Patient Experience Research Centre, Imperial College London School of Public Health, London, UK
Department of Global Health and Development, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.
BMJ Open. 2020 Feb 12;10(2):e033202. doi: 10.1136/bmjopen-2019-033202.
To explore healthcare providers' perceptions and experiences of the implications of a patient data-sharing agreement between National Health Service (NHS) Digital and the Home Office on access to NHS services and quality of care received by migrant patients in England.
A qualitative study using semi-structured interviews, thematic analysis and constant-comparison approach.
Eleven healthcare providers and one non-clinical volunteer working in community or hospital-based settings who had experience of migrants accessing NHS England services. Interviews were carried out in 2018.
England.
Awareness and understanding of the patient data-sharing agreement varied among participants, who associated this with a perceived lack of transparency by the government. Participants provided insight into how they thought the data-sharing agreement was negatively influencing migrants' health-seeking behaviour, their relationship with clinicians and the safety and quality of their care. They referred to the policy as a challenge to their core ethical principles, explicitly patient confidentiality and trust, which varied depending on their clinical specialty.
A perceived lack of transparency during the policy development process can result in suspicion or mistrust towards government among the health workforce, patients and public, which is underpinned by a notion of power or control. The patient data-sharing agreement was considered a threat to some of the core principles of the NHS and its implementation as adversely affecting healthcare access and patient safety. Future policy development should involve a range of stakeholders including civil society, healthcare professionals and ethicists, and include more meaningful assessments of the impact on healthcare and public health.
探讨医疗保健提供者对国民保健服务（NHS）数字与内政部之间的患者数据共享协议对英格兰移民患者获得国民保健服务和所接受护理质量的影响的看法和经验。
使用半结构化访谈、主题分析和恒比法的定性研究。
11 名在社区或医院环境中工作的医疗保健提供者和 1 名非临床志愿者，他们有移民使用英格兰国民保健服务的经验。访谈于 2018 年进行。
英格兰。
参与者对患者数据共享协议的认识和理解各不相同，他们将此协议与政府缺乏透明度联系起来。参与者深入了解了他们认为数据共享协议如何对移民的寻医行为、他们与临床医生的关系以及他们的护理安全和质量产生负面影响。他们将该政策视为对其核心伦理原则的挑战，这些原则明确涉及患者保密性和信任，具体取决于他们的临床专业。
政策制定过程中缺乏透明度可能导致卫生工作者、患者和公众对政府产生怀疑或不信任，这是权力或控制观念的基础。患者数据共享协议被认为对国民保健制度的一些核心原则及其实施构成威胁，因为它对医疗保健的获取和患者安全产生了不利影响。未来的政策制定应涉及包括公民社会、医疗保健专业人员和伦理学家在内的一系列利益相关者，并对其对医疗保健和公共卫生的影响进行更有意义的评估。
