Data Protection Impact Assessments

Clinical triage to be completed from home during the COVID 19 pandemic via video from GoodSAM.

There is currently sparse information relating to the use of ambulance services by the prison population. Some work in Australia has investigated the use of emergency health services following release from prison, but not the use of emergency health services during stay in prison.

Previous work extracting data from clinical records in four prisons saw that many of the prison population are identified as having long-term conditions (LTCs) and are amongst some of the most vulnerable members of society.

There are 14 remand prisons within the region covered by Yorkshire Ambulance Service NHS Trust (YAS). Initial work indicated that the highest proportion of ambulance calls originating from prisons were made by Health Care Professionals (HCP). However, further details regarding the reason for calls, any treatments provided and the resulting disposition of these patients is unknown.

The aim of this evaluation is to understand the current level of demand, reasons for demand and patient disposition when emergency ambulance calls are made from prisons in the Yorkshire and Humber region.

As part of the N365 product, the Teams rollout is part of a suite of applications, including Microsoft office and will replace the out of support Office 2010 and SharePoint 2010. Products within this include; Office (Word, Excel, PowerPoint, etc.) Teams SharePoint OneDriveTEAMS DPIA – Final March 2021 Page 3 of 26 Plus additional components that will allow workflows, forms and advanced functionality to develop line of business improvements.

This DPIA needs to be read in conjunction with the NHSD DPIA

The Bike to Work Scheme has been available to Yorkshire Ambulance Staff since 2011. The platform that we use is the Vivup benefits platform. This is already available to YAS staff but we have received approval to increase the value available to staff through the scheme. The Bike to Scheme limit has been raised from £1000 to £3000.

Data is collected in order to discount salary as part of the Bike To Work scheme. The types of data collected is detailed below: The employee self-registers on the platform using their First name, Last Name and Email address. This allows them to access the dedicated Employer portal to view their benefits.

Ascenti will provide Musculo skeletal care for the Trust staff including physiotherapy.

Ascenti will hold staff data to effectively assess and treat the patient.

The Trust is participating in the National Pilot Evaluation of Body Worn Cameras (BWc). The BWC’s are capable of capturing both video and audio information. These will be used by uniformed operational staff and be fitted to their Trust issued clothing.

With the progression of technology, the devices have become smaller, lighter and more easily carried by staff. It is widely known that members of the public, going about their daily lives, are likely to have their movements and identity captured on a multitude of surveillance systems and it is of paramount importance to mitigate any privacy risks and issues associated with body worn cameras.

This pilot demonstrates YAS commitment to supporting front line staff regarding instances of violence and aggression.

The project will ask staff to share information regarding their health condition that would require an adjustment to be made to enable them to work without barriers. This information can be shared with a new manager and will contain monitoring information about the adjustment.

N365 forms with controlled limited access to SharePoint will hold the information in the FORMS application and an exported spread sheet.

Supporting the sharing of information to allow referral of patients over the age of 18 who have been clinically assessed by a Yorkshire Ambulance Service clinician and are believed to have ongoing substance misuse issues or have taken an unintentional overdose and are not conveyed by ambulance to the hospital.

The patient must consent to this referral

The the End of Life Pilot across the WY&H region is to provide interoperability between the disparate systems in the region, providing a golden thread of patient record information that is securely and appropriately available at the point of care across the full health and care system.

There is a clear case for change that is focused around the ability to deliver safer, more effective and joined-up care and to achieve more efficient (and cost-effective) internal processes.

The British Heart Foundation (BHF) are leading a project to create a National Defibrator Network (NDN) which is also known as The Circuit.

The NDN is a secure national repository of data on the location of defibrillators for public use. It is designed to synchronise every 60 seconds with the computer aided dispatch (CAD) system within each of the UK’s 14 ambulance services. In doing so, it provides the emergency dispatcher with vital data on the location of the nearest defibrillator at the time of an out-of-hospital cardiac arrest (OHCA) so that the bystander can be directed to the nearest one.

From summer 2021, location data (and relevant data such as times of opening of the building which the defibrillator is housed) will be shared through a public facing web application if the Guardian has given permission for that data to be shared.

Nationally there is an expectation and a need for all ambulance trusts to join The Circuit to map the locations of all their CPADs. The Circuit would enable us to manage all CPAD activations more effectively.

To support the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway. This will also support investigations relating to the pathway if this becomes necessary.

When making referrals, YAS clinicians will share personal information (as highlighted above) and health information about their patient with staff in the receiving service, to enable the receiving service to identify the correct patient and ensure appropriate continuity of care.

When making referrals, YAS clinicians will share personal information and health information about their patient with staff in the receiving service, to enable the receiving service to identify the correct patient and ensure appropriate continuity of care. This may include details passed to the receiving service by telephone, written Patient Information Leaflets left with a patient for a receiving clinician to use after YAS attendance, or by sharing a summary ePR directly with the receiving clinician via the Universal Receipt function.

Person-identifiable or special-category information will also be shared between the organisations for the purpose of investigations arising from patient care episodes.

Pathways team identifies an issue that they wish the service provider to investigate but this will also utilise the patient’s NHS number.

This DPIA will support the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway.

This will also support investigations relating to the pathway if this becomes necessary. YAS clinicians will share information and health information about their patients with staff in the receiving service to enable appropriate continuity of care.

YAS have a Patient Level Information Costing system which is currently undergoing a migration to a new more efficient hosted PLICS system. The software provider will process the information differently as in it will be hosted by the supplier rather than YAS

When making referrals YAS clinicians will share personal information and health information about their patient with staff at the receiving service. This will enable the receiving service to identify the correct patient and ensure appropriate continuity of care.

This information will also be shared between the organisations for the purpose of investigations arising from patient care episodes.

To support the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway. This will also to support investigations relating to the pathway if this becomes necessary.

To support the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway. Also to support investigations relating to the pathway if this becomes necessary.

Manual phone communications between Trusts to be replaced by an automated system transfer of patient information using the Trust’s CAD system to transfer and receive patient/caller information related to the patient/patients details and health/condition.

Research studies that involve determining outcomes of patients who receive care from Yorkshire Ambulance Service require the linking of ambulance data with other datasets, such as hospital episode statistics and Office for National Statistics mortality data. This is achieved by utilising NHS Digital, who acts as the gatekeeper for these datasets.

To support the onward referral of patients from 999 into primary care disposition following NHS Pathways assessment.

Information is collected at the point of calling 999, this information is then added following a clinical consultation.

The information is then shared with primary care providers to enable onward referral.

Supporting the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway.

This will also support investigations relating to the pathway if this becomes necessary.

To support the formation of an agreement with Barnsley council enabling YAS EOC staff to refer patients who fall and need assistance to the service and to monitor the effectiveness of the pathway. This will also support investigations relating to the pathway if this becomes necessary

Yorkshire Ambulance Service (YAS) and the University of Sheffield (UoS) have a long history of data sharing for research purposes, in order to improve the standard of care provided to our patients and service users.

Previously, separate DPIAs have been created for every study, despite the fact that the legal basis, type of data and method of transfer are usually the same.

This DPIA is intended to cover all future transfers of patient identifiable data between YAS and the UoS, and follows guidance issued jointly by the HRA, MHRA and ICO

As a result of legislation coming into force on 11th Nov 21, only staff who are fully vaccinated against Covid 19 or medically exempt will be able to enter care homes. Currently the Trust hold this information in COVMIS.

This information was obtained as a result of staff receiving their vaccination from YAS or by providing information to YAS about vaccinations obtained elsewhere. This information relating to YAS driving staff & Volunteers will be extracted from COVMIS and entered onto Cleric, the PTS dispatch system. This information will then be available to Logistics staff to enable them to plan appropriate journeys to staff.

The High Intensity User Group meeting shares information relating to patients who are making frequent contact with emergency services to identify and assess unmet health, social and environmental needs.

The group ensures individual patients receive the most appropriate care for their needs whilst protecting the capability of member services to respond to others within the community by managing demand on services.

To support the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway. This will also support investigations relating to the pathway if this becomes necessary.

YAS apprenticeship programme currently utilises the ESFA ILR entry tool to upload learner details to the ESFA and claim funding. This is an inputting tool used to create xml reports, it is downloaded from the government ESFA website and located on two YAS laptops.

We are switching from this to the Health Education England provided management information system Maytas. Maytas is managed by Health Education England through a contract of services with the developer and supplier Tribal Education Ltd. HEE will provide user licences and access to YAS for use of the Maytas system and will process and validate YAS learner data.

Patient facing staff will be advised by secure email/letter to home address that their vaccination status will be downloaded directly from NIVS.

Details of evidence downloaded from NIVS will be uploaded to Covmis. In time, all data from Covmis will be extracted and migrated in bulk to ESR. Covmis at this point will be de-commissioned.

Supporting the formation of an updated clinical pathway allowing YAS clinicians to refer patients to the service and to monitor the effectiveness of the pathway.

Also to support investigations relating to the pathway if this becomes necessary.

The Counter Fraud team at AuditOne completed a proactive review of Staff Expenses and Eligibility which was finalised in July 2020. The following conclusions were made: Governance, risk management and control arrangements provide limited assurance that the risks identified are managed effectively. Compliance with the control framework was not found to be taking place. Immediate and fundamental remedial action is required. Due to the inconsistency in mileage and expenses claims the Trust is required to introduce an electronic software system for the claiming of mileage and expenses claims. The software the Trust has chosen is E-Expense DPIA December 2021 v1.0 Signed Page 3 of 20 only one of two which is authorised to work with ESR and is provided by Giltbyte. The software they own that we will use is called Easy

Ambulance Staff, volunteers and student paramedics are to be encouraged to complete the national Association of Ambulance Chief Executives (AACE) survey, conducted by Zeal Solutions Ltd, so their IPC experiences and feedback, with resulting trends and themes, can be used to identify:

1) best practice across the United Kingdom

2) areas where the sector can do better, with subsequent sharing of actions and timeframes to address the learning

3) the impact of IPC requirements on staff confidence, attitudes and behaviours in the workplace.

This key aim of the EOC BC Improvements project is to improve the resilience of the EOC in the event of a business continuity event which leads to the loss of EOC services. It aims to introduce and facilitate a move towards a 50/50 model in the delivery of the core dispatch function, split equally between the Wakefield and York sites.

Key job roles will also be based equally between the two sites. One of the key aspects of this project is the re-location of current staff (non EOC) from offices currently based on the first floor at Fairfields. Staff will have the option to either use hot desk facilities on the ground floor of Fairfields or move to other Trust locations. Therefore, there will be a requirement to consult with circa 48 members of staff affected by the relocation.

Currently IUC/111 verbally shares information with third party ambulance services to dispatch emergency medical assistance following telephone triage of patients. The new process does not impact on what information is shared, just the method of sharing.

The new process will send the information electronically via secured ITK messaging from 111 into the recipient system. This is required to speed up ambulance response time, reduce 111/IUC call length and improve accuracy.

The data forms the clinical record, documenting history of events the assessment findings, treatments following urgent or emergency face to face care.

The data is used for direct patient care which includes generating an accurate patient record. Including access to some additional plans of care e.g. mental Health or End of Life. In- addition the use for incident investigation, clinical audit purposes and may include research*. *Research ethics and consent will be followed as per national guidance.

One of the key aspects of this project is the realignment of current workforce with the roles of Emergency Care Assistant; Emergency Care Assistant (ASW); EMT 1; EMT 1/Student Paramedic (BU); EMT 1 (AAP); Assistant Practitioner and Urgent Care Support Worker to the new A&E career framework model and new roles. Therefore, there will be a requirement to consult with circa 1200 members of staff affected by the organisational change.