I am writing to make an open government request for information under the Freedom of Information Act 2000. This request seeks to understand key clinical technology stacks, associated suppliers and contract durations at East Lancashire Hospitals NHS Foundation Trust.
Please provide information regarding the use of the following clinical software systems at East Lancashire Hospitals NHS Foundation Trust:
· EPR (Electronic Patient Record): An Electronic Patient Record (EPR) is a digital version of a patient’s paper chart. EPRs are real-time, patient-centered records that make information available instantly and securely to authorized users.
· Patient Engagement Portal: A Patient Engagement Portal is an online platform that enables patients to interact with their healthcare providers, access their medical records, schedule appointments, and receive educational materials and support.
· Patient Access System: A Patient Access System allows patients to manage their appointments, access personal health information, and communicate with healthcare providers, enhancing their overall experience and engagement.
· Virtual Ward Software: Virtual Ward Software is used to manage and monitor patients remotely, typically those with chronic conditions or those recovering from surgery, to provide continuous care and reduce hospital admissions. – see below cyber exemption
· Population Health Management Software: Population Health Management Software helps healthcare providers manage and analyze health data for a specific population to improve health outcomes, reduce costs, and enhance the patient experience.
· Contact Centre: Contact Centre software facilitates communication between patients and healthcare providers, managing inbound and outbound calls, emails, and other forms of communication efficiently. – see below cyber exemption
· Telecare Software: Telecare Software provides remote care services to patients, using technology to monitor health conditions and support independent living, often for elderly or disabled individuals. – see below cyber exemption
For each clinical system listed above, please provide the following details where possible:
a) System type:
b) Supplier name:
c) System name:
d) Date installed:
e) Supplier contract expiration: - see below commercially confident exemption
f) Is this contract annually renewed? - Yes/No - see below commercially confident exemption
g) Do you currently have plans to replace this system? - Yes/No
h) Procurement framework:
i) Other systems it integrates with: - see below cyber exemption
j) Total value of contract (£): - see below commercially confident exemption
k) Notes - e.g. we are currently out to tender:
l) Framework used:
l) If no system exists, what alternative do you use?
Trust Response:
Please see attached document.
Cyber exemption –
We believe that disclosing details would undermine the cyber security of our infrastructure. It would reveal information about our cyber security operations and architecture which would be useful to potential cyber-attackers. We have therefore withheld this information in accordance with sections 31(1)(a) and (b) as well as section 24(1) FOIA. These are qualified exemptions and require a public interest test to be performed, as follows.
The NHS is aware of the increasing threat of cyber-crime to organisations, especially including high-profile organisations such as the NHS. With this in mind, we consider that disclosure of core architecture would prejudice the prevention and detection of crime (including cyber-crime) and also the apprehension and prosecution of offenders. Therefore, this information is exempt by virtue of section 31(1)(a) and (b) FOIA. This is a qualified exemption and the public interest test applies.
We accept there is a legitimate public interest in the effectiveness of measures being employed to keep the NHS safe and secure. This is especially important given that this infrastructure is maintained using public fund. However, this is outweighed by the risks of criminal activity being undertaken if the information was disclosed. The release of this material could provide valuable information to those wishing to launch a cyber-attack against the Trust or the wider NHS. Knowledge of the core architecture would allow potential cyber-attackers to build up a picture of our capability and capacity in this area. It could provide those groups or individuals with an indication of where to focus their efforts when targeting our systems. Groups planning attacks are known to conduct extensive research and will take advantage of the ‘mosaic effect’ by combining information from different sources. If this information were to be combined with other information already in the public domain or obtained from elsewhere, the disclosure of it could assist in mounting an effort to breach or bypass cyber security measures, with serious consequences for both staff and patients.
In these circumstances it is our view that the public interest in maintaining the exemption outweighs the public interest in disclosing the information.
Section 24(1) – National security
In addition to the increased threats and incidents of cyber-crime, national security is also increasingly under threat from those organisations and individuals who seek to use technology to disrupt the workings of public bodies. To limit these risks, we are also withholding the information for the purpose of safeguarding national security. This information is therefore also exempt by virtue of section 24(1) FOIA. This is a qualified exemption and the public interest test applies.
Again, we accept there is a legitimate public interest in the effectiveness of measures being employed to keep the NHS safe and secure. This is especially important given that this infrastructure is maintained using public funds.
However, we consider that it is not in the wider public interest to disclose this information because, as well as the risk posed to the security of the NHS, there is also a risk of national security being compromised. Knowledge of the core architecture would allow potential cyber-attackers to build up a picture of our capability and capacity in this area. It could provide those groups or individuals with an indication of where to focus their efforts when targeting our systems. Groups planning attacks are known to conduct extensive research and will take advantage of the ‘mosaic effect’ by combining information from different sources. If this information were to be combined with other information already in the public domain or obtained from elsewhere, the disclosure of it could assist in mounting an effort to breach or bypass cyber security measures, with serious consequences. As the NHS is an essential part of the UK’s public health and emergency response and these security measures also protect the proper functioning of Category One Emergency provision, the disclosure of this information may also compromise national security.
In these circumstances it is our view that the public interest in maintaining the exemption outweighs the public interest in disclosing the information.
Commercially confident exemption –
The Trust is unable to provide the information requested as this information is commercial in confidence. This information is exempt under section 43 (commercial interests) of the Freedom of Information Act (FOIA), as the information would be likely to prejudice the commercial interests of those involved.
Section 43 (2) is a qualified exemption which means the Trust must undertake a public interest test. The Trust has considered the public interest in disclosing this information and while it is in the public interest to disclose information that informs the public of how we spend our money, especially where this relates to the provision of public services, we have determined that the prejudice arising from disclosure outweighs the benefit to the public in this instance.
