Next, you can find some of the most FAQs regarding the National Opt-Out, organised in different sections (Implementation; Consent; Audit Compliance and Case Ascertainment; Transfers).
IMPLEMENTATION
What is the date when the opt-out will go live?
Healthcare providers in England must comply with the opt-out by the 31 July 2022.
Local practice is to enter all patients on SSNAP before checking against opt-out list. Before locking, we check against the list and then request to delete all of those who have opted out. Is this best practice?
No, you must check the list of patients you want to enter on SSNAP against the opt-out list using MESH first, and then only enter on SSNAP the ones who have not opted out. You cannot create a record for a patient that has opted out.
If the patient is not on the opt-out list, does the patient still need to give SSNAP consent? Will consent be mandatory to ask from July?
No, SSNAP consent is not mandatory. However, where efforts have been made to seek consent from the patient, this can be recorded on the pro-forma.
Does the opt-out apply to all patient data or just identifiable data?
It applies to all data; no data can be recorded if the patient is on the opt-out list unless they consent with your service for their data to be added onto SSNAP.
Do we screen patients for NDOO if we need to start a non-acute community record on SSNAP?
Yes, every patient must be screened against the opt-out regardless of if coming from an acute or non-acute pathway.
How do we get access to MESH?
Please visit this website with guidance on MESH https://digital.nhs.uk/services/message-exchange-for-social-care-and-health-mesh
CONSENT
If someone consents on initial assessment, can we add them on SSNAP regardless of data opt-out?
Yes, a patient’s consent to be on SSNAP overrides the patient being on the opt-out.
Will SSNAP be providing a Consent form?
Yes, SSNAP consent forms and information leaflets can be found here: https://www.strokeaudit.org/Patients,-Carers-Public-Area/What-data-does-SSNAP-collect.aspx
Should the consent be gathered in a paper version or is the note in hospital electronic system enough?
The decision on how to record consent is up to each Trust. SSNAP provides the following consent forms that could be used for it: https://www.strokeaudit.org/Patients,-Carers-Public-Area/What-data-does-SSNAP-collect.aspx
If we gain consent that overrides NDOO and we send this data to another team, how will they know this?
Consent recorded either in question 3.9 or 7.14 will be shown to the next teams, so they’ll be able to see if the patient has provided consent. SSNAP are also in the process of adding a flag to the Clinical Case Management screen to easily identify those that have given consent.
If the previous team has recorded patient consent, does our team need to check the patient against the opt-out?
No, consent recorded by a previous team can be taken as the will of the patient for their care data to be on SSNAP.
If a patient has not opted out, but also was not asked for consent, what option do we use in Section 3 and 7 regarding Consent?
In this case you can choose ‘Patient not asked’
If a patient has refused consent, but has not opted-out, can they still be entered onto SSNAP?
Yes, a record can be started for this patient on SSNAP. SSNAP consent applies only to release of patient identifiable information (NHS number, name, etc.), so data about care processes can still be added to the record. When you indicate on the SSNAP record that the patient has refused consent, all identifiable information will be wiped from the record, but the other measures will remain.
For patients who are re-admitted, do we need to seek consent for each spell?
If the patient has given consent at a previous team, then you do not need to seek consent again.
AUDIT COMPLIANCE AND CASE ASCERTAINMENT
How will this affect expected cases and case ascertainment?
We recognise that the number of patients that have opted out will vary regionally. We will continue to keep this under review and if you are finding that there are high rates of opt-out patients that are affecting your team being able to meet the expected cases threshold, please contact our helpdesk: ssnap@kcl.ac.uk
Will you be adjusting Audit compliance scoring to account for the extra time that the NDOO process add to data entry?
Currently, to achieve 100% for the audit compliance measures: “Number of days from when patient is admitted/onset to when the record is started” and “Number of days from when the patient is discharged from the team's care to when the record is locked to discharge” a team must achieve this within a median of 7 days, and so no adjustments will be made. We will keep monitoring how long it takes for MESH to return a list and whether this is impacting audit compliance. Please contact our helpdesk (ssnap@kcl.ac.uk) if this is taking more than a few days.
TRANSFERS
We are a community rehab team and have just received a record from an acute team. When we checked against the NDOO list, this patient has opted-out. Do we delete the record altogether?
No, the record should be revoked to the previous team who can choose ‘Discharged somewhere else’ on Section 7. The record does not need to be deleted.
How does this affect non-admitting providers who do not start records?
Non-admitting providers will still have to check against the opt-out list before adding any data to the record, in case the patient has subsequently opted out since first admission. However, if they find that on Section 3 or Section 7 it is flagged by the previous team that the patient has consented for their data to be on SSNAP, then they do not need to check that record against the opt-out.
When inputting as a rehab community team, how would we know that someone is not on SSNAP because of opting out and not just because they have not been added at the acute stage which is something we currently face a lot?
For those cases when you are missing records that should have been transferred by an acute site, please contact the acute site to check the reason why the transfer has not been done.