Tier 2 Information Sharing Agreement (Template)

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Warrington Information
Sharing Framework
Warrington Information
Sharing Agreement
(Tier 2)
Arrangements for the sharing of:
Insert title / short description of information to be shared
From:
To:
Insert organisation name
Insert organisation name
Over the period of:
Insert time period
T2
APPROVAL:
Approving Body 1:
Approved on:
Insert organisation name
Insert date
Approving Body 2:
Approved on:
Insert organisation name
Insert date
Approving Body 3 (if applicable):
Approved on:
Approving Body 4 (if applicable):
Approved on:
Version Number:
Effective from:
Effective to:
Eg, Version 1.0
Insert date
Insert date
VERSION CONTROL
VERSION
AMENDED
DATE
AMENDED BY
MAIN CHANGES
For all queries relating to this Agreement please contact:
[Insert name]
[Insert Team / Directorate Name]
[Insert Organisation]
[Insert address]
Email: [Insert email address]
Tel: [Insert phone number]
1.
Introduction
1.1
Sharing information and data is vital to ensure residents receive appropriate services,
care and treatments; we prevent the harm or neglect of vulnerable people; we deliver
our statutory functions; and we deliver services in a more effective and efficient way.
1.2
This Information Sharing Agreement is part of a set of documentation that together make
up the Warrington Information Sharing Framework (see Appendix A), including a Tier 1
Information Sharing Agreement which includes the signatories of all member
organisations of the Framework. These documents can be accessed via the Warrington
Partnerships website at www.warringtontogether.co.uk.
1.3
This Tier 2 Agreement details the specific purpose, impact, legislative powers, consent
arrangements, procedures and process for review related to the sharing of the following
information:
[Insert description / list of data to be shared. For example, “data about hospital
users admitted for alcohol related injuries or illnesses, including their name,
address, date and time of admission, summary of injury or illness, location injury
was obtained (if appropriate) and summary of advice / support given by attending
physician / medical personnel.]
1.4
This data will be used for the purposes of:
[Insert description of data usage. Be clear and specific. For example “(a)
identification of frequent visitors who are potentially at risk of victimisation, (b)
identification of frequent visitors who are likely to require support from alcohol
intervention team, (c) identification of ‘hotspot’ areas for alcohol related accidents
or attacks. ]
1.5
The partners to this Agreement may only use the information disclosed as set out in 1.4.
They may not regard shared information as intelligence for the general use of their
organisation, unless set out above. They may not pass the information on to any third
party, without specific amendment and addition to this Tier 2 Agreement.
2.
Legality
2.1
Sharing personal information in accordance with this Agreement is lawful under the Data
Protection Act 1998 schedule 2 condition 6(1):
E.g. The processing is necessary for the purposes of legitimate interests pursued
by the data controller or by the third party…
2.2
And other legislation or statute as follows:
E.g. Childrens Act 1989 (s17) – This supports powers to data share where
necessary to support / protect children (example not used in reference to above
hospital example).
2.3
All staff involved with this Agreement must be made aware that disclosure of personal
information, which cannot be justified on legal or statutory grounds, whether
inadvertently or intentionally, could be subject to disciplinary action.
3.
Involved parties
3.1
Each organisation signed up to this Agreement is a member of the Warrington
Information Sharing Framework. Each organisation has previously signed the Tier 1
Information Sharing Protocol, which sets out the principles and minimum standards
under which information will be shared between organisations. Details of this can be
found on the Warrington Partnership website at www.warringtontogether.co.uk.
3.2
The Warrington Information Sharing Framework members involved in this Agreement
are:
a) Insert organisation and team name
b) Insert organisation and team name
3.2
This Agreement is owned equally by all participating members and is co-ordinated and
administered on their behalf by:
Insert title of role (role) of Insert organisation name (organisation)
3.3
The Data Controllers for 1.3 above are:
a) Insert title of role (role) of Insert organisation 1 name (organisation)
b) Insert title of role (role) of Insert organisation name (organisation)
4.
Confidentiality and consent
4.1
In agreeing this Agreement consideration has been taken of its impact on the privacy
and confidentiality of service users and their personal information. It is good practice to
seek informed consent of service users. However, disclosure without consent is lawful if
certain conditions are met. For example, personal information may be shared when
made anonymous or to ensure the performance of public functions or legal obligations.
4.2
The Data Controller is responsible for ensuring that data subjects are advised that their
information is being or may be shared.
4.3
Consent and advise arrangements for this Agreement are:
Insert detail of whether consent will be sought and how. If not, please describe
lawful conditions under which the information is disclosed without consent.
Briefly describe how service users will know their information is shared.
4.4
To support confidentiality and consent arrangements further operational detail of consent
forms, guidance for staff and service users, complaints procedures and any other
relevant operational procedure documentation is outlined in a Tier 3 Operational
Arrangement.
5.
Information security
5.1
Security for the exchange of information will be achieved through:
Insert brief description of data sharing procedures. E.g use of encrypted devices,
telephone referrals, use of secure email.
5.2
Security for the storage of information will be achieved through:
Insert brief description of data storage procedures.
5.3
Security for the disposal of information will be achieved through:
Insert description of data disposal procedures.
5.4
To support information security further operational detail of data transfer, storage and
disposal is outlined in a Tier 3 Operational Arrangement.
6.
Monitoring and review
6.1
This Agreement will be reviewed insert time period / date
6.2
It is agreed by all signatories that either organisation listed in this Agreement, or the
Warrington Partnership Information Governance Board, may request a review of
compliance at any time, either delivered themselves, or via a third party. All requests will
be adhered to unless under exceptional circumstances which prevent either party
involvement.
7.
Approval
The signatories below confirm
•
Their organisation is signed up to the Warrington Tier 1 Information Sharing Protocol.
•
Resources and trained personnel are in place to fully maintain the procedures set out
in the Agreement above.
•
This Agreement will be registered via the Warrington Partnerships website.
•
Review periods have been agreed and will be upheld.
Organisation 1: Insert name or organisation
Senior Information Risk Owner (SIRO):
Name:
Signature:
Job title:
Email address:
Date:
Phone number:
Caldicott Guardian (where appropriate
and available):
Signature:
Name:
Job title:
Date:
Email address:
Phone number:
Data controller
Name:
Signature:
Job title:
Email address:
Date:
Phone number:
Organisation 2: Insert name of organisation
Senior Information Risk Owner (SIRO):
Name:
Signature:
Job title:
Email address:
Date:
Phone number:
Caldicott Guardian (where appropriate
and available):
Signature:
Name:
Job title:
Date:
Email address:
Phone number:
Data controller
Name:
Signature:
Job title:
Email address:
Phone number:
Date:
Appendix A
Table 1 – Warrington Information Sharing Framework
Tier 1 - Information
Sharing Protocol and
Declaration of
Acceptance and
Participation (DAP)
A signed statement of willingness from organisations across
Warrington to enter into information sharing agreements. This
sets out the principles and minimum standards under which
information will be shared between organisations.
Approval level: Senior accountable officer, SIRO and Caldicott
Guardian (where available).
Tier 2 - Information
Sharing Agreement
Sets out the detail of what information will be shared, why, between
who and the legal basis under which it will be shared. Provides an
overview of the procedures involved in data transfer, storage and
disposal.
Approval level: SIRO, Caldicott Guardian, Data Asset Owner and
relevant strategic manager (for example, Assistant Director)
Tier 3 – Operational
Arrangement
These include the specific processes involved in the transfer,
storage and disposal of data to ensure it complies with legal
requirements, including details of consent documentation.
Approval level: Data Asset Owner and Operational manager.
Guidance notes
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