Supporting Caldicott Guardians across the UK


Helen Dyer

Helen Dyer is Caldicott Guardian for ExamWorks UK, the British subsidiary of a US corporation. She is the company’s Director of Nursing and the biggest component of her work is concerned with assessing patients for continuing health care, under contract from the NHS.

Across England, some patients qualify after leaving hospital for continuing health care to be paid for by the NHS, while others receive means-tested support from the local authority, pay for themselves, or do without. The decision about who qualifies depends on a clinical assessment of care needs requiring access to confidential data.

In most parts of England those assessments are carried out by staff from the NHS or local authority, but in some areas the work is contracted out to private sector companies such as ExamWorks UK. Full and accurate assessments depend on having access to the reports and records of every member of the multi- disciplinary team who has had contact with the patient, as well as to documents held by the Clinical Commissioning Group and local authority. The process depends on having good information sharing agreements. Getting them right is one of Helen’s concerns as Caldicott Guardian.

She says: “It’s really important for me to integrate my Caldicott responsibility throughout my work as Director of Nursing. It’s not a bolt-on. I reckon I spend about 10% of my time on Caldicott work, but for the most part I do it in tandem with my other work. I often wear my Caldicott Guardian hat at meetings where I also wear my Director of Nursing hat.”

A recent example of a Caldicott intervention came when she was asked to sign off a contract with a Clinical Commissioning Group to give assurance that it complied with Caldicott principles. She said it wasn’t the job of a Caldicott Guardian to sign off contracts but to advise. Her advice was that the CCG was planning to send a large volume of confidential personal data without an adequate legal gateway. Nowhere was there evidence that people would be asked to give their consent for data to flow to a private company outside the NHS for continuing healthcare assessment. It was thanks to Helen’s vigilance as Caldicott Guardian that the CCG put this right.

She says: “When I first became a Caldicott Guardian, there was nothing to help those of us working in the private sector. At the outset Google was my best friend. I was fortunate that I found out how to attend some excellent Caldicott Guardian training. That was pivotal. It opened up access to networking events where I met other Guardians.”

Helen keeps a log of the Caldicott advice that she gives. She makes brief monthly reports on her Caldicott activity to the ExamWorks UK board and to its information governance (IG) board. And, as part of the company’s compliance with IG Toolkit requirements, she produces an annual Caldicott plan, which is approved by both boards. Other company activities include rehabilitation services and disability assessments.

She says: “I work closely with our SIRO. We have adjacent desks. When I’m on leave she can deal with things, although given the nature of the work there’s very little that can’t wait until I get back.”

Helen is a member of the UK Caldicott Guardian Council and led the work to set up its regional network in north-east England.