About the Primary Care Appeals service
NHS Resolution is responsible for ensuring a prompt and fair resolution of appeals and disputes between primary care contractors (including GPs, dentists, opticians and pharmacists) and NHS England. The Primary Care Appeals service handles this area of work. The Primary Care Appeals service also maintains a database of primary care contractors who have had decisions affecting their inclusion in the National Performers Lists which enables pre-employment checks to be carried out.
What personal (including sensitive/special categories of) data do we collect?
We collect the following information:
- Primary care contractors: name, and address, appeals or disputes you have lodged and associated submissions and evidence, including financial, performance and health-related matters with regard to said appeal or dispute. For Performers List matters, the name, address, date of birth and professional registration number and any associated documents provided by the commissioning body. This information also includes the names of any Directors and, where relevant, professional registration number.
- NHS staff members: contact details, submissions with regard to any appeals or disputes.
- Consultant advisors: contact details, advice as to appeals or disputes, financial information in relation to fees.
- Panel members: contact details, professional qualifications, registration or membership numbers, training records, financial information in relation to fees.
- Service providers (solicitor): contact details, information concerning involvement in the handling of an appeal or dispute, financial information in relation to fees.
- Public feedback on pharmacy applications: name, address, postcode, email address and consultation feedback.
- Demographic data: the ethnicity of the person lodging the appeal or application for dispute resolution.
How we use your personal data
We use this information for the following purposes:
- Determining appeals against decisions in accordance with the NHS (Pharmaceutical Services) Regulations 2013 concerning the provision of NHS pharmaceutical services and GP dispensing services;
- Determining contractual disputes between primary care contractors and NHS England;
- Determining disputes over the assessment of GP Registrars’ allowances under relevant Directions;
- Determining other occasional appeals and applications under various regulations and directions governing primary care;
- Responding to enquiries from NHS England Local Area Teams or those acting on their behalf as to whether there have been any decisions taken against a primary care contractor on the relevant National Performers List; and
- Analysing demographic data to ascertain if, amongst other things, certain groups are over or under represented in appeals and disputes in order to share learning.
Please note that decisions, including the name of the contractor, are published on the NHS Resolution website.
We also use information held by the Primary Care Appeals service for the purposes of internal training and the auditing of our decisions.
How we collect your data
Where data has been obtained indirectly, the personal data is obtained from NHS England and Health Boards (Wales, NI and Scotland).
Where we receive data that has been collected from public sources such as public feedback on pharmacy applications, providing we have contact details, such as an email address, we will inform the data subject of the personal data we are holding within a reasonable period of obtaining the personal data and no later than one month. The exception to this is where there would be disproportionate effort (to provide the privacy notice).
We will not share this data with other third parties.
How long we keep your personal data
In order to determine how long we keep your personal data, we follow the NHS Records Management Code of Practice. You can find information about our retention schedules in our Records Management Policy – this document will outline the duration that we keep specific information for.
Who we share your personal data with
We share information with third parties such as our legal panel, police, NHS Counter Fraud Authority, the Department of Health and Social Care or other government departments, regulatory and/or other public authorities, to comply with legal obligations or where this is otherwise necessary and it is lawful to do so, including disclosures made to protect patient safety or to enhance public protection.
The lawful basis for processing your data
For all of the processing of personal data undertaken by Primary Care Appeals, the lawful basis for processing is:
- It is necessary for compliance with a legal obligation;
- It is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller; and
- It is necessary for reasons of substantial public interest, on the basis of Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.
Processing data outside of the European Economic Area
In some cases we process your personal data outside the European Economic Area (EEA) where countries may not have laws which protect your personal data to the same extent as in EEA.
We are obliged to ensure that your personal data is processed securely and is protected against unauthorised access, loss or destruction, unlawful processing and any processing which is inconsistent with the purposes set out in this privacy notice.
Currently we use:
We have reviewed and risk assessed third parties that hold and process data outside of the EEA and are satisfied with their assurance – for example, we will not consider organisations that are not signed up to the Privacy Shield.
We will update this privacy notice from time to time to reflect any changes to our ways of working. Please contact our Data Protection Officer if you would like more information about the safeguards we have in place.
The right to lodge a complaint with your local supervisory authority
You have the right to lodge a complaint about the way we handle or process your personal data with a supervisory authority.
We ask that you please attempt to resolve any issues with us first, although you have a right to contact your supervisory authority at any time.
The supervisory authority for the UK is the Information Commissioner.
Subject access requests
We are legally required to act on requests and provide information free of charge with the exception of requests that are manifestly unfounded, excessive or repetitive.
If we determine this to be the case we may charge a reasonable fee or refuse to act on the request. We will respond to acknowledge your request and provide the information within one month of receiving your request. Please send your request to: email@example.com.
NHS Resolution contact details
NHS Resolution’s purpose is to provide expertise to the NHS to resolve concerns fairly, share learning for improvement and preserve resources for patient care.
We provide the following core services to our customers:
- Claims Management delivers expertise in handling both clinical and non-clinical claims through our indemnity schemes.
- Practitioner Performance Advice delivering an expert advice, support and interventions on the fair management of concerns about the performance of doctors, dentists and pharmacists.
- Primary Care Appeals offers an impartial resolution service for the fair handling of primary care contracting disputes.
- Safety and Learning supports the NHS, our members and beneficiaries to better understand their claims risk profiles, to target their safety activity while sharing learning across the system to improve patient care.
Our contact details are available on our contact web pages.
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