

The remote site at Oakwood Park service has gone live with the same technology in place, but will soon have a different set up. Staff will be required to use a laptop computer although the mobile phone will remain in situ to facilitate WIFI access.

Recommendation and conclusion:

Low risk

In support of the Sussex wide Resilience response to COVID 19, this project is a collaboration between Maidstone and Tunbridge Wells NHS Trust (MTW) and Healthwatch East Sussex.

The aim of the project is to undertake wellbeing checks with individuals recently discharged from Hospital in order to assess both the discharge process and as a means of assessing whether those discharged have any other support requirements.

The wellbeing checks will be undertaken on the phone by the staff and volunteers of Healthwatch East Sussex.

To facilitate this, MTW will provide the name and contact details of discharged patients to be contacted on a daily basis to Healthwatch East Sussex. This will only occur where individuals have been offered this opportunity and given their consent to be contacted. Anyone can opt out of the process at any stage.

The contact details provided will be for those individuals discharged from hospitals of facilities delivered by MTW and where they reside in East Sussex. The number of referrals from MTW to HWES may fluctuate but is anticipated to be approximately 10 per day.

The contact details of those requiring wellbeing checks will be distributed securely using email addresses (password protected) and telephone calls on a regulated basis to Healthwatch staff or pre-approved volunteers solely for this purpose. In undertaking the wellbeing checks, information will be collected on the participating individuals in response to a number of prompts. The information provided by each individual may relate to their health circumstances and personal details and may be classified as sensitive information. This will be recorded and stored solely for the purposes of delivering this project.

The information from all of the engagements will then be collated by Healthwatch staff. This will be undertaken to both facilitate effective project management and to ensure that appropriate protocols are followed in the use of personal information.

No personal data or information will be retained by Healthwatch East Sussex Staff or Volunteers beyond the term of the project. A summary of non-personalised information will be communicated back to MTW on a monthly basis to inform contract management and to identify any trends in the issues identified by individuals.

Personal details may be relayed to MTW in circumstances where individuals contacted as part of the wellbeing check process identify significant concerns or complaints about the discharge process, or where there is a clinical need to do so. Consent for this to occur will be sought and the process will only occur where this is provided,

East Sussex Clinical Commissioning Group (CCG) are the funders of the project, and delivery may also be of interest to East Sussex County Council who deliver Children’s Services and Adult Social Care. Neither of these organisations will play a role in delivery of the project, nor will they have access to the personal information provided by MTW to Healthwatch East Sussex or vice-versa.

Recommendation and conclusion:

Acceptable low risk

The Project aims to provide an electronic system to support the on-lining and day to day management of volunteers within MTW.  This will require process of person identifiable data provided to the Trust by volunteers.

• Providing a platform for Mtw Voluntary Service to assist in managing the relationship with their volunteers.

• Providing scheduling, training, outbound communications, hours logging, feedback and reporting functionality to Customers using Volunteer Impact

• Providing communications and reporting functionality to Volunteers and MTW using Member Impact.

• Providing selected volunteers with personal information they need to Volunteer at MTW with whom they have been assigned as well as communications and reporting functionality to Volunteers.

Recommendation and conclusion:

For the avoidance of doubt, nothing in this DUA shall prevent Better Impact processing Protected Data where it is required to do so under applicable EU or English law and, in such circumstances, Better Impact shall notify the Customer of that legal requirement unless applicable law prohibits such notification.

The aim of this project is to improve the way clinicians from KCHFT have access to patient test results.

MTW’s SHUK screening service is a service that covers the whole of Kent.  This means that a patient from East Kent with a positive test following an SHUK screen may be advised visit their ‘local’ Sexual Health clinic.

Currently if a patient when a patient has an appointment in East Kent the service contacts MTW E-Bureau (the administration side of MTW SHUK) for the test results.  With this temporary view only access, the clinician in East Kent will gain the consent of the patient in the appointment to view their results within the SHUK system.

The reason for a DPIA is due to the fact that the KCHFT clinician could access results of clients who are not their patient providing they have the correct identification data required for each individual.

Recommendation and conclusion:

Accepted low risk

The install of CYRUS will enable our off site cervical screening providers to access outcomes of cases for failsafe purposes.

It will reduce the need for the Colposcopy Admin Team to do this manually, making our time more effective.

Free system provided by CYRUS under the instruction of BSPS (Berkshire & Surrey Pathology Services) who undertake our Cervical Screening Tests as this ceased to be done in house Nov 2019.

Free support

Recommendation and conclusion:

Low/medium risk

NHS 111 First aims to encourage the use of NHS 111 Online and telephony as the primary means to access integrated urgent care. The Covid pandemic has changed the way the public access health services and how NHS services can now respond to the needs of patients.

The new offer will include;

• NHS 111 (both online and via existing telephony) as the single entry point for urgent care services.

• A move away from ‘walk in’ demand into the ED or UTC as the first choice to access urgent care.

• Improve demand management whilst reducing waiting times through offering patients who would usually self-present to the UTC an ‘appointment’ with the most clinically appropriate service.

• Embracing remote assessment/virtual consultation and the use of technology to support

• Preventing nosocomial infection by ensuring patients does not congregate together in ED/UTC waiting areas.

• Ensuring patients get a clear communication of what they need to do and where they need to go in order to resolve their urgent care problem.

• Protecting those at risk, including patients and staff.

Recommendation and conclusion:

Moderate/minor risk

The Laboratory Information Management System (LIMS) Project considers the need to implement a single shared LIMS in place of the four legacy LIMS current used at the four acute Trusts. The LIMS Project is at the most advanced stage of the three projects and procurement is about to begin. The single shared LIMS will give staff from the four acute Trusts access to patients’ digital records held by others. The LIMS Project is in the procurement stage.

Recommendation and conclusion:

Medium/low risk

The project aims to introduce a track and trace system for items being delivered and collected by the Transport Department.

Currently there is not a robust system in place to ensure items collected are delivered in a timely fashion.

With the introduction of this system it will give us the capability to provide proof of delivery and accountability of items passing through the Transport Department.

Transport drivers will be allocated tasks.  The Driver will add a unique barcode to each item of the goods for transportation.  The barcode will be scanned into the tracking system using a PDA.  The despatching department will sign as confirmation of collection to confirm chain of custody.

Driver will either be assigned a delivery task, either the goods destination point or a transport hub (goods in department) where a receipting individual will be asked to sign and confirm receipt of goods.

Data relating to each transaction will be stored on a cloud-based system, provided by a third party, with controlled access to the information through unique usernames and passwords.

Recommendation and conclusion:

Low risk

Clinical teams support children and young people and their families. They would expect data to be used in this way and agree to this. All PID is under their control. There are no concerns over the processing of this data as it is anonymised and DigiBete is fully supported by NHS-E, having demonstrated all necessary data security and protection requirements.

DigiBete offers an innovative approach to digital, clinically approved resources delivered remotely. It supports a paperless, efficient and cost effective way of helping patients better manage their conditions.

There are no concerns over the service, it has already been adopted by 90% of clinics in England and Wales.

Recommendation and conclusion:

DigiBete has all necessary compliance requirements and certification and full data security and protection policies in place.

All data is fully encrypted, securely transferred and stored in secure cloud servers in UK

UK (London) based servers – no transfers outside UK.

This project aims to install software that will allow respiratory physiology to set up a watchpat, which will be handed to the patient to wear overnight. The watchpat will record the following data during the night SpO2, PAT, HR, Actigraphy Snore level, Body position and chest movement. The patient will then bring the device back and the department will link it to the zzzPAT software, which will download the data recorded and allow the department to interrogate and report on this data, recommending treatment if required.

Recommendation and conclusion:

To our knowledge there are no prior concerns or security flaws.

Its not novel and is used within other Trusts.

To collect and reduce outstanding debts in the overseas visitors department.  This will be achieved by sharing of relevant data with an external debt collection agency.

Recommendation and conclusion:

Reduced low risk

SHUK is the on line STI screening service that is delivered by Maidstone and Tunbridge Wells NHS Trust (MTW NHS Trust) and provides access to STI testing for all Kent residents > 16 years of age.

SHUK E-Bureau manages all positive and reactive results ensuring patients are contacted and directed to an appropriate service of their choice for care and treatment which can include attending a sexual health service.

MTW NHS Trust delivers clinic based sexual health services in West and North Kent (Maidstone, Tunbridge Wells, Tonbridge, Sevenoaks, Dartford and Gravesham).

KCHFT delivers clinic based services for those living in East Kent (Ashford, Canterbury, Dover, Shepway and Thanet)

The aim of this project is to allow clinicians working in KCHFT sexual health services to document clinic attendance and transfer of care for patients who have been advised to attend a sexual health clinic in East Kent via the MTW Kent wide online screening service.

The reason for a DPIA is to support KCHFT clinicians being given access to SHUK care records so that they can document on a patent record that the attendance and transfer of care of a patient has occurred enabling confirmation of attendance and support measuring satisfactory outcomes for all patients managed by the MTW E Bureau.

Recommendation and conclusion:

Accepted low risk

Maidstone and Tunbridge Wells NHS Trust (MTW) urgently wish to access Pillar 1 & 2 Test positive data for the following reasons:

– People are attending emergency departments saying that they have COVID19. Front line staff are currently reliant on manually liaising with them to check a text/email they have and then adding them to our system

– For other people we are testing them on arrival and having to wait a day or so for a result.

– If we knew for everyone, or a significant proportion of them, attending our ED their test result without needing to test or check their result this would dramatically help our processing and management of COVID19 positive patients.

Requests have been made by MTW to access this data via NHS route however there has not been any response. Until a secure route via NHS is established, KCC Public Health, who are now the data controllers for the testing data for their patch, have volunteered to share this data with MTW until a permanent solution is reached.

Recommendation and conclusion:

Low risk

The Processor Data will be deleted once secure route via NHS is established

The project is being undertaken in collaboration with NHSE who are also providing funding for a 24-month period. The project will initially focus on two cancer types: advanced/metastatic upper gastrointestinal and gynaecological cancers, although there will be potential to widen the criteria as the project develops. There are two key elements to the project:

1. There will be a rapid access ambulatory ascitic drainage service. This will allow oncology teams to make direct referral to a protected interventional radiology session where drainage of ascitic fluid can be undertaken as a day case.

2. There will be an enhanced supportive care clinic set up for patients with advanced cancers that are either ineligible for systemic anti-cancer therapies or for patients who chose not to follow that pathway if offered. Given the current circumstances patients will be offered a virtual clinic appointment for an initial assessment by a senior palliative care nurse (the option of face to face assessments will also be offered). This will enable the needs of the patient to be assessed and advice given (eg symptom control) or referral to other services (eg dietician, physiotherapy, benefits advice). In addition to the standard holistic assessment the patients will be asked to complete an IPOS score, which is a validated palliative care symptom assessment tool. Patients will be followed up in the ESC clinic where further assessment will take place (including further IPOS), and onward referral to community services advised if indicated.

The project is designed for patients that would normally use MTW as their base hospital for their cancer treatment.

At the end of the 24 month funding period it is not yet know what elements, if any will continue to be provided as this will depend on benefit to patients (as assessed by the project) and affordability.

Recommendation and conclusion:

Low risk

Reconfiguration of 4 ipads donated to the breast care nurse team by Breast Cancer Kent for trust use. This will enable us to access the secure website for infoflex V6 on these devices. The aim is that we can then use these devices to enable us to make the transition from paper to electronic patient notes as the trust/breast cancer charity will be able to provide us with keyboards to use with these devices. We have so far been unable to make the transition to electronic notes due to lack of available hardware within the team. This has resulted in us being able to carry out any work remotely during the Covid pandemic, necessitating us all being in the office. It also and severely impacts on our ability to work cross site effectively.

Recommendation and conclusion:

No DPIA needed

To enable service users to request personal information under a SAR or Access to Health Records request and the Trust to disclose documentation electronically through a portal.

Recommendation and conclusion:

No concerns regarding the common law duty of confidentiality. Low risk

Paediatric units across the South East do not have access to a live bed state system or dashboard showing pressures and bed availability across the region.  The South Thames Paediatric Network have developed this dashboard in conjunction with all the local hospitals including MTW to identify available paediatric beds when under OPEL 3/4 across the sector.  The dashboard also offers the ability to capture and share key contact information for trusts and will improve communication, patient pathways and patient flow across the South East. The dashboard has been developed by Beautiful Information and already runs in adult areas within MTW – including ED

Recommendation and conclusion:

No DPIA required

Ratification date:

project or process name:

DPIA summaries:

Recommendation and conclusions:

·        UK legislation, Blood Safety and Quality Regulations 2005

·        Statutory Instruments 2005/50, 2005/1098 and 2006/2013

·        EU Directives, 2002/98/EC, 2004/33/EC, 2005/61/EC and 2005/62/EC.

It must allow restricted access to blood component storage devices and contain a full audit trail of the blood components movements and administration to patient, in accordance with the above UK legislation.

Evidence of the value of such systems is outlined in the QUIPP report, ‘Electronic blood transfusion: Improving safety and efficiency of transfusion systems  http://www.evidence.nhs.uk/qipp ’.

Specifically

1.   To increase patient safety by ensuring the right patient receives the blood in a fully auditable manner. The bedside module of the system will alert in real time:

• if blood is not matched to the patient (wrong patient or wrong blood)
• if a unit of blood has been out of the fridge longer than allowed
• is out of reservation time and no longer suitable for that patient

2.  To enable full traceability of the blood components as required, including ward receipt and end fate of unit. 100% positive traceability is an MHRA essential target.

3. Increase efficiency as outlined in the Proven Case Study listed above by improved use of nursing and laboratory staff time https://www.nice.org.uk/resources/qipp/29453/attachment?niceorg=true

Recommendation and conclusion:

Accepted low risk

This project will create an online backup, source control and versioning solution for the Development Team’s Penta PowerBI reports.  It will enable better team working by the use of Microsoft Azure DevOps.

Recommendation and conclusion:

Accepted low risk

Clinical Audit is moving from a locally hosted Microsoft Access database, to an intranet based clinical audit management system called Ulysses hosted on Microsoft Azure Servers in UK South Datacentres. MTW uses the process of auditing to monitor compliance against national and local standards, the results and conclusions are used to improve patient care and outcomes. In addition, when changes are implemented, the re-audit feature is used to ensure improvements are sustained over time.

Ulysses Audit module enables Managers and Staff to take responsibility for the recording of their own information and by mapping the organisation’s audit process; it encourages staff to follow “best practice” improving the quality of data.

Ulysses Alert module is used for the dissemination of any information, such as policy documents, NICE Guidance, FSN’s (Field Safety Notices) from external agencies e.g. MHRA (Regulating Medicines & Medical Devices). Security within the system ensures that Alerts are only viewable by appropriate staff members.

Recommendation and conclusion:

Accepted low risk

An informative workshop, providing prospective parents with evidence-based information and to give them an introduction to breastfeeding

Recommendation and conclusion:

Accepted low risk

Service templates for the provision of the Discharge Medicine Service

Recommendation and conclusion:

Accepted low risk

Data sharing with our local West Kent Primary care network in relation to frail patients who attend the EDs frequently (three or more times within 3 months period).

As part of NHS long term plan to actively manage patients care in the primary care settings and to proactively manage the health and social care of our elderly population, Maidstone and Tunbridge Wells (MTW) hospital intends to go in agreement to share the data of all frail patients, who attend our Emergency Department (ED) more than three occasions, with our local primary healthcare providers. This is to allow for proactive management of the healthcare needs of these individuals through multidisciplinary meetings. Frail patients in this context refer to patients over the age of 70.

Recommendation and conclusion:

Accepted low risk

The primary objective of AEC and AFU is to reduce and remove delays in the patient pathway, allowing services to process emergency patients within the same day as an alternative to hospital admission.

Ultrasound imaging is regularly performed within AEC/AFU, but the units have to borrow an Ultrasound machine from ED (when available) or delay the test until it’s available or refer patients to radiology services for simple scans which could be performed in AEC/AFU.

The handheld portable Ultrasounds will mean that existing scan requests can be cancelled if an alternate diagnosis is obvious upon undertaking a handheld scan. Furthermore, tests can be prioritised where significant anomalies are obviously detected in initial bedside point of care assessment. This facility will therefore help expedite patient care through the department.

Recommendation and conclusion:

Accepted low risk

Robotic Process Automation (RPA) is an emerging form of transactional process automation technology based on the notion of software robots or ‘digital’ workers replicating the way humans interact with applications on a computer. RPA software allows data to be handled in and between multiple applications at a greater speed and reliability than humans, for example, receiving emails containing forms/invoices etc. extracting the data and then inputting the data into an electronic staff/patient record or ledger system. Following a successful review of Robotic Process Automation vendors carried out by KCHFT there was a subsequent procurement of RPA software based on an identified solution to deliver significant streamlining and workforce efficiencies, whilst also enabling human capacity to be realigned to more value-adding activity.

MTW are looking to utilise this solution in partnership with KCHFT, so that the infrastructure built and experience they have gained can be shared and economies of scale can be released to benefit both parties.

RPA software uses ‘virtual’ workers to replicate the way humans interact with applications on a computer. As a result, entire digital business processes can be performed without any human intervention, at a greater speed and reliability.

The aim is to implement the software within the Trust, starting within Human Resources, with a view to delivering a number of key benefits.  NHS Improvement are actively endorsing RPA uptake across NHS organisations to assist with the transformation of Trust corporate services

Recommendation and conclusion:

Accepted low risk

This is initially a one-month pilot at one of our main sites, with a view to expand to all our sites across West Kent.

This system offers an ‘express pod’ on exit, which is a series of faces for patients to indicate how their visit went, together with a QR code access should they wish to leave any written feedback.

The data captured can be used as real time monitoring as well as enabling us to see spikes/trends in either direction.

The system is web based and compatible with mobile phones, which will allow patients to respond at their convenience.

We also intend to use the system as a staff well-being feedback monitor.

Recommendation and conclusion:

Accepted low risk

Ratification date:

project or process name:

DPIA summaries:

Recommendation and conclusions:

This is a project to establish a means of using semi-automated methods for analysing Friends and Family Test (FFT) free text patient experience feedback in NHS trusts in order to improve services. This programme of work will help NHS provider organisations better understand and be reactive to FFT qualitative feedback, gaining deeper insights to make service improvements. The outputs of this project will form the basis of a “best practice” tool kit for FFT users, such as trusts, so that they can reproduce the developed methods, as well as technological solutions, including algorithm code.

This work aims to fill a gap in support available to the health system, where due to lack of time, resource and skill, FFT free text data is not being systematically analysed and used to its full potential by NHS provider organisations.

– Machine learning algorithms will be refined/developed, tested and validated across different service settings (e.g. community, MH, Acute) in four provider organisations, using FFT comments. They will aim to classify feedback to help identify areas for service improvement near real time. The work will explore and use methods that can identify emerging themes and flag feedback that is of interest.

– Four trusts will be selected as initial trial sites to help test and validate the solution. Through developing, validating and piloting in different service areas the work will evaluate the transferability of the machine learning algorithms (or developed method) and how to accommodate for any variation.

– For each service area a deeper exploration of user needs will be conducted (e.g. through workshops or focus groups), learning more closely how they want to be able to analyse, visualise, report and disseminate findings. This will include mapping how FFT free text is embedded in their current quality improvement process, including any relevant IT processes or infrastructure.

– This work will include development of a way to visualise and disseminate free text data, such as an online dashboard.

The aim of this piece of work is to improve the use of FFT and its free-text component in selected trusts, i.e., trusts that are not utilising patient feedback to its full potential for QI. This will involve supporting trusts to develop their analytical capabilities and digital infrastructure pertinent to near real-time patient experience reporting for subsequent QI. This will involve developing methodology to process and analyse FFT free text that can be easily reproduced and autonomously managed locally.

Recommendation and conclusion:

Accepted low risk

1) Phase 1

a. Maternity Services DataSet (MSDS v2) This is Trust Level Maternity Mothers and Baby Activity submissions. The dataset will be the post NHS D validated version with consistent data content. It will requested back from NHS D by the Trusts and then submitted to the HISBI developed processes for importing into the Kent and Medway Maternity Data Warehouse.

Recommendation and conclusion:

Accepted low risk

The Trust needs to increase our reporting capacity to meet the demands of the service and we are contracting with Hexarad to provide this increase in our reporting capacity.

Recommendation and conclusion:

Accepted low risk

Provision of a Colposcopy patient management solution based on a client/server Microsoft Access/SQL Server database.  PHE commissioned solution from the Screening QA Service (Midlands & East) for Trusts to capture colposcopy data, enabling the reporting of national standards and to assure the quality of the service.

The new MASEY system is required to upgrade the existing MS Access

version.

The upgraded system enables the colposcopy service to report current standards in an accurate and timely manner.  The existing system does not collect the minimum dataset.

The existing system does not report current standards, and as previously mentioned it does not collect these data to enable certain reporting.

MASEY is a single Trust database unlike the current system which requires a database instance for each hospital within the Trust providing a colposcopy service.  MASEY will provide an accurate return on clinic activity and system administration will be more efficient.

The current version of the database uses MS Access for data storage, unlike MASEY which uses SQL Server.

Free system provided by Public Health England.

Free Support.

This DPIA has been updated to reflect that BSPS (Berkshire & Surrey Pathology Services) personnel will also require read only access to our system who undertake our Cervical Screening Tests as this ceased to be done in house Nov 2019.

They also need access to outcomes for failsafe purposes. They will access our system with individual logons via a RAS server provided by the Trust.

Recommendation and conclusion:

Accepted low risk

To implement ProKnow, a CE marked medical device for radiotherapy offering a cloud-based data repository and data analytics tools, to improve radiotherapy treatment safety and learning by enabling:

1) Clinical oncology peer review of radiotherapy patients’ treatment planning,

2) Peer review within and between Operational Delivery Networks (ODNs),

3) Inter-ODN clinical audit,

4) National radiotherapy image data archiving,

5) National radiotherapy data sharing and analysis.

Recommendation and conclusion:

Accepted low risk

The personal files held by the Employee Relations team will be digitised by Xerox. This will involve handing over the files to Xerox for transportation to their facility, where they will be scanned and then returned to the Trust in digital format. This will involve approximately 6900 files and an estimated total of 1,000,000 individual documents. The files passed to Xerox does not include medical, bank or physical recruitment files.

Recommendation and conclusion:

Accepted low risk

The Kent and Medway ICS is forming its cloud-based medics collaborative, to enable clinicians to cross-cover shifts across 6 NHS Trusts – exponentially expanding the size of individual Trust’s staff pool, and ultimately deliver more patient care hours. The drive to grow a medics collaborative, regardless of speciality, is built on the ICS’s long-term vision to improve patient care while improving the working lives of its clinicians. This DPIA covers the MTW implementation of the Locums Nest System.

Recommendation and conclusion:

Accepted low risk

The Managed Equipment Services (MES) Project will implement a Managed Services Contract (MSC) solution from multiple providers under a single umbrella management contract, for all Kent and Medway laboratories. It is envisaged that no personal information on either staff or patients from one acute Trust will be accessible by relevant staff at the other three acute Trusts.

The Laboratory Information Management System (LIMS) Project considers the need to implement a single shared LIMS in place of the four legacy LIMS current used at the four acute Trusts. The LIMS Project is at the most advanced stage of the three projects and, as at the time of revising this document (v0.4), the LIMS tender process is nearing the end. The single shared LIMS will give staff from the four acute Trusts access to patients’ digital records held by others.

Recommendation and conclusion:

Accepted low risk

MTW Endoscopy has been awarded with training Academy status which will involve trainee from other Trusts to be trained in Endoscopy procedure at Maidstone and Tunbridge Wells Hospital for a period of two weeks. In this time trainees will have access to patient personal data and information.

Recommendation and conclusion:

Accepted low risk

THE SOLUTION

Artificial intelligence (AI) platforms can support better asthma care by identifying “complex” events leading to re-admission / attendance in hospital settings2. By applying AI to the follow-up of asthma patients with a recent exacerbation, opportunities for intervention to reduction hospital admission and improve longer term asthma control may be identified.

THE PROPOSAL

50 patients who attend MTW for an unscheduled asthma attack (clinician-diagnosed and requiring a provision of emergency steroid course Prednisolone 40 mg daily for ≥3 days) will be identified for this project. They will be offered an electronic peak flow device linked to a smartphone app (Smart Asthma3) to monitor symptoms, peak flow and use of reliever inhalers immediately following their attendance at hospital. The patients will be tracked remotely and contacted by a respiratory specialist nurse / Specialist HCP to review the above within 2 weeks of their asthma attack. Patient’s feedback on the device and re-attendance within 3 months will be audited.

Recommendation and conclusion:

No risks identified

Collection of radiology information system (RIS) data by information at Maidstone and Tunbridge Wells NHS Trust and shared with Kate Silvester Ltd for the purpose of analysing patient flow, demand and activity for the Radiology Quality Improvement project.

This process forms part of the teaching for the Health Improvement Practitioner course.

Recommendation and conclusion:

Accepted low risk

Annual medical appraisal is a GMC requirement. MTW has to date used a MACG4 form. A PDF document with the ability to embed documents. This form has no password protection. The MAG4 form support has been withdrawn and we have no option but to move to an on-line system. MTW has approved the L2P online system as a replacement. This is a commercial package widely used by NHS Trusts.

This project aims with the support of L2P to use the new system from 1 September 2022 onwards. Appraisals will no longer take place using the MAG4 form

Recommendation and conclusion:

No risks identified

Recommendation and conclusion:

Accepted low risk

To use CEC Healthcare coding to remotely code day case activity that cannot currently be coded but internal trust resource

Recommendation and conclusion:

No risks identified

To streamline multiple quality governance functions to InPhase Oversight. These functions include PMO/QI tracking, regulatory quality assurance and Clinical Governance (except Patient Safety – currently Datix).

InPhase is an internet based fully integrated Governance, Business Intelligence, Performance Management, Reporting and Dashboard technology providing secure password based logins. Access to each module of the system can be restricted by Trust “Super Users” to ensure the integrity of the system and the data held on it.

Recommendation and conclusion:

Accepted low risk

MTW wishes to trial a SaaS product –the CAREFUL platform – in the clinical areas covered by the Intensive care units (ICUs) and Cardiac Care Unit (CCU) at Tunbridge Wells Hospital and Maidstone Hospital.

The trial intends to prove that CAREFUL will improve the efficiency and safety of clinical handover and patient flow by creating visibility and accountability of crucial patient information, tasks and status within and between the multi-disciplinary teams responsible for critical care.

Recommendation and conclusion:

Accepted low risk

Two GPs from BGMP have developed their knowledge and skills in gynaecology, so that they will be able to see and treat patients who cannot currently be treated in a Primary Care setting.

The demand and capacity planning for MTW gynaecology is currently showing a gap of 1703 new appointments per annum to achieve the required levels of new outpatient appointments to meet the 110% target for 2022/23; patients are also waiting 16-20 weeks for first appointment if non-urgent. Increased outpatient backlog also impacts elective activity, as longer outpatient waits means patients wait longer for surgery, often not being offered surgery within recommended national guidelines [and affecting MTW RTT achievement].

In March 2020, the number of West Kent patients waiting for treatment at the end of the month in gynaecology at MTW was 1,920. At the latest published waiting list position in December 2022, this figure stood at 3,530, an increase of 84%To establish a GP with Extended Role (GPwER) led Community Gynaecology pathway with MTW and Borough Green Medical Practice (BGMP).

Recommendation and conclusion:

Accepted low risk

Open Eyes is an EPR system designed for ophthalmology care and has been in the trust since 2017.

We are now expanding the use of the system to cataracts and other modules which will involve processing of additional data.

Recommendation and conclusion:

Accepted low risk

We are implementing a salary sacrifice Holiday scheme, which will allow employees to book a holiday, which will then be repaid by the employee paying monthly instalments via salary sacrifice. (Terms and Conditions apply)

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

Ratification date:

project or process name:

DPIA summaries:

Recommendation and conclusions:

After a patient has died there are numerous process that need to be followed internally prior to the patient being released to the funeral director. The deceased patient and their relatives come into contact with three distinct teams that cross three directorates.

1. The Bereavement Team
2. Medical Examiner Service Team
3. The Mortuary Team

The teams are moving to a cloud-based specialist software, a comprehensive purpose-built solution that captures all the patient processes from death to leaving the hospital.

Eden will provide a system that is:

• Secure system -with different levels of access by authorisation level that can be monitored
• Provides a full audit trail -which covers each step of the patient’s progress and logs which staff member has carried out each action.
• Interfaces with the Trust EPR to enable demographic data to be pulled through -eliminating transcription errors and time saving.
• Bereavement – allows recording of funeral directors, QAP’s etc. and specific information regarding completion of legal paperwork, including certificates and cremation papers and other information relevant to bereavement.
• Correspondence record – for all interactions, family members, coroners, etc.
• Central documentation store for internal and external authorities
• Record referrals by coroners and post mortem examinations, plus prevents release of a patient without coroner’s authority
• Patient release controls to ensure patients are only released with appropriate level of authority from coroner/relatives, whilst also ensuring organs and tissue is accounted for prior to release.
• Capacity management of fridges, organs and tissues. Which will allow national returns to be completed with ease and remotely.

Recommendation and conclusion:

Accepted low risk

This project will compare the efficacy of diagnostic services from two different companies to analyse and report on DNA samples of consenting patients.

Workflow:

1. A patient undergoing investigation for a designated condition is asked if they would be prepared to undergo genetic testing in order to inform diagnosis
2. If the patient consents, then a sample is taken by a clinician.
3. The sample is labelled with the Hospital Number known only to the referring clinician and those within the Trust with access to the patient’s clinical records.
4. The clinician places an order for the relevant test using the Hospital Number, Date of Birth, Age and Gender at Birth assigned to the test sample.
5. The sample is sent to the laboratory facility that is supporting the trial on behalf of the chosen participating company
6. The laboratory performs the analysis and publishes its report on the portal operated by the company concerned.
7. The clinician logs onto the portal and retrieves the report identified by the given Hospital Number and Date of Birth as unique identifiers for the patient they are treating.

Recommendation and conclusion:

Accepted low risk

Virtual wards support people, who would otherwise be in hospital, to receive the care and treatment they need in their own home or usual place of residence.

They let health care professionals monitor and support people’s health and wellbeing remotely. Monitoring can be carried out by using remote technology or wearable devices that capture information, such as vital signs.

Recommendation and conclusion:

Accepted low risk

The primary objective of AEC and AFU is to reduce and remove delays in the patient pathway, allowing services to process emergency patients within the same day as an alternative to hospital admission.

Ultrasound imaging is regularly performed within AEC/AFU, but the units have to borrow an ultrasound machine from ED (when available) or delay the test until it’s available or refer patients to radiology services for simple scans which could be performed in AEC/AFU.

The handheld portable ultrasounds will mean that existing scan requests can be cancelled if an alternate diagnosis is obvious upon undertaking a handheld scan. Furthermore, tests can be prioritised where significant anomalies are obviously detected in initial bedside point of care assessment. This facility will therefore help expedite patient care through the department.

Recommendation and conclusion:

Accepted low risk

ProSoma Core is a server-based software application which will be used to independently perform a secondary dose calculation for the verification of radiotherapy treatment plans before release for clinical use.

The software is hosted on Trust-based servers.

Recommendation and conclusion:

Accepted low risk

Medical Education has been put in contact with a supplier that assists several Trusts in providing a My Medical app as a secure platform as a resource hub for Junior Doctors and Medical Students to link with their governing team Medical Education.

The app is a closed secure platform (not accessible or visible to the general public) that helps with the Junior Doctor and Medical Student Induction programmes and teaching programmes, it is a paperless based system that many of our neighbouring Trusts utilise for this purpose – a central resource for Doctors and Medical Students to access all information regarding their training. We normally contact them via multiple emails and reminders, this will provide them with a one stop access to the information they require, without the barrage of constant emails, therefore streamlining effectively.

The Medical Education Team administer the platform and provide access to only Junior Doctors and Medical Students whilst on placement in the Trust, then remove them once they leave as the new rotating users will then be added.

Recommendation and conclusion:

Accepted low risk

The overall aim of the ICB’s Complex and Crisis Care Pathways team -supporting children on complex and crisis pathways – is to improve the quality of the experience of Kent and Medway children and young people (CYP) who require specialist inpatient treatment for acute and prolonged enduring mental illness, neuro-developmental disorders or eating disorders.

To do this, a key part of the roles, is to have oversight of the CYP who currently require, or may be at risk of requiring inpatient treatment for the conditions stated above. A number of organisations are responsible for the care of these vulnerable CYP, and personal data must be shared between these providers to ensure that care for these CYP can be planned in an efficient way, providing individuals with the most appropriate treatment and achieving the best outcomes.

These organisations are:

• Kent and Medway Clinical Commissioning Group
• SPFT (Provider Collaborative)
• East Kent Hospitals University Foundation Trust
• Maidstone and Tunbridge Wells NHS Trust Dartford and Gravesham Trust
• Medway NHS Foundation Trust
• North East London Foundation Trust
• Kent and Medway NHS and Social Care Partnership Trust
• Kent County Council

Recommendation and conclusion: Accepted low risk

Unfortunately, Huawei have been removed as a vendor from the UK market meaning that the existing servers cannot be upgraded or expanded.

In order to resolve the performance issues, a replacement SAN is needed urgently. A business case was approved on 6 June 2023 and an order has been placed with NetApp for new servers

which are expected to be delivered in July 2023.

However, in the short term, the IT team are also looking at the option of storing and facilitating access to Trust data files stored in the Cloud as a way of alleviating pressure on the Maidstone

SAN. The team are working closely with Maple Networks with a view to starting this migration very quickly. This DPIA will cover this temporary interim solution.

Recommendation and conclusion:

Accepted low risk

Unfortunately, Huawei have been removed as a vendor from the UK market meaning that the existing servers cannot be upgraded or expanded.

In addition to this, at times throughout the day/week we see spikes that hit up to 100%. The equipment supplier, Huawei support our findings. A number of emergency changes have been

applied in order to alleviate some of the pressure, but have had little effect and the performance issues still persist.

All remedial actions have now been exhausted and the Trust has no option, but to invest in new hardware earlier than planned in this financial year.

In addition to the work planned for installation of the new permanent solution, the retrieval of data temporarily migrated to the temporary cloud solution will also be migrated to the permanent

NetApp solution as part of this project work.

It addition our current SAN supplier, Huawei have withdrawn their sales support from the UK market and it is becoming increasingly difficult to order replacement parts or receive support in a timely manner.

Recommendation and conclusion:

Accepted low risk

research to accelerate the development of new therapies. Through its self-service, Health

Insurance Portability and Accountability Act (HIPAA), General Data Protection Regulation

(GDPR), and Lei Geral de Proteção de Dados Pessoais (LGPD) Brazil’s data protection law – compliant platform of federated Electronic Health Records (EHR), datasets, and consulting partnerships, TriNetX puts the power of real-world data into the hands of its worldwide community to improve protocol design, streamline trial operations, and enrich real-world evidence generation.

TriNetX allows researchers to utilise data to make informed decisions with respect to research projects and clinical trials. Data is anonymised/pseudonymised prior to utilisation.

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

▪ Data encryption is supported via TLS 1.2

▪ Product consumption in the cath lab procedures is recorded against a patient hospital number for supply chain traceability and governance purposes.

The consumption of products used in each procedure needs to be captured for billing and quality purposes. It also enables the procedure consumption report to be linked with hospital CVIS system should this be required.

Recommendation and conclusion:

Accepted low risk

Management System (EPROMS) implementation.

• To implement ‘Noona’, a cloud based EPROMS tool into the Prostate and gynaecological neoplasm acute radiotherapy follow up pathway.

• Noona is a product owned by Varian and compatible with ARIA our radiotherapy treatment verification system.

• Improve patient care by enabling patients to report side effects from radiotherapy in real time and receive support from clinician’s and health care professionals involved in their care in a specified time frame, ensuring they can be triaged to the most appropriate and immediate support.

• Enable clinicians to review increases in or new symptoms which could indicate a progression in disease or worsening of side effects which would then lead to more timely interventions.

• It will be able to remind patients when investigations such as blood tests are due and remind patients of clinic appointments to reduce the risk missed appointments.

• Help patients to manage low grade side effects and alert them to more serious side effects which require immediate intervention with pre-set alerts. Minimising un necessary GP and hospital interventions. Empowering the patient to be in control of their health care, and contributing to the NHS net zero goal. As well as contributing to the NHS long term plan of digital interaction between patient and health care providers.

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

The report is being developed to assist delivery of one of the Trusts objectives around reducing temporary staff spend, linked to the Breakthrough Objective for the Sustainability theme of the Trust’s overall strategy deployment.

Recommendation and conclusion:

Accepted low risk

In addition, the reporting from the Telstra Health UK tools is often several months behind as their processing requires access to HES data flows which are in arrears, so by providing access to local data flows, we are able to gain an early view of performance and our coding.

This project requires the local flow of SUS data to Telstra Health UK using the approach in the attached document.

Recommendation and conclusion:

Accepted low risk

2. Wearable Devices – Somnotouch (CDC) Development of a West Kent Sleep Service

3. Sleep Service (CDC) Development of a West Kent Sleep Service & NIV Service at MTW

From an MTW respiratory service perspective the lack of a sleep service is a negative factor in recruitment and retention of medical and physiology staff. The existing service model creates rework and missed opportunities to join up care across sleep, COPD and home oxygen services.

Furthermore, as we look to develop an MTW bariatric service access to a local sleep service will be beneficial as part of the optimisation pathway for surgery.

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk

The key functionality expected to be implemented by NHS England includes enabling:

• patients to view their outpatient appointments through the PEP.
• the Trust to send a waiting list validation questionnaire to patients through the PEP.
• provide patients with single point of access to contact the provider inc. cancel appointments.
• enable patients to access their correspondence through the PEP.

Maidstone and Tunbridge Wells NHS Trust (MTW) have procured Patients Know Best (PKB) an untethered NHSApp compliant, mature Patient Engagement Portal to deliver on the NHS England expectation.

The PEP is a key component in the ‘empowering patients and citizens’ section of MTW’s Digital and Data Strategy, aligned with our regional and the national ‘What Good Looks Like’ framework for developing digital services.

The project is aligned with the existing NHSApp integration, and PEP developments across Kent & Medway ICS. Strategically this creates a growing untethered Patient Engagement Portal across southeast, London and eastern regions which will provide patients with a single PEP with the ability to control secure sharing of their health and care information across care providers.

This strategic alignment will create ongoing opportunities for joined up pathways, standardisation of business rules within the Kent & Medway ICS and across adjoining counties.

Our deployment phase involves planning a mass enrolment of the core functions of the portal, integrated with Trust systems.

The portal is intended to patients / carers the ability to:

• View their appointments and episodes of planned and emergency care
• Request Cancel / Reschedule
• Engage with their care and the Trust through digital correspondence

• • View Appointment Letters
  • Discharge Letters
  • Endoscopy & Cardiology reports
  • Outpatient Correspondence.
• Have controlled view of test results (Path/Rad)
• Complete MTW authored Clinical and Administrative Questionnaires

• • Wait List Validation
  • Care Plans
  • Initiate Patient Initiated Follow-Up
• Utilise secure messaging to the Trust’s Clinical teams
• Enable Patients to control sharing of their MTW PKB Record to other Health Professionals.
• Enable Patients to control sharing their records outside of MTW to MTW Clinicians where Other Trusts utilise the PKB Record.

The initial October Go Live is intended for Adult Patients with Key PAS Transactions for Patient demographics, Outpatient appointments, Admissions and Discharges and correspondence where currently sent via Xerox hybrid mail, Wait list validation questionnaires and providing the ability for Patients to request a cancel or reschedule of booked appointments.

The Trust intends to continually develop a deeper use of the portal with specific Clinical services over the life of the contract.

The NHS App will make it easier for patients to register and claim their record, request cancellations and reschedule of their appointments, reducing the number of missed appointments, which will contribute to increased efficiencies and reduced waiting times for assessment and treatment.

Recommendation and conclusion:

Accepted low risk

Recommendation and conclusion:

Accepted low risk