scholarly journals NHS Scotland Public Benefit and Privacy Panel (PBPP) – Does a Proportionate Governance Review Work?

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Carole Morris ◽  
Ashley Grey
Keyword(s):  
Measurement Tool ◽  
Tier 2 ◽  
Audit Process ◽  
The Public ◽  
Public Benefit ◽  
Audit Review ◽  
Tier 1 ◽  
Governance Process ◽  
Access To Data ◽  
Privacy Risks

IntroductionSince its’ inception in 2015, the NHS Scotland Public Benefit and Privacy Panel (PBPP) has approved over 200 applications for access to data. The PBPP are accountable to the public and must demonstrate their assessment of applications for data use in terms of envisaged public benefit and potential privacy risks. Objectives and ApproachIn 2017 the first annual audit took place. The purpose of the audit exercise was twofold; establish that the governance process is robust and that proportionate governance criteria are the correct measurement tool. The full PBPP committee reviewed a random selection of 10 applications approved at Tier 1 between January 2016 and December 2016. Committee members were split into groups and sent paperwork relating to the application. A review record was completed covering the questions within the proportionate governance criteria. Review records were sent to the PBPP Panel Manager for collation and an audit record compiled for each application. ResultsApplications were identified where a discrepancy existed between the Tier 1 decision and the PBPP Committee audit review. These audit records were tabled for discussion at a workshop involving a subgroup of PBPP Committee and Tier 1 panel members. From the ten applications that were randomly selected, six were consistently reviewed by both the Tier 1 and Tier 2 Committee with no referral points identified from the either Tier. 4 were identified for discussion in a workshop including representatives from both Tiers. During the discussion it was agreed that 2 out of the 4 should have triggered a further review by Tier 2 but that the decision to approve all 4 applications would have remained. Conclusion/ImplicationsThis suggests that both Tiers have a sound understanding of the proportionate governance criteria and that for the majority of applications this is being interpreted uniformly and that the audit process is required to ensure this is maintained going forward.

scholarly journals NHS Scotland Public Benefit and Privacy Panel (PBPP) – Much Ado about Governance 3 years on

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Carole Morris ◽  
Ashley Gray ◽  
Jennifer Scott
Keyword(s):  
Decision Making ◽  
New Technologies ◽  
Action Plan ◽  
Tier 2 ◽  
The Public ◽  
Public Benefit ◽  
Tier 1 ◽  
Information Governance ◽  
National Information

IntroductionSince its’ inception in May 2015, the Public Benefit and Privacy Panel has provided a centralised, simplified and truly national Information Governance scrutiny process. It has successfully harnessed expertise across NHS Scotland health boards implementing a collaborative approach which contributes to consistency and continued capacity development across the sector. Objectives and ApproachOver the last 3 years PBPP developed several procedures within its’ operations to become more efficient and achieve consistent decision making to ensure there is adequate information sharing amongst both Tier 1 and Tier 2 PBPP members. These components include: Integrated working with eDRIS team to support applicants pre submission Established an operational group with action plan Monthly reporting to NHS Boards Information Governance colleagues Annual learning and sharing workshop Annual audit of Tier 1 Proportionate Governance approved applications Documented Case Law Information Sheets on categories of applications to aid consistent decision making ResultsTier 1 panel members have noted that the quality of applications is noticeably improved when assistance is provided pre-submission aiding the speed of their proportionate review and that reference documents provide valuable information on the foundations of previous decisions. As a result of this and other improvements 90% of all applications are approved by Tier 1. Only those deemed highly complex or novel proposals are usually referred to Tier 2 at which 8% are reviewed and approved out of committee via email and the remaining 2% are heard at a Full Committee meeting. Whilst the average “clocked” days for an application is approximately 31 days. Conclusion/ImplicationsPBPP needs to continue to evolve in order to continue providing efficient and pragmatic IG assessments for new technologies, more complex, voluminous data linkages and innovation. This is no mean feat in a fast paced environment and we have to ensure those involved are given sufficient time to do so.

scholarly journals Beyond CQI-9: A Customized Approach to CQI-9 and Supplier Management

2021 ◽  
Author(s):  
Andrew Armuth ◽  
Nicholas Grider
Keyword(s):  
Heat Treatment ◽  
Task Force ◽  
Supplier Management ◽  
Treatment Quality ◽  
Tier 2 ◽  
Audit Process ◽  
Defense Contractors ◽  
Limited Effectiveness ◽  
Tier 1 ◽  
World Class

Abstract The current Automotive Industry Action Group (AIAG) CQI-9 audit process has limited effectiveness to proactively detect heat treatment quality risks in Tier-1 and Tier-2 supply bases. A cross-functional engineering organization developed an improved supplier audit form using CQI-9, National Aerospace and Defense Contractors Accreditation Program (NADCAP), International Automotive Task Force (IATF), and specific internal company standards to distinguish and quantify production issues that may have been undiscovered with the existing CQI-9 approach. Representatives from engineering, commercial, and manufacturing crafted a more complete approach to supply chain quality. This new audit format (Beyond CQI-9) has demonstrated the ability to quantify heat treatment concerns, reduce future engineering resource costs, and develop new and existing heat treatment suppliers to meet world class quality levels.

Governing Commercial Access to Health Data for Public Benefit: Charity Law Solutions

2019 ◽  
Vol 28 (2) ◽  
pp. 247-269
Author(s):  
Jessica L Bell
Keyword(s):  
Health Data ◽  
Independent Data ◽  
Significant Extent ◽  
Data Governance ◽  
The Public ◽  
Public Benefit ◽  
Company Limited ◽  
Access To Health ◽  
Charity Commission ◽  
Access To Data

Abstract There is a growing body of evidence that supports the view that research participants and the public are concerned about commercial access to health data. Evidence also suggests that attitudes are ameliorated when charity organisations are involved and where research promises to deliver ‘public benefit’. To a significant extent, therefore, mechanisms that ensure the public benefit are key to sustaining public and participant support for research access to health data. As a regime founded on the concept of public benefit, charity law provides regulatory and governance mechanisms through which the public benefit of a charity is protected and promoted. This article examines the merits of charity law mechanisms and analyses their significance for governance of commercial access to health data for public benefit, using UK Biobank Ltd, a charitable company limited by guarantee, as an example. The article critically analyses three charity law mechanisms that operate to ensure that an organization providing access to data meets its public benefit requirements: charitable purposes; members’ and directors’ powers and duties; and accountability via the oversight powers of the Charity Commission and charity proceedings in court. The article concludes that there is potential for the charity model to be the benchmark for governing commercial access to health data for public benefit research, but notes the limitations of the model and recommends the appointment of independent data governance committees to further bolster the charity law framework.

scholarly journals Should free-text data in electronic medical records be shared for research? A citizens’ jury study in the UK

2020 ◽  
Vol 46 (6) ◽  
pp. 367-377 ◽  
Author(s):  
Elizabeth Ford ◽  
Malcolm Oswald ◽  
Lamiece Hassan ◽  
Kyle Bozentko ◽  
Goran Nenadic ◽  
...  
Keyword(s):  
Clinical Information ◽  
Service Planning ◽  
Structured Data ◽  
Free Text ◽  
Patient Privacy ◽  
Text Data ◽  
The Public ◽  
Public Benefit ◽  
The Uk ◽  
Privacy Risks

BackgroundUse of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical policy.MethodsEighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns.ResultsJurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing.ConclusionsInformed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data.

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

التأثيرات السياسية في استدامة الدين العام في موازنة العراق 2019

2020 ◽  
Vol 2020 (66) ◽  
pp. 1-26
Author(s):  
م.م أحمد حامد جمعة ◽  
◽  
د. كمال فيلد البصري
Keyword(s):  
Public Debt ◽  
Public Spending ◽  
The Political ◽  
Financial Policy ◽  
Public Expenditures ◽  
Public Budget ◽  
Political Decision ◽  
The Public ◽  
Public Benefit ◽  
Political Impact

This study clarifies the analysis of the reality of the financial policy in the budget of Iraq 2019, and that analysis is evaluated by tracking the elements of the public budget from public expenditures and public revenues, and the study focuses on the size of the political impact on the path of public spending, as well as the analysis of public spending and revenues in various sectors and sections of the public budget. This study also shows the size of the risks resulting from the continuation of the financial deficit, as well as the risks of public debt according to the indicators of its sustainability analysis within the financial and economic indicators that express the risks of public debt. The study emphasized that public spending is still based on the political decision and does not achieve the principles and objectives of the economic budget that achieve the public benefit. The necessity requires efficient spending and fair distribution in order to avoid future public debt risks and their impact on future generations

Optimal Timing for Launching Installation of Tier 2 and 3 Systems of School-Wide Positive Behavioral Interventions and Supports

2021 ◽  
pp. 109830072199608
Author(s):  
Angus Kittelman ◽  
Sterett H. Mercer ◽  
Kent McIntosh ◽  
Robert Hoselton
Keyword(s):  
Longitudinal Study ◽  
Behavioral Interventions ◽  
Structural Equation ◽  
Equation Modeling ◽  
Optimal Timing ◽  
First Year ◽  
Tier 2 ◽  
Positive Behavioral Interventions ◽  
Tier 1 ◽  
Tier 3

The purpose of this longitudinal study was to examine patterns in implementation of Tier 2 and 3 school-wide positive behavioral interventions and supports (SWPBIS) systems to identify timings of installation that led to higher implementation of advanced tiers. Extant data from 776 schools in 27 states reporting on the first 3 years of Tier 2 implementation and 359 schools in 23 states reporting on the first year of Tier 3 implementation were analyzed. Using structural equation modeling, we found that higher Tier 1 implementation predicted subsequent Tier 2 and Tier 3 implementation. In addition, waiting 2 or 3 years after initial Tier 1 implementation to launch Tier 2 systems predicted higher initial Tier 2 implementation (compared with implementing the next year). Finally, we found that launching Tier 3 systems after Tier 2 systems, compared with launching both tiers simultaneously, predicted higher Tier 2 implementation in the second and third year, so long as Tier 3 systems were launched within 3 years of Tier 2 systems. These findings provide empirical guidance for when to launch Tier 2 and 3 systems; however, we emphasize that delays in launching advanced systems should not equate to delays in more intensive supports for students.

scholarly journals Global Inland Capture and Culture Finfisheries Follow Different Trends When Evaluated by the Human Development Index

2021 ◽  
Vol 13 (15) ◽  
pp. 8420
Author(s):  
Peter W. Sorensen ◽  
Maria Lourdes D. Palomares
Keyword(s):  
Socioeconomic Factors ◽  
Human Development ◽  
Human Development Index ◽  
Developed Countries ◽  
Global Scale ◽  
Tier 2 ◽  
Development Index ◽  
Tier 1 ◽  
Catch Reconstruction ◽  
Tier 3

To assess whether and how socioeconomic factors might be influencing global freshwater finfisheries, inland fishery data reported to the FAO between 1950 and 2015 were grouped by capture and culture, country human development index, plotted, and compared. We found that while capture inland finfishes have greatly increased on a global scale, this trend is being driven almost entirely by poorly developed (Tier-3) countries which also identify only 17% of their catch. In contrast, capture finfisheries have recently plateaued in moderately-developed (Tier-2) countries which are also identifying 16% of their catch but are dominated by a single country, China. In contrast, reported capture finfisheries are declining in well-developed (Tier-1) countries which identify nearly all (78%) of their fishes. Simultaneously, aquacultural activity has been increasing rapidly in both Tier-2 and Tier-3 countries, but only slowly in Tier-1 countries; remarkably, nearly all cultured species are being identified by all tier groups. These distinctly different trends suggest that socioeconomic factors influence how countries report and conduct capture finfisheries. Reported rapid increases in capture fisheries are worrisome in poorly developed countries because they cannot be explained and thus these fisheries cannot be managed meaningfully even though they depend on them for food. Our descriptive, proof-of-concept study suggests that socioeconomic factors should be considered in future, more sophisticated efforts to understand global freshwater fisheries which might include catch reconstruction.

scholarly journals Seismic characteristics of polygonal fault systems in the Great South Basin, New Zealand

2020 ◽  
Vol 12 (1) ◽  
pp. 851-865
Author(s):  
Sukonmeth Jitmahantakul ◽  
Piyaphong Chenrai ◽  
Pitsanupong Kanjanapayont ◽  
Waruntorn Kanitpanyacharoen
Keyword(s):  
Three Dimensional ◽  
Late Eocene ◽  
Seismic Survey ◽  
Fault System ◽  
Normal Faults ◽  
Tier 2 ◽  
South Basin ◽  
Fault Systems ◽  
Tier 1 ◽  
Polygonal Fault

AbstractA well-developed multi-tier polygonal fault system is located in the Great South Basin offshore New Zealand’s South Island. The system has been characterised using a high-quality three-dimensional seismic survey tied to available exploration boreholes using regional two-dimensional seismic data. In this study area, two polygonal fault intervals are identified and analysed, Tier 1 and Tier 2. Tier 1 coincides with the Tucker Cove Formation (Late Eocene) with small polygonal faults. Tier 2 is restricted to the Paleocene-to-Late Eocene interval with a great number of large faults. In map view, polygonal fault cells are outlined by a series of conjugate pairs of normal faults. The polygonal faults are demonstrated to be controlled by depositional facies, specifically offshore bathyal deposits characterised by fine-grained clays, marls and muds. Fault throw analysis is used to understand the propagation history of the polygonal faults in this area. Tier 1 and Tier 2 initiate at about Late Eocene and Early Eocene, respectively, based on their maximum fault throws. A set of three-dimensional fault throw images within Tier 2 shows that maximum fault throws of the inner polygonal fault cell occurs at the same age, while the outer polygonal fault cell exhibits maximum fault throws at shallower levels of different ages. The polygonal fault systems are believed to be related to the dewatering of sedimentary formation during the diagenesis process. Interpretation of the polygonal fault in this area is useful in assessing the migration pathway and seal ability of the Eocene mudstone sequence in the Great South Basin.

Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 14-14
Author(s):  
Charu Aggarwal ◽  
Melina Elpi Marmarelis ◽  
Wei-Ting Hwang ◽  
Dylan G. Scholes ◽  
Aditi Puri Singh ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Molecular Testing ◽  
Tier 2 ◽  
Newly Diagnosed ◽  
Next Generation ◽  
First Line ◽  
Tier 1 ◽  
Tier 3 ◽  
The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

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