Professional Documents
Culture Documents
[Organisation name] and Suffolk GP Federation CIC, for the Sharing of Information
concerning [Service in question]
This Information Sharing Agreement defines the arrangements for processing person
identifiable information between [Organisation name] and Suffolk GP Federation CIC:
Yes / No
Yes / No
Patient Name
Patient Address
Patient Date of Birth
Patient NHS Number
GP Practice/GP
Date referral received
Date/s and details of appointment/s booked
8.1 For PII classed as personal information, please state the applicable conditions from
schedule 2 of the DPA, that will allow lawful sharing.
2a) The processing is necessary for the performance of a contract to which the data subject
is a party
8.2 For PII classed as sensitive information, please also state the applicable conditions
from schedule 3 of the DPA, that will allow lawful sharing.
10.0 What media is used for transferring the data (format and method)?
12.0 Who will handle the data? Please state the authorised users.
13.0 How long will the data be held i.e. Retention period?
Any information held will not be retained for any longer than is necessary for the purpose
that it was obtained for. Please give details.
For the purposes of allowing the exchange of personal identifiable information for business
reasons, whilst ensuring that the information is exchanged and transferred in a safe and
secure manner, in order to protect individuals’ privacy and confidentiality at all times, the
undersigned agree to adhere to the arrangements stated above, in conjunction with the
overarching Policy.