Patient data sharing for immigration enforcement purposes: a qualitative study of healthcare providers in England
PHE ePoster Library. Papageorgiou V. Sep 12, 2019; 274435; 231
Vasiliki Papageorgiou
Vasiliki Papageorgiou
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Abstract
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Abstract Introduction
In 2017, a Memorandum of Understanding (MoU) was agreed between the Home Office and NHS Digital formalising an arrangement for non-clinical patient data to be shared to trace suspected immigration offenders, without patient consent nor, sometimes, clinicians' knowledge. Although this has since been withdrawn, critics expressed concerns about potential consequences to public and migrant health. This study explores healthcare providers' perceptions of the effects of the MoU on access to NHS services by migrant patients.Method12 semi-structured interviews were conducted in July 2018 with healthcare providers working in community, hospital or voluntary sector-based settings in England. Data were analysed using thematic analysis.
Results
Three major themes emerged regarding perceived implications to (1) patient experience, (2) ethical principles of public health, (3) power and relationships, including how participants felt the MoU was influencing migrants' health-seeking behaviour in terms of fear or concerns about accessing health services. Participants described a subsequent negative impact on the trust held between doctors and patients and referred to the policy as a challenge to their ethical principles, particularly patient confidentiality, which was contextualised by clinical specialty.
Conclusion
The MoU was regarded as threatening some of the guiding principles of the NHS, and this study highlights how sharing healthcare data may have an impact on patient experience. Future policies should consider involving medical ethicists and meaningful consultations with public bodies to help improve transparency but also to prevent any potential wider negative implications to public health owing to policy agreements influencing access to healthcare. External funding details
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