WannaCry prompts promise of extra cash towards NHS security
UK.gov pledges transparency in long-awaited response to data and consent reviews
The NHS is to get a funding boost for cybersecurity measures, while the UK government has promised patients a digital service that lets them see who's accessed their health records.
The commitments are part of its response to two reviews into patient data – one from the National Data Guardian for health and care, Fiona Caldicott, and one from the Care Quality Commission – that were published last year.
The response (PDF) accepts the recommendations of both reviews, which included a simplified model for consent, the adoption of 10 data security standards and significant improvements to the way data use is communicated to the public.
'Small changes just as good as dosh'
The government also took the opportunity to emphasise that it is tackling security problems within the NHS, dedicating a section to lessons learned from May's WannaCry attack that brought many hospitals to their knees.
It pledged to boost investment in data and cybersecurity "above" the £50m promised in the last Spending Review. Although the government didn't put an exact figure on this, it said £21m of the total pot will be prioritised to boost resilience at major trauma sites.
A further chunk will be used to address "key structural weaknesses" like unsupported systems. The government said work was under way to figure out the fastest and most cost-effective way to do this, and NHS Digital is to publish technical advice on how to identify such systems this month.
"Local organisations should be aiming to have isolated, moved away from or be actively managing any unsupported systems by April 2018," the response said.
However, the government also argued that "small changes can make big differences" and emphasised the need for better staff training and leadership on security issues.
Simple changes involving people and processes are often more effective than implementing expensive technological solutions; high-value rather than high cost interventions.
We are aware of incidents where cyber-attacks have exploited basic vulnerabilities that could have been avoided by regularly reviewing existing firewall rules and password management practices, actions costing very little, but requiring vigilance, education and commitment.
Such efforts will involve a culture change within organisations, more clarity about what happens when people don't pass training (spoiler: help them understand how to handle data properly) and a revamped information governance toolkit – due in April 2018.
Clarity on consent
The government also announced plans to help people understand how, why and when their data is being used.
By December 2018 it plans to have a digital service for people to see who has accessed their summary care record, and, by March 2020, an online service for people to see how their data is being used for purposes other than direct care.
There will also be a simpler consent and opt-out model that offers more clarity on how personal information will be used outside of direct care, and when data sharing is a legal requirement.
The new approach will be phased in, with all patients who have already registered a type one opt-out (which objects to identifiable data being shared outside of their GP) honoured until 2020.
Those with a type two opt-out (which says people don't want identifiable data to be shared beyond NHS Digital) will be helped to transfer over, the government said.
There are also commitments to stronger sanctions for data misuse and to put the National Data Guardian on a statutory footing, as well as plans for better public education campaigns.
Phil Booth, co-ordinator of campaign group MedConfidential, welcomed the government's commitment to ensure people know how their medical records are being used.
"This means that patients will have an evidence base to reassure them that their wishes have been honoured," he said. "Some of the details remain to be worked out, but there is a clear commitment from the Secretary of State. The focus on digital tools shows the benefit to the whole NHS of the work towards NHS.uk. It is now up to NHS Digital and NHS England to deliver."
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