United Kingdom Freedom of Information Act 2000, Local Government and Everyday Regimes of Practice

The United Kingdom’s Freedom of Information Act 2000 commenced in 2005 with the objectives of openness and transparency, accountability, better decision making and public involvement in decision making. However, there have been limited studies of its long-term impacts on government practices and how far the Act has delivered on its stated objectives, and even fewer studies into how Freedom of Information works in practice, especially at local government level. Addressing these gaps in existing knowledge, this research seeks to critically evaluate existing regimes of practices across local authorities. It seeks to identify the multiple practices surrounding the implementation of the 2000 Act, evaluate how these practices are reproduced, and generate lessons for practice and alternative modes of delivering Freedom of Information.

The Cost of Fraud Prediction Errors

We compare seven fraud prediction models with a cost-based measure that nets the benefits of correctly anticipating instances of fraud, against the costs borne by incorrectly flagging non-fraud firms. We find that even the best models trade off false to true positives at rates exceeding 100:1. Indeed, the high number of false positives makes all seven models considered too costly for auditors to implement, even in subsamples where misreporting is more likely. For investors, M-Score and at higher cut-offs the F-Score, are the only models providing a net benefit. For regulators, several models are economically viable as false positive costs are limited by the number of investigations regulators can initiate, and by the relatively low market value loss a "falsely accused" firm would bear in denials of requests under the Freedom of Information Act (FOIA). Our results are similar whether we consider fraud or two alternative restatement samples.

Interoperability in NHS Acute Trusts within England: a Situation and Capability Analysis using Freedom of Information requests

Background Many central initiatives to improve digital maturity and interoperability in the NHS started after 2015. There are few prior assessments of digital maturity and interoperability. Methods Freedom of Information Act requests were sent to all English Acute NHS Trusts and Clinical Commissioning Groups (CCGs) to obtain information regarding digital maturity according to the Healthcare Information and Management Systems Society (HIMSS) Electronic Medical Record Adoption Mode (EMRAM) scale, and interoperability. Results One third of Acute NHS Trusts have an EMR that meets requirements for EMRAM stage 6 or above. 17.4% of responding Trusts considered this. 59.1% of responding Trusts stated that their EMR allows for functional interoperability with other (interoperable) EMRs. The majority of responding Trusts had not conferred with other Trusts when making EMR purchasing decisions. Discussion In order to realise the benefits of digitisation and interoperability, we discuss policy recommendations including actions for local health economies.

Saving the Freedom of Information Act

Enacted in 1966, The Freedom of Information Act (or FOIA) was designed to promote oversight of governmental activities, under the notion that most users would be journalists. Today, however, FOIA is largely used for purposes other than fostering democratic accountability. Instead, most requesters are either individuals seeking their own files, businesses using FOIA as part of commercial enterprises, or others with idiosyncratic purposes like political opposition research. In this sweeping, empirical study, Margaret Kwoka documents how agencies have responded to the large volume of non-oversight requesters by creating new processes, systems, and specialists, which in turn has had a deleterious impact on journalists and the media. To address this problem, Kwoka proposes a series of structural solutions aimed at shrinking FOIA to re-center its oversight purposes.

O-106 Non-donor IVF treatment cycles in the UK need to be re-evaluated against the 1.625 million oocytes retrieved

Study question Are IVF clinics collecting too many oocytes per retrieval procedure? Summary answer IVF cycles performed in the UK appear to be retrieving far too many oocytes, most of which may never be used and are probably discarded. What is known already For justifying IVF with low AMH, older women, poor responders, the Bologna and POSEIDON consensuses were developed. The positive linear correlation between cumulative live birth rates and numbers of oocytes collected is well established, thereby focussing intensely on stimulation regimes and the growth of FER cycles and oocyte freezing activities. The associated risk of OHSS is well-known. However, over-stimulation practices and numbers of oocytes retrieved within IVF remain unknown as is the impact on patients’ health, emotional and financial welfare. This UK dataset uniquely reveals numbers of oocytes retrieved against IVF cycles undertaken, and which may well reflect global practices. Study design, size, duration This is a retrospective observational cohort study of oocyte retrieval procedures for non-donor IVF cycles in the UK between 2015 and 2018. Data were obtained from UK HFEA under the Freedom of Information Act 2000. For fresh oocytes, data were obtained for the number of cycles retrieving 1-5, 6-15, 16-25, 26-49, 50-59, and 60+ oocytes. The number of cycles that led to no oocytes was obtained as well as data on the utilisation of oocytes. Participants/materials, setting, methods The data from the HFEA covers up to 86 UK IVF clinics undertaking non-donor IVF. IVF clinics are legally obliged to provide IVF dataset as part of the licence requirement. The unbiased data was gathered independently by HFEA staff under the Freedom of Information Act 2000. Specifically, the number of treatment cycles with; 0, 1-5, 6-15,16-25, 26-49, 50-59, and 60+ oocytes retrieved for each year was requested. Additional limited data could be gained. Main results and the role of chance For 2015-2018 there were 172341 fresh oocyte retrieval cycles, where 10148 (5.9%) cycles from 9439 patients did not yield any oocytes. In this period, 42574 cycles (24.7%), 91797 cycles (53.3%), 23794 cycle (13.8%) and 3970 cycles (2.3%) yielded 1-5 oocytes, 6-15 oocytes, 16-25 oocytes, 26-49 oocytes respectively, while 58 cycle (0.033%) yielded over 50 oocytes. The data was accountable by 5-85 clinics and the outcomes and patterns remained uniform across the 4 years. The main desired oocyte yield of 6-15 oocytes occurred in 53.3% of IVF cycles distributed evenly across the clinics. However, 16.1% of cycles were associated with 16-49 oocytes retrieved per IVF cycle, while 58 (0.03%) cycles led to greater than 50 oocytes retrieved. The maximum number of oocytes collected was not provided by the HFEA due to technical reasons. The total number of oocytes collected over 4-years numbered 1,624,912 oocytes from 147274 women yielding on average 11 oocytes per patient. These oocytes were fertilised to yield 931,265 embryos (57.3% converted). The fate of 42.7% oocytes remains unknown. Of the embryos created, 209,080 (22.4%) were transferred over 172,333 cycles, while 219,563 (23.6%) embryos frozen and the fate of 53.97% of embryos remained unaccounted for. Limitations, reasons for caution This retrospective analysis spans 4 years in which stimulation regimes, patient characteristics, or outcomes were unavailable. Only a qualitative analysis is possible with the HFEA dataset, but the corresponding data is unique and of public interest. The outcome of unaccounted oocytes appears a limitation in the regulatory body data set. Wider implications of the findings This unique observation on IVF clinics practices suggests that the high oocyte number per retrieval procedure needs re-evaluation. In particular, this needs to focus on the side-effects, including OHSS and procedure-related complications. In addition, the outcome and cost of unused frozen oocytes need to be established. Trial registration number not applicable

8. Public Interest Immunity and Related Matters

Chapter 8 examines the doctrine of public interest immunity. It discusses the development of the law; ‘class’ claims and ‘contents’ claims; national security and analogous concerns; proper functioning of the public service; the two main contexts in which public interest immunity disputes in criminal cases have arisen—the disclosure of the identity of police informers, and the disclosure of the location of police observation points; how the doctrine of public interest immunity stands alongside, and probably overlaps with, the operations of the Freedom of Information Act 2000; and section 10 of the Contempt of Court Act 1981, which governs the disclosure of sources of information contained in publications.