Blog: Demystifying the Confidentiality Advisory Group and building relationships with Integrated Care Systems

Last updated on 22 May 2024

Dr Paul Mills, HRA Confidentiality Advice Service Manager, writes about how the Confidentiality Advisory Group (CAG) is building relationships with Integrated Care Systems and Integrated Care Boards.

The blog follows an event, held earlier this month, where Paul spoke to staff from Integrated Care Boards across the country about the use of confidential data.


Dr Paul Mills, HRA Confidentiality Advice Service Manager

The information held within the NHS holds enormous power, both for medical research and for planning services to enable better care for patients. However, the public also needs to trust that their medical information will be used in a safe and transparent way, particularly when it is identifiable. One of those important safeguards is the Confidentiality Advisory Group (CAG) who advise on whether requests to use identifiable patient information without patient consent should be approved. CAG sees its role to get information to flow, but only where the applicant can show a wider public interest in the activity that is sufficient to override individual privacy. One of myths we frequently hear is that applying to the CAG is a complicated process, one which can feel quite daunting.

That is why I was delighted to be invited to speak at a workshop for new and experienced information governance staff from across Integrated Care Systems (ICSs). Integrated Care Boards play a vital role in planning health services within the ICS and since being legally established in 2022, they had increased contact with the CAG to undertake important functions which underpin better delivery of NHS services and improved care for patients across England. Last year CAG supported many ICBs to deliver risk stratification – a process by which large NHS datasets are brought together to identify patients most at risk of hospitalisation and who can then receive preventative care by their GP. We are also having many conversations with ICBs on population health management whereby NHS data is analysed to identify how best to deliver services for the benefit of the local population.

ICBs and ICSs are still maturing and there is sometimes uncertainty about what CAG is, when an application may be needed and what steps they need to take. This was the focus of the recent workshop and enabled ICSs to think about how they use identifiable patient information, whether they should apply to CAG and, if so, how to prepare a good application in line with our guidance.

It was heartening to see such a level of interest from ICSs. We understand that no two applications may be the same, and so place an importance on supporting applicants prior to, during, and after the application process. The workshop was one way in which CAG can support ICSs on a larger scale. Given the role of ICSs to plan the best possible delivery of patient care, and how patient information can play a vital role in this, CAG is keen to work to work with ICSs to support the use of identifiable patient information where necessary.

The workshop has led to a number of follow up conversations with ICBs on how they use patient information to plan health services. I hope that this workshop was reassuring to staff that the CAG is there to assist in getting the information to flow whilst ensuring that the law is followed, patients and the public are informed which embeds trust in the process.

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