Freedom of information is costing the NHS – patients must come first

20 February 2012

By Sue Slipman

NHS bodies are being forced to spend millions on FoI instead of patients and the rules need to change, argues the Foundation Trust Network

The Foundation Trust Network (FTN) fully supports the principles of openness and transparency, but in light of the financial pressures being faced by NHS providers we believe it would be sensible to re-focus freedom of information (FoI) activity more clearly on matters of public interest and to streamline the process for responding to legitimate requests.

This was the FTN's response to the Justice Select Committee which is taking a fresh look at the Freedom of Information Act to see whether it is working effectively.

The FTN represents over 200 members, and is the voice of public providers of healthcare in the NHS - NHS foundation trusts and NHS trusts seeking to become foundation trusts. Our members span the acute healthcare, mental health, ambulance and community sectors.

It probably costs them some £30m a year to service requests under the Freedom of Information Act. This is a significant sum of public money – and results in resources being diverted from the core business of caring for patients to answer questions for commercial organisations that may be gathering data to help them decide whether to bid for an NHS contract.

FTN members are inundated with rising numbers of FoI requests – many of them well beyond the spirit of the act. One member has seen a rise in FoI requests of over 30 per cent in the past year. Another trust estimates that each FoI request costs over £500, adding up to an annual bill for the trust of between £175,000 and £250,000.

Foundation trusts' concerns centre on the cost of responding to these requests at a time when resources are under pressure. In some cases staff are routinely given over to responding to FoI requests and this is directly impacting on trusts' normal business. For instance, in one trust staff who would otherwise book appointments are routinely diverted to FoI work for one or two days at a time. Reports of one to two members of staff being redeployed to respond to FoI requests are typical.

A small trust estimates its cost at over £50,000 a year – this only covers staff dedicated to receive, log and process requests – and does not take into account the time of other staff involved in reviewing and determining appropriate responses, including front-line clinical staff.

Requests under the act that cost up to £600 for government departments, or £450 for all other public authorities including health organisations, are conducted without charging the requestor. This translates to 18 hours work, or two and a half person-days at £25 an hour before a charge is made for the cost of responding. The FTN believes that this threshold should be lowered.

The FoI Act was never intended to be a fishing ground for aggressive competitors to gain advantage over public providers by getting their hands on commercial information, but that's what it is becoming.

Many of our members report a massive increase in requests from commercial companies seeking a commercial advantage. One NHS trust says that commercial organisations requesting data for marketing purposes make up nearly 40 per cent of FoI requests. These requests are counter to the spirit of the act. Commercial organisations that may be competitors to public providers can seek information, but they do not have to provide it. This is not a level playing field.

The requests include information on: details of IT contracts; competitors determining whether to bid for services; suppliers requesting commercial information, for instance about the use of medical supplies, agency staff or requesting precise details about contract end dates; the names of competitor companies invited to tender; contracts or relationships with other commercial companies; and companies compiling databases of contact information to sell on.

This is not how the act was envisaged to work. It was also not put in place so NHS resources could be diverted to do research to form the basis of students' dissertations and research projects.

Some trusts are making huge efforts to publish more information of their websites so that patients and the public can find information. One trust has found that this led to a small fall in FoI requests. When the information is already published as part of a publication scheme or in a virtual reading room, or has been requested previously, the FoI requestor can be referred directly to the publication scheme. These referrals are not counted within the FoI request numbers.

The FTN would liked to see the act changed so that existing data could be used where appropriate, so trusts do not have to spend unreasonable amounts of time tailoring specific data requests when an alternative presentation would meet the needs of the requestor.

Sue Slipman is chief executive of the Foundation Trust Network