May 2021

Request received

Please tell me how many children who access the Roston overnight facility for disabled children in Camborne are currently receiving their full entitlement or allocation of overnight stays. Please provide data as at 30 April 2021 (or as near to that date as possible).

Our response

NHS Kernow does not hold the information requested, for more information please contact Cornwall Partnership NHS Foundation Trust’s freedom of information team who are the providers.

Request received

1. How much money does your integrated care system (ICS) spend on radiology outsourcing, overall and per outsourcing provider if multiple providers exist?
2. What percentage of total radiology spending does this correlate to?
3. How many vacancies for consultant radiologists exist in your ICS?
4. What percentage of personnel costs are spent on locum staff in your reporting radiology department?
5. Has your ICS invested in radiology artificial intelligence products? If so, please detail the annual costs per artificial intelligence tool purchased.
6. What PACS and RIS provider(s) are you currently using at your ICS? Please provide the annual spend for such software.
7. Please describe the amount of x-ray images taken in your ICS by body part.

Our response

NHS Kernow does not hold the information requested. Whilst Cornwall and the Isles of Scilly is deemed to be an ICS it is not a legal entity in its own right and is made up of multiple health and care organisations working collectively.

Royal Cornwall Hospitals NHS Trust and University Hospitals Plymouth NHS Trust are the providers of radiology services for residents of Cornwall and the Isles of Scilly. Please contact them to find out if they hold the information you need.

Request received

Please supply all evidence that NHS Kernow considered in relation to the assessment dated 12 January 2021 by the multi-disciplinary team recommending that (name redacted) was refused continuing healthcare. Please also provide the basis of NHS Kernow’s decision to accept that recommendation.

How many people with dementia have been accepted for CHC and how many people with dementia have been rejected for CHC by NHS Kernow over the past 3 years?

Our response

NHS Kernow exempts this information on the grounds that it is personal information. Advice has been given that this question is more appropriate to the subject access request process.

• 2018/2019: Eligible = 47, not eligible = 191, total = 238
• 2019/2020: Eligible = 15, not eligible = 139, total = 154
• 2019/2020*: Eligible = exempt, not eligible = exempt, total = 42

Please note that the information provided is the number of people who had a checklist in the years requested and not all people in Cornwall and Isles of Scilly who have a diagnosis of dementia.

* For 2021, NHS Kernow holds the information but where the numbers are less than 5, the information cannot be disclosed. It could potentially identify the individuals involved, especially if combined with other data, this would constitute a breach of the Data Protection Act 2018. Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information.

Request received

1. The number of people assessed by the CCG as being eligible for full NHS continuing healthcare (CHC) funding who are currently having only a percentage of the entire cost of their care package funded by the CCG.
2. If there are people who are assessed as eligible for full CHC funding but are having only a percentage of their care package funded by the CCG, in how many cases is the reason because they have received a personal injury compensation pay out?
3. The number of cases in the last 10 years where the CCG has assessed a person to be eligible for full NHS CHC but has only paid a percentage of the overall cost of the assessed care package.

Our response

Questions 1 to 3 is zero. Please note that NHS Kernow was formed on 1 April 2013. If you require information prior to this date please contact Department of Health’s legacy team.

Request received

1. How do you obtain blood collection tubes for liquid biopsies on cancer patients?
2. From what suppliers do you obtain these products?
3. Were these products purchased through a tender or framework? If so, which one? Please provide details including the name, reference and where this was published.
4. Are you under contract with your current supplier(s) for the above? If so, what is the start and end date of the contract?
5. Can you provide the name and contact details for the person(s) responsible for procuring these products?
6. Can you provide contact details for the department responsible for managing this service?

Our response

NHS Kernow does not hold the information requested, for more information please contact Royal Cornwall Hospitals NHS Trust.

Request received

1. Which of the following orthotic services do you have locally? Product and clinical, product only in-house, clinical service only or fully managed service?
2. If your service is run by a third party, who is your current provider? When did the current agreement start? When does the current agreement expire? What was the total value of the contract? Is there an allowance for increasing patient numbers and activity each year? Is the contract a lump sum, block contract or pay or BPR for activity basis? What is the current cost per orthotist session in your trust?
3. Do you run your tender in-house or is it outsourced?
4. Which frameworks are you able to buy from currently for orthotic:
   • clinical service
   • stock products
   • bespoke products
5. Are you considering a tender at the moment?
6. What orthotics services are provided by the NHS in your jurisdiction?
7. How many sessions do you run per week for orthotists, LOP and footwear technicians?
8. How many full-time equivalent orthotists work in your trust?
9. How many appliance officers and administrators do you employ in the orthotics service?
10. Over the past 3 financial years how many orthotics patients were treated (please breakdown by year)?
11. For orthotic product, which do you currently order orthotic footwear from or do you make these in house? Which companies do you currently order insoles from or do you make these in house? Please provide annual volumes of prescriptions and orders and total spend for the last 12 months (April 2017 to March 2018) and the lead times.

Our response

For questions 2 (current cost per Orthotist session in your trust) and 7 to 11 inclusive NHS Kernow exempts release of this information under section 43(2) of the Freedom of Information Act.

1. Fully managed service.
2. Service information:
   • current provider: Steepers
   • Agreement start date: 30 April 2018
   • Agreement expires: 29 April 2022
   • Total value of the contract: 1.04m (circa) per annum
   • Allowance for increasing patient numbers and activity: Yes, via contract terms
   • Contract activity: Blended of block for service element and payment for consumables according
3. In house.
4. NHS supply chain national framework.
5. No.
6. None.

Request received

Treliske hospital have very kindly provided me with your contact details in response to my enquiry about the transport provision by Ezec for the trust. I would be grateful if you could provide me with the service level agreement that exists between yourselves as the commissioning agent and the provider Ezec for transport for the trust.

Our response

Please email our FOI team to request a copy of the service level agreement.

Request received

1. How many cyber attacks (incidents) did your organisation experience in the last 3 years?
2. If these statistics are available within the cost limit, how many of those incidents involved malware, ransomware, hacking or phishing emails?
3. How many incidents over the last 3 years were reported to the Department of Health and Social Care (DHSC), whether under the Security of Network and Information Systems Regulations 2018, or otherwise?
4. How many incidents over the last 3 years resulted in a notification to the Information Commissioner’s Office (ICO)?
5. How many incidents over the last 3 years were reported to both DHSC and the ICO?

Our response

NHS Kernow exempts the release of the information requested under section 31(3) of the Freedom of Information Act (FOIA).

Section 31(3) of the FOIA allows a public authority to neither confirm nor deny whether it holds information where such confirmation would be likely to prejudice any of the matters outlined in section 31(1). This includes information the disclosure of which would or would be likely to prejudice the prevention or detection of crime.

As section 31(3) is a qualified exemption, it is subject to a public interest test for determining whether the public interest lies in confirming whether the information is held or not.

Factors in favour of confirming or denying the information is held

NHS Kernow considers that to confirm or deny whether the requested information is held would indicate the prevalence of cyber attacks against the organisations ICT infrastructure. This would reveal details about the organisation’s information security systems. NHS Kernow recognises that answering the request would promote openness and transparency regarding the organisation’s ICT security.

Factors in favour of neither confirming nor denying the information is held

Cyber attacks, which may amount to criminal offences for example under the Computer Misuse Act 1990 or the Data Protection Act 2018, are rated as a tier 1 threat by the UK Government. NHS Kernow, like any organisation, may be subject to cyber attacks. Since it holds large amounts of sensitive, personal and confidential information, maintaining the security of this information is extremely important.

NHS Kernow considers that confirming or denying whether the requested information is held would provide information about our information security systems and its resilience to cyber attacks. There is a very strong public interest in preventing the organisation’s information systems from being subject to cyber attacks. Confirming or denying the type of information requested would be likely to prejudice the prevention of cybercrime, and this is not in the public interest.

If NHS Kernow were ether to confirm or deny the existence of the information, the disclosure would be likely to prejudice the effective conduct of public affairs for the organisation, the NHS or any other government department. As such conflicts with section 36(2c) of the FOIA.

Balancing the public interest factors

NHS Kernow has considered that if it were to confirm or deny whether it holds the information, it would enable potential cyber attackers to ascertain how and to what extent we are able to detect and deal with security attacks. NHS Kernow’s position is that complying with the duty to confirm or deny whether the information is held would be likely to prejudice the prevention or detection of crime, as the information would assist those who want to attack the organisation’s ICT systems.

Disclosure of the information would assist a hacker in gaining valuable information as to the nature of NHS Kernow’s systems, defences and possible vulnerabilities. This information would enter the public domain and set a precedent for other similar requests. Which, in principle, would result in NHS Kernow being a position where it would be more difficult to refuse information in similar requests.

To confirm or deny whether the information is held is likely to enable hackers to obtain information in mosaic form combined with other information to enable hackers to gain greater insight than they would ordinarily have, which would facilitate the commissioning of crime such as hacking itself and also fraud. This would impact on NHS Kernow’s operations including its front line services. The prejudice in complying with section 1(1)(a) FOIA is real and significant as to confirm or deny would allow valuable insight into the perceived strengths and weaknesses of NHS Kernow’s ICT systems.

Request received

1. How many estimated adult patients have type 1 diabetes in NHS Kernow?
2. How many adult type 1 diabetes patients registered are under primary care and not seen in secondary care for their annual review?
3. How many of these patients have type 1 diabetes and have an A1c as recorded above 9mmol?
4. How many of these patients with an A1c of 9mmol and wear CGM?

Our response

1. 3,005
2. Primary care carry out all annual reviews. People are seen in secondary care for any complications such as foot care or renal disease.
3. 305.
4. NHS Kernow does not hold this information. This may be available from the providers, please contact Royal Cornwall Hospitals NHS Trust or University Hospitals Plymouth NHS Trust.

Request received

1. The current wait time for an undiagnosed adult to see a psychiatrist for ADHD after being referred from a GP on the NHS.
2. The current wait time for an undiagnosed child to see a psychiatrist for ADHD after being referred from a GP on the NHS.
3. The current wait time to see a cognitive behavioural therapist for ADHD following an ADHD diagnosis.
4. The number of children (under the age of 18) with an ADHD diagnosis.
5. The number of children (under the age of 18) with an ADHD diagnosis who are also being treated for a psychiatric comorbidity. Including, but not limited to: depression, anxiety, personality disorders such as borderline personality disorder, sleep disorders and substance abuse. Please provide this as a breakdown by comorbidity.
6. The number of adults (over the age of 18) with an ADHD diagnosis.
7. The number of adults (over the age of 18) with an ADHD diagnosis who are also being treated for a psychiatric comorbidity. Including, but not limited to: depression, anxiety, personality disorders such as borderline personality disorder, sleep disorders and substance abuse. Please provide this as a breakdown by comorbidity.
8. Please could you also provide the average wait time for each year from 2015-2020, if doing so will not push this request over the cost limit.

Our response

NHS Kernow does not hold the information requested, for more information please contact Cornwall Partnership NHS Foundation Trust.

Request received

1. Have NHS Kernow checked the qualifications of all the people providing talking therapy, psychotherapy and cognitive behavioural therapies by a counsellor, psychotherapist or mental health assistant at your practices? As well as other commercial services you send patients to? If so, how have you done this?
2. Could you provide me with the most up to date documents and guidance you have on how you choose providers for your therapy services?
3. Have NHS Kernow paid for patients to have therapy/treatment through the NHS with unqualified, unregulated and unsupervised commercial services? Meaning those providing the therapy at these commercial services have not undertaken the appropriate recognised training, do not hold an honours degree in a relevant subject and are not on one of the voluntary registers accredited by The Professional Standards Authority.

Our response

1. No, this is the responsibility of the provider. Further information regarding contract requirement is available on NHS England website and the NHS standard contract (section 5 staff).
2. To request a copy of the procurement protocol, please email our FOI team.
3. No.

Request received

1. Do you currently use any form of electronic signing tool?
2. If yes, who is your current provider? When does the contract expire? How much does it cost per year? How many licences (users or transactions) do you have?
3. How many documents do you send for signature and approval annually? What percentage are printed?
4. Are your signing processes primarily paper-based?
5. What is your current annual spend on paper, postage and document storage?
6. Do you currently have any active projects or initiatives aimed at reducing the amount of paper-based processes?
7. If so, who is leading it?
8. How much employee time is it taking to create, send, chase and store documents that require signature?
9. How many employees do you have?
10. What percentage of employees work remotely?
11. Can you provide names and contact details for the following people within your organisation? CIO and IT director, head of IT, head of digital transformation, head of housing operations, head of legal, head of HR and head of legal services.
12. Do you currently use any of the following Microsoft applications? Office 365, SharePoint, Teams, Dynamics and Power Automate>
13. Do you use any Adobe products? If yes, which ones?
14. What primary software systems do you use? (deployed systems, product name, vendor, version, contract end date and number of licences) for human resources, patient related, legal services and email and collaboration?
15. Do you have a senior information risk officer (SIRO) and Caldicott Guardian? If so, can you please share their contact name, email and phone number.
16. Understanding that every member of the NHS has to be GDPR compliant, what is the current approval and signature process?

Our response

1. No.
2. Not applicable.
3. NHS Kernow does not hold this information.
4. Yes- currently use electronic signatures or email verification.
5. NHS Kernow does not hold the information broken down as required. For 2020/21 financial year the spend for stationery including paper was £3,086, postage and carriage was £7,990 (this includes all delivery charges, not just postage), packing and storage was £7,547 (this includes all storage costs, not just document storage).
6. Yes.
7. NHS Kernow does not release the names of employees below director level. Paul Hulme, interim director of people and corporate services.
8. NHS Kernow does not hold this information.
9. 287.
10. Approximately 95%.
11. NHS Kernow does not release the names of staff below director level. Andrew Abbott is the director responsible for IT.
12. We use Office 365, SharePoint, Teams and Power Automate.
13. No.
14. We use ESR for human resources and NHS.net for email and collaboration.
15. Yes. Our SIRO is Clare Bryan, chief financial officer and our Caldicott Guardian is Natalie Jones, chief nursing officer.
16. Mandatory e-learning training package.

Request received

1. What is the name of the ICS and STP?
2. Does your ICS and STP currently have in place a strategy to deliver a community diagnostic hub (CDH) to match the 1 CDH per 1m capita by 2024? If yes, answer questions 3 to 5. If no, answer questions 6 to 8.
3. Who is responsible for delivering the implementation of a CDH in your local area? Please provide full name, job title, relevant contact details and the organisation or body.
4. How advanced do you expect the CDH to be within the next 3 financial years?
5. What will be the funding mechanism for CDH delivery in your ICS and STP?
6. Is your ICS and STP currently preparing a strategy to deliver a CDH over the next 3 financial years?
7. Who is responsible for developing your local CDH delivery strategy if it is not being developed by your specific ICS and STP?
8. If there is no strategy in place that you are aware of, what is the reason that your ICS and STP is not developing a strategy to deliver a CDH?
9. Does your ICS and STP intend to incorporate new build options to deliver your CDH? If yes, will you utilise any existing estate? If no, does your existing estate currently have the resources needed to deliver your CDH? If you intend to use both new and existing estate, what is the split likely to be?
10. Will you be seeking to work with private partners to deliver your CDH? If so, what will be the timescales for inviting stakeholders to tender.
11. Within your ICS and STP, where does delivering a CDH sit within your current spend priorities at the acute level? Please outline in priority order your top 3 projects at present. If delivering a CDH is not within your top 3 projects at present, please explain why, and where possible, please outline the timescale for which you expect delivering a CDH will be within your top 3 priority projects.

Our response

1. Cornwall and Isles of Scilly Health and Care Partnership.
2. No, strategy is currently in development.
3. Not applicable.
4. Not applicable.
5. Not applicable.
6. Yes.
7. It is being developed by the ICS.
8. Strategy is currently in development.
9. At present we are looking at existing locations, however, new facilities may be needed once estates feasibility work is completed.
10. This has not yet been determined.
11. Cornwall and Isles of Scilly Health and Care Partnership are currently undergoing a prioritisation process, so it is not possible to answer this question currently.

Request received

1. Would you please be so kind as to confirm whether you provide IVF treatment to women whose partner already has living children so that we may update our records accordingly?
2. Additionally, should you be able to provide any explanation on the position of your CCG in respect to this matter, it would be greatly appreciated.

Our response

All NHS Kernow’s commissioning policies including assisted conception can be found on our website.

The criteria that cover previous children is included below:

3.3 Previous children: Assisted conception treatment is restricted to couples where:

• there are no living children from the current relationship
• at least 1 partner does not have any living children from previous relationships

This includes biological and legally adopted children and offspring who are adults

This was updated from a position in 2019 where no NHS funding was available if either partner had living children from a previous relationship.