Contact tracing, data and the NHS - some questions answered by NHSX

Derek du Preez Profile picture for user ddpreez April 27, 2020
Contract tracing could help the UK in its fight against Coronavirus. However, there are concerns about its effectiveness and data privacy.

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(Image by William Iven from Pixabay )

The NHS’s central digital unit - NHSX - has revealed more details of the government’s plans for digital contract tracing, which is being put forward as one of the tools that could be used to help contain the spread of the novel Coronavirus in the UK as and when lockdown restrictions are eased. 

A blog post, written by NHSX CEO Matthew Gould and Dr Geraint Lewis, draws particular attention to the data privacy concerns people may have surrounding the use of tracing technology. NHSX has said that the soon to be released app and any future development will be transparent and comply with the law around the use of data. 

Contact tracing apps - which use bluetooth technology via your smartphone to keep track of who you come into close contact with - have been touted as one of the ways to better manage the spread of the novel Coronavirus and help ease lockdown restrictions. 

The idea being that if you start to experience symptoms in line with COVID-19, you then self report these into an app and that then lets everyone you came into contact with know to self-isolate too.

The development of these contact tracing apps have been aided by Google and Apple coming together to develop an API - and a future platform built into their respective OS’s - that would allow for a solution that doesn’t rely on a central authority.

However, as reported on diginomica/government, theory and reality are two very different things. Experts have already laid out that the technology is open to trolling, that uptake is necessary but hard to ensure, and that errors are likely.

In addition to this, the Ada Lovelace Institute in the UK last week said that there is no evidence to support the immediate deployment of digital contact tracing. 

However, NHSX said that the NHS will be launching a contact tracing app in the coming weeks, which it states will automate the process of contact tracing - with the aim of reducing transmission of the virus. 

The blog post states:

The app will be part of a wider approach that will involve contact tracing and testing. We are working hard to make sure that all these elements are properly linked up, to make it as seamless as possible and to ensure the app complements more traditional measures that, working together, can protect vulnerable groups and those who cannot or do not want to access digital tools.

The app will give the public a simple way to make a difference and to help keep themselves and their families safe. The technology is based on research evidence developed by epidemiologists, mathematical modellers and ethicists at Oxford University’s Nuffield Departments of Medicine and Population Health.

The government announced last week that it would also be hiring 18,000 people to help aid its efforts in contact tracing once lockdown measures ease. 

Data privacy at the core

It is clear from the NHSX blog that the organisation is keen to allay any concerns about the government extending its powers when it comes to the collection and use of personal data. 

NHSX states that the data log of how close you are to others with the app also downloaded will be anonymous and stored on your phone. If you become unwell, users will have the choice to allow the app to inform the NHS which, “subject to sophisticated risk analysis”, will trigger an anonymous alert to other app users with whom you came into significant contact with. 

The app will then advise you what action to take if you have been close to someone who has become symptomatic and this advice will be approved by the Chief Medical OFficer. 

NHS notes that “scientists and doctors will continuously support us to fine-tune the app to ensure it is as helpful as possible”. 

In future releases of the app, citizens will be able to choose to provide the NHS with extra information about themselves to help the government identify hotspots and trends. 

Specifically on data privacy concerns, NHSX says: 

The data will only ever be used for NHS care, management, evaluation and research. You will always be able to delete the app and all associated data whenever you want. We will always comply with the law around the use of your data, including the Data Protection Act and will explain how we intend to use it. We will be totally open and transparent about your choices in the app and what they mean. 

If we make any changes to how the app works over time, we will explain in plain English why those changes were made and what they mean for you. Your privacy is crucial to the NHS, and so while these are unusual times, we are acutely aware of our obligations to you. Just as the NHS strives at all times to keep your health records confidential, so it will keep the app data secure. Patient confidentiality is built in to the NHS. It is one of our key values.

NHSX goes on to say that it has prioritised security and privacy in all stages of the app’s development, starting with the initial design and user testing. It will also be publishing the key security and privacy designs alongside the source code, to support a peer review approach. 

The digital unit has also consulted on its plans with the Information Commission, the National Data Guardian’s Panel and the Centre for Data Ethics and Innovation. It has also established an ethics advisory board for the app. 

The blog post finishes by stating: 

We are committed to listening to your ideas and concerns to ensure this app will develop and improve over time. We will explain to app users when and why we make any changes. User-testing sits at the heart of the app’s design, its implementation and its continuous improvement.

This new app has the potential to contribute towards the country returning to normality - but only if a large proportion of the population installs it.  Which means that millions of us are going to need to trust the app and follow the advice it provides. To earn that trust, we will continue to work based on transparent standards of privacy, security and ethics.

My take

No one knows how effective these contact tracing apps will be. Evidence suggests that they will need 60% plus uptake from the general population to have any effect. Getting that level of support and engagement from the public will require transparency and evidence that their data rights are being protected. If NHSX’s latest words are taken at face value, it appears that it seems to understand that.

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