The UK's Department for Work and Pensions is drawing up plans for an internal service that allows it to automate slurps of medical data on claimants to dole out health-related benefits.
In an ad posted on the UK's Digital Marketplace, DWP said the work was currently in alpha and it now wanted a supplier to deliver a technical proof of concept to expose NHS data to the department's systems.
The aim, it said, is to cut down the time and cost involved in gathering information the department needs to make a decision about "the right support" for someone with a health condition or disability.
The ad stated the DWP had already carried out proof-of-concept research with what it described as a "medical records broker". The department declined to name this provider when asked by The Register, but the listing said Niche Health Limited – an NHS records software provider that appears to go by the name iGPR – "were engaged in the discovery phase".
The current processes that grant DWP access to NHS data are paper-based, slow and expensive, and it wants to tap into a "growing landscape" of solutions for data sharing within and beyond the NHS, the ad stated
In addition, the department's ad claimed that citizens don't always know what information is needed, and GPs don't always have details of "functional capability" – it said a digital system would speed this up and give DWP a direct line to the right professionals.
The new service aims to both digitise the current ad-hoc system for requests – which might be how a condition affects someone on a day-to-day basis – and to automate the existing process for requests for medical information, such as GP details, hospital records and conditions diagnosed.
This information is used to decide on awards for benefits like Universal Credit, Employment and Support Allowance and Personal Independence Payment, and DWP emphasised that it is shared with patient consent.
DWP said the work was being done under the "assumption" that the legal basis for data exchange would be "informed consent", but that it "would expect design assumptions to be tested through the proof of concept phase". The department declined to say what other legal bases it might consider.
'GPs shouldn't be de facto DWP assessors'
The move to link up NHS data with DWP's benefits systems comes as the department is under fire for its fit-to-work assessments, and as the government is under growing pressure over what many see as fundamental flaws in its Universal Credit scheme.
And it follows a series of government data-handling controversies, including a Memorandum of Understanding between the NHS and the Home Office for immigration enforcement that was paused under the weight of public and political opinion.
One of the criticisms of that deal was that it risked deterring people from seeking medical attention, and Med Confidential coordinator Phil Booth warned of similar problems with DWP's latest proposal.
"Patients must know that what they tell their doctor will never be used against them, and GPs must never become de facto DWP assessors due to 'data sharing'," he said. "The information patients give to their doctor must be untainted by external pressures, or people will come to harm."
Booth also claimed that NHS doctors feel under pressure not to provide fit notes to DWP in some cases, and urged the government not to bake poor processes into an automated system.
"Automating bad processes doesn't improve them – it makes them worse. And if it [DWP and its assessors] won't trust the information it already gets from NHS professionals, why should DWP have even more?"
DWP declined to answer questions from El Reg on whether impact assessments, for instance on data protection, had been carried out, or whether and how a medical records broker being involved might affect the doctor-patient relationship.
However, some of the suppliers who asked questions about the contract through the Digital Marketplace appear to have picked up on the implications of the project.
"Is there an MOU [memorandum of understanding] in place between DWP & NHS regarding data sharing?" one asked. DWP said that as it was "already working with NHS Digital, this would be an extension of this work".
The Register understands that there isn't a specific MOU in place for data-sharing, and that any work to digitise processes for information exchange has been limited to one-off projects. Patients, for example, with a terminal illness can now ask their doctor to send a form known as DS1500 electronically.
Another supplier asked if there was a "bigger picture" of when data would be shared across government, for example with councils. But DWP said this was "out of scope" of this piece of work.
Technical spec: Open-source database tech, work in AWS cloud
In the call for proposals, DWP said that a feature team in Leeds is building a system "to capture information from citizens and present this to DWP agents". This call is to find a supplier to develop a viable solution to build requests for medical information into the Leeds team's system.
"DWP require an API solution/system to expose this [NHS] data," the call document advised. "DWP are looking for direct integration if possible. A Technically Viable Product (TVP) is the outcome DWP are looking for."
The supplier ad stated that discovery phase research had "identified current and emerging technologies to support interoperability between healthcare organisations and test the viability of automating / digitising the current manual processes that surround information requests between DWP and NHS".
The department said the solution should use API gateway patterns, open source database technologies, Node.js and Java, and be containerised.
It should also should be built on cloud agnostic tools that can be deployed to an AWS platform "without much change", so it can be easily ported into DWP's Health AWS Cloud, where DWP's applications to support multiple benefit lines are hosted.
DWP said the solution would be assessed on whether it aligned with "DWP Blueprint patterns" – but when asked for more details, the department said it was an internal document that couldn't be shared, and that any solution with a DWP environment "should follow a Micro services and Event driven architecture".
The department said the outcome of the work didn't have to be production ready but would need to "be in a state that DWP can take it forward and develop and deliver it - we are looking for something beyond technical options with illustrative prototypes / wireframes".
The project, which closed for applications last night, is offered for a 12 week contract, to start by 18 March. No budget was given for the work.
The Register contacted NHS Digital for comment, and the body confirmed that this is a DWP project. ®