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Researchers call for greater NHS transparency to cut FOI costs

The Freedom of Information Act (FOIA) is a valuable tool in healthcare research, but its use could be avoided with greater transparency of NHS policies, according to researchers.

A report published today (19 October) concludes that, to benefit healthcare research, the FOIA must be used carefully – as a ‘scalpel’ rather than a ‘sharp knife’ – and researchers need greater guidance for their academic institutions to do so.

The Act allows anyone to obtain information from public authorities. Dr Simon Hammond from the University of East Anglia (UEA) made an FOI request as part of research into dementia care, requesting NHS Trusts’ guidance and policies for dementia services and explored its effectiveness as a research tool.

Dr Hammond said: “While the FOIA allowed us to systematically gather vital information for research we wouldn’t otherwise have, researchers retain a moral responsibility in exercising FOI requests cautiously and to use it as a ‘scalpel’ rather than a ‘sharp knife’.

“The Act can be seen both as a legitimate way to gather information but also as a crude weapon of coercion which carries a cost to the authority being approached. Research is typically voluntary while FOI requests may be seen as allowing researchers to force the release of data.”

Based on calculations from previous research into FOI, it was estimated that processing the requests in this case carried a collective maximum cost to the NHS of up to £75,150 – more than a consultant’s yearly salary.

The UEA team suggests the need to use the Act and the costs associated with responding could be avoided with greater transparency of information across the NHS.

“We used the FOIA to systematically gather literature not otherwise available,” said Prof Chris Fox, of UEA’s Norwich Medical School. “This raises the question of why NHS trusts don’t already make policy documents accessible and – equally importantly – why clinicians are duplicating existing but inaccessible policies without sharing knowledge.

“In our view, competitiveness between NHS trusts encourages the perception of commercial sensitivity in creation of these policies, missing the opportunities for openly sharing documents for research, public information or public empowerment.”

If the information required for the UEA team’s study was already accessible by being ‘realistically accessible’ or ‘in the public domain’ – both existing FOI exemptions – their request and the time taken to process it would not have been necessary.

The report concludes that researchers need increased guidance from their academic institutions in order to ensure the effective use the Freedom of Information Act. The report states: “We now need to ensure some propriety in academic use of this avenue of enquiry, perhaps prioritising the ‘public good’. Academic research institutions need to issue guidance regarding if, and when. FOI requests are appropriate.”

The research follows the publication in March of the Independent Commission on Freedom of Information report by Lord Burns' – which concluded that no changes were needed to the current FOI Act.

‘Freedom of Information Act: scalpel or just a sharp knife?’ is published in the Journal of Medical Ethics on Wednesday 19 October 2016.

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