NHS Digital Data Release Register - reformatted
Hackney Council projects
40 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).
LAPH HES via NHS Digital Portal — DARS-NIC-387526-Y0J4L
Type of data: information not disclosed for TRE projects
Opt outs honoured: No - data flow is not identifiable, Anonymised - ICO Code Compliant (Does not include the flow of confidential data)
Legal basis: Health and Social Care Act 2012, Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii), Health and Social Care Act 2012 - s261 - 'Other dissemination of information', Health and Social Care Act 2012 s261(1) and s261(2)(b)(ii), Health and Social Care Act 2012 s261(2)(b)(ii), Health and Social Care Act 2012 s261(2)(a)
Purposes: No (Local Authority)
Sensitive: Non Sensitive, and Sensitive, and Non-Sensitive
When:DSA runs 2019-04-01 — 2020-03-31 2018.03 — 2023.11.
Access method: Ongoing, System access, System Access
(System access exclusively means data was not disseminated, but was accessed under supervision on NHS Digital's systems)
Data-controller type: LONDON BOROUGH OF HACKNEY
Sublicensing allowed: No
- Hospital Episode Statistics Admitted Patient Care
- Hospital Episode Statistics Accident and Emergency
- Hospital Episode Statistics Outpatients
- Hospital Episode Statistics Critical Care
- Emergency Care Data Set (ECDS)
- Hospital Episode Statistics Accident and Emergency (HES A and E)
- Hospital Episode Statistics Admitted Patient Care (HES APC)
- Hospital Episode Statistics Critical Care (HES Critical Care)
- Hospital Episode Statistics Outpatients (HES OP)
The data provided by the Pseudonymised HES Extract Service will be used by the Local Authorities in fulfillment of its public
health function, specifically to support and improve:
1. the local responsiveness, targeting and value for money of commissioned public health services;
2. the statutory core offerpublic health advice and support provided to local NHS commissioners;
3. the local specificity and relevance of the Joint Strategic Needs Assessments and Health and Wellbeing Strategies
produced in collaboration with NHS and voluntary sector partners on the Health and Wellbeing Board;
4. the local focus, responsiveness and timeliness of health impact assessments; and, among other benefits
5. the capability of the local public health intelligence service to undertake comparative longitudinal analyses of patterns of
and variations in:
a) the incidence and prevalence of disease and risks to public health;
b) demand for and access to treatment and preventative care services;
c) variations in health outcomes between groups in the population;
d) the level of integration between local health and care services; and
e) the local associations between causal risk factors and health status and outcomes.
The main statutory duties and wider public health responsibilities supporting these processing objectives are as follows:
1. Statutory public health duties that the data will be used to support
a) Duty to improve public health: Analyses of the data will be used to support the duty of the Local Authority under Section
12 of the Health and Social Care Act 2012 to take appropriate steps to improve the health of the population, for example by
providing information and advice, services and facilities, and incentives and assistance to encourage and enable people to
lead healthier lives;
b) Duty to support Health and Wellbeing Boards: Analyses of the data will be used to support the duty of the Local Authority
and the Clinical Commissioning Group (CCG)-led Health and Wellbeing Board under Section 194 of the 2012 Act to improve
health and wellbeing, reduce health inequalities, and promote the integration of health and care services; the data will also
be used to support the statutory duty of Health and Wellbeing Boards under Section 206 of the 2012 Act to undertake
Pharmaceutical Needs Assessments;
c) Duty to produce Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWBs): Analyses
of the data will be used to support the duty of the Local Authority under Sections 192 and 193 of the 2012 Act to consult on
and publish JSNAs and JHWSs that assess the current and future health and wellbeing needs of the local population;
d) Duty to commission specific public health services: Analyses of the data will be used to support the Local Authority to
discharge its duty under the Local Authorities Regulations 2013 to plan and provide NHS Health Check assessments, the
National Child Measurement Programme, and open access sexual health services;
e) Duty to provide public health advice to NHS commissioners: Analyses of the data will be used by Local Authorities to
discharge its duty under the 2013 Regulations to provide a public health advice service to NHS commissioners;
f) Duty to publish an annual public health report: Analyses of the data will be used by Directors of Public Health to support
their duty to prepare and publish an annual report on the health of the local population under Section 31 the 2012 Act;
g) Duty to provide a public health response to licensing applications: Analyses of the data will be used by the Director of
Public Health to support their duty under Section 30 of the 2012 Act to provide the Local Authoritys public health response
(as the responsible authority under the Licensing Act 2003) to licensing applications.
2. Wider public health responsibilities supported by analysis of the data
a) Health impact assessments and equity audits: Analyses of the data will be used to assess the potential impacts on health
and the wider social economic and environmental determinants of health of Local Authority strategic plans, policies and
b) Local health profiles: Analyses of the data will be used to support the production of locally-commissioned health profiles
to improve understand of the health priorities of local areas and guide strategic commissioning plans by focusing, for
i. bespoke local geographies (based on the non-standard aggregation of LSOAs);
ii. specific demographic, geographic, ethnic and socio-economic groups in the population;
iii. inequalities in health status, access to treatment and treatment outcomes;
c) Surveillance of trends in health status and health outcomes: Analyses of the data will be used for the longitudinal
monitoring of trends in the incidence, prevalence, treatment and outcomes for a wide range of diseases and other risks to
d) Responsive and timely local health intelligence service: Analyses of the data will be used to respond to ad hoc internal
and external requests for information and intelligence on the health status and outcomes of the local population generated
and received by the Director of Public Health and their team.
These lists of the statutory duties and wider public health responsibilities of the Local Authority are not exhaustive but set
the broad parameters for how the data will be used by the Local Authority to help improve and protect public health, and
reduce health inequalities. All such use would be in fulfillment of the public health function of the Local Authority.
No sensitive data is requested under this application. The data provided would include derived demographic and geographic
fields, the standard non-sensitive HES diagnostic and operative fields, and a common (across all Local Authorities)
pseudoHESID to enable admissions to be linked over time.
Contributed to JSNA updates - currently in draft form, pending publication at https://hackney.gov.uk/jsna
Access to the data will enable the Local Authority to undertake locally-focused and locally-responsive analyses of health
status and health outcomes. For example, the data will be used to produce analyses of health inequalities for non-standard
geographies and for specific social or ethnic groups in the local population to help ensure that the health challenges facing
the local population particularly the most disadvantaged have been identified and responded to appropriately by the
Local Authority and its partners.
It is recognised that in fulfilling its public health duties using HES data, the Local Authority will deliver significant benefits.
The Local Authority therefore commits in any renewal request to providing additional detail on benefits that relate to their
local use of the data.
The results of the analyses of the data will be used by the Local Authority to support the discharge of its statutory duties in
relation to public health, and wider public health responsibilities. Outputs will include (but not be limited to) the routine
and ad hoc production of:
a) Joint Strategic Needs Assessments;
b) Joint Health and Wellbeing Strategies;
c) the annual report of the Director of Public Health;
d) reports commissioned by the Health and Wellbeing Board;
e) public health and wider Local Authority health and wellbeing commissioning strategies and plans;
f) public health advice to NHS commissioners;
g) responses to licensing applications and other statutory Local Authority functions requiring public health input;
h) local health profiles;
i) health impact assessments and equity audits; and, among other outputs
j) responses to internal and external requests for information and intelligence on the health and wellbeing of the
The specific content of and target dates for these outputs will be for the Local Authority to determine, although it is
required to comply with national guidance published by the Department of Health, Public Health England and others as
appropriate, for example, on the timetable for publishing refreshed JSNAs.
All outputs will be of aggregated data with small numbers suppressed in line with the HES Analysis Guide.
The Pseudonymised HES Extract Service will enable the Local Authority to undertake a wide range of locally-determined and
locally-specific analyses to support the effective and efficient discharge of its statutory duties in relation to health, and
wider public health responsibilities.
Access to the data is provided to the Local Authority only, and will only be used for the health purposes outlined above. The
data will only be processed by Local Authority employees in fulfilment of their public health function, and will not be
transferred, shared, or otherwise made available to any third party, including any organisations processing data on behalf of
the Local Authority or in connection with their legal function. Such organisations may include Commissioning Support Units,
Data Services for Commissioners Regional Offices, any organisation for the purposes of health research, or any Business
Intelligence company providing analysis and intelligence services (whether under formal contract or not).
The Local Authority will use the data to produce a range of quantitative measures (counts, crude and standardised rates and
ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data. Typical uses will
1. Analyses of disease incidence, prevalence and trends: The age, sex, LSOA, ethnic group, Indices of Deprivation and
diagnosis fields typically will be used to produce directly standardised coronary heart disease admission rates for the Local
Authority, and for appropriate benchmark and comparator areas. Confidence intervals will then be produced for these rates,
and the rates analysed using statistical process control methods, to determine whether there are any significant variations
in the prevalence of heart disease with the Local Authority. The data will also be used to analyse changes over time in the
prevalence of heart disease. The results of these analyses will then be used to inform the production of local health profiles,
JSNAs and JHWSs; support the core offerpublic health advice provided by the Director of Public Health to NHS
commissioners; and advise any enquiries into health inequalities requested by the Health and Wellbeing Board.
2. Analyses of hospital admission rates: The data will also be used, for example, to produce comparative and longitudinal
hospital admission rates among children and young people, particularly for injury and self-harm, to support the overarching
responsibility of the Local Authority to safeguard and promote the health and welfare of all children and young people
under the 1989 and 2004 Children Acts. Statistics based on these analyses will be used by the Director of Public Health to
advise the Director of Childrens Services and Lead Member for Childrens Services, and inform and guide the provision of
safeguarding services by the Local Authority.
Conditions of supply and controls on use
In addition to those outlined elsewhere within this application, the Local Authorities will:
1. only use the HES data for the purposes as outlined in this agreement;
2. comply with the requirements of the HSCIC Code of Practice on Confidential Information, the Caldicott Principles and
other relevant statutory requirements and guidance to protect confidentiality;
3. not attempt any record-level linkage of HES data with other data sets held by the Local Authority, or attempt to identify
any individuals from the HES data;
4. not transfer and disseminate record-level HES data to anyone outside the Local Authority;
5. not publish the results of any analyses of the HES data unless safely de-identified in line with the anonymisation standard;
6. comply with the guidelines set out in the HES Analysis Guide;
7. ensure role-based control access is in place to manage access to the HES data within the Local Authority.
The Director of Public Health will be the Information Asset Owner for the HES data and be responsible on behalf of the Local
Authority to the HSCIC for ensuring that the data supplied is only used in fulfillment of the approved public health purposes
as set out in this application. The Local Authority confirms that the Director of Public Health is a contracted employee to the
permanent role within the Local Authority, accountable to the Chief Executive.
A maximum of ten years data will be retained at any point, such that as each new data year is received, the oldest year will
be deleted eg. the 2004/05 data year will be deleted once the final complete 2014/15 data year has been received. The
Local Authority will securely destroy the years data within six weeks of receiving the latest annual dataset and provide a
data destruction certificate to HSCIC.
The historic data will be used by the Local Authority in fulfilment of its public health function, and specifically to:
a) recognise and monitor trends in disease incidence and prevalence and other risks to public health;
b) recognise and monitor trends in treatment patterns, particularly hospital readmissions, and outcomes;
c) recognise and monitor trends in access to treatment and care between demographic, geographic, ethnic and socioeconomic
groups in the population; and
d) recognise and monitor trends in the association between the wider social, economic and environmental determinants of
health and health outcomes
for the purpose of informing the planning, commissioning and provision of effective health and care services at a local level.
Project 2 — NIC-86183-K1Q2W
Type of data: information not disclosed for TRE projects
Opt outs honoured: Y ()
Legal basis: Health and Social Care Act 2012
Sensitive: Non Sensitive
When:2017.06 — 2017.08.
Access method: Ongoing
- Personal Demographics Service (PDS) data
Objective for Processing:
The Authority wishes to access the NHS Number and basic demographic details (ie, name, address, date of birth, date of death, registered GP practice), in order to meet its statutory functions within adult social care in terms of:
• Ensuring integrated care
• Cooperating with partners
• Sharing of support plans
• Review of care provision
• Movement of people
• Discharge of patients from hospital
• Discharge of patients who have received treatment for a mental disorder
Social Care Operational Context
Social care professionals directly involved in a patient’s care need to access the most up-to-date information about the patient, using the social care case management system. They also need to be able to engage with local healthcare colleagues who are also caring for the patient. The means of ensuring that social care and healthcare colleagues are referring to the same individual is through the use of the NHS Number, together with basic demographic information, such as name, address and date of birth. Therefore social care departments need to access the PDS to get or confirm the NHS Number, and, crucially, to determine if there is a date of death recorded.
The case management system is subject to its own information governance arrangements, and data sharing agreements have been established across the health and social care partners in the Authority’s area.
The types of participating healthcare organisations are:
• Acute Trusts
• Community Healthcare Trusts
• Mental Health Trusts
• GP Practices
• CCGs - for users involved in direct patient care, and not in the commissioning functions of CCGs
The method of accessing the PDS determines the type of user accessing the PDS. For case management systems with an online real-time tracing capability, it will usually be the social care professionals themselves. For the Demographics Batch Service (DBS) offline method it will be the administrators who support the social care professionals. System administrators will also need access in order to resolve data quality issues, for example where there are discrepancies between the data in the case management system and that in the PDS.
The following types of social care record held by the authority are included in the scope of this submission.
-Adult Case files; Residential Care (looked after in care); Home Care
-Blind / Partially Sighted or Deaf Adult files
-Physically disabled client / Disability Services file
-Deprivation of Liberties
-Learning Disability client Case file
-Mental Health client case file
-Transitions (the transition from child social care provision to adult social care provision)
-Safeguarding: any adult case file that contains a Safeguarding Adults activity
The method of accessing the PDS determines the type of user accessing the PDS. For case management systems with an online real-time tracing capability, as in this case, it will usually be the social care professionals themselves. System administrators may, from time-to-time, also need access in order to resolve data quality issues.
High Level Use Case
For people receiving support from Adult Social Care then the NHS may share their NHS Numbers with Adult Social Care. This is so that the NHS and Adult Social Care are using the same number to identify clients whilst providing care. By using the same number the NHS and Adult Social Care can work together more closely to improve care and support.
The NHS Number is accessed through an NHS service called the Personal Demographics Service (PDS). Adult Social Care sends basic information such as client name, address and date of birth to the PDS so it can find the NHS Number. Once retrieved from the PDS the NHS Number is stored on the Authority’s Adult Social Care case management system.
It should be noted that the NHS Number is not shared with any other organisation directly. It is used within the case management system and to link health and social care information together.
The NHS Number will only be requested for adult social care cases where its use will contribute to the direct care of the person. The rules by which a person’s NHS Number will be requested are as follows:
• Recorded on the Adult Social Care case management system with at least one allocated worker. This shows that the case has been allocated to a social worker either for assessment, review or ongoing support. It is at this point that the social worker will need to contact health partners in order to provide a holistic assessment of need and to ensure that any support provided is aligned to current health interventions.
• The allocation has no end date recorded, the case is currently with a social worker
• The person does not have a date of death recorded
The NHS Number then has two uses, the first being a unique identifier to allow social care information to be displayed, the second being the inclusion of the NHS Number on printed material that is used by health and social care colleagues in the provision of direct care.
NHS Number use in the Case Management System
The NHS Number will also be printed on a subset of social care printed documentation that is specifically used to communicate between health and social care organisations, currently around 100 documents have been identified. This brings the benefit of better co-ordinated and safer care across health and social care through the use of the unique identifier rather than a reliance on name and date of birth to identify a patient.
These printed forms relate to:
• support and care planning
• reablement and rehabilitation
• medical consent
• GP consent
• transitional beds
• deprivation of liberty
• case review
Most of the benefits detailed in this section relate to patient or practitioner benefits and not individual organisation benefits. The NHS Number is used to facilitate greater joining up of care across the whole health and social care system, as such it is impossible to say that health realise the benefit here and social care realise the benefit there. In the integrated world the patient and those delivering care and support are the ones that directly see the benefit.
The use of joined up information across health and social care brings many benefits. One specific example where this will be the case is the discharge of patients into social care. At the moment delays in discharge (commonly known as bed blocking) can occur because details of social care involvement are not readily available to the staff on the hospital ward. The hospital simply does not know who to contact to discuss the ongoing care of the patient. The linking of social care and health information via the NHS Number will help hospital staff quickly identify if social care support is already in place and who the most appropriate contact is. Ongoing care can be planned earlier in the process because hospital staff will know who to talk to.
The addition of adult social care data, enabled via the storage of the NHS Number, will bring additional benefits:
• better coordinated and safer care across health and social care enabled through the sharing of real-time information
• better co-ordination of discharges from hospital into social care, as explained above
• more time to spend on planning and coordinating social care because health staff can identify and involve social care staff earlier in the process
• earlier intervention to maximize the opportunities of reablement services leading to greater independence for patients
• less paperwork and more efficient use of social care resources
The PDS will return a single matched NHS Number and associated patient demographics or an error code and description. The returned NHS Number will be used to update the adult social care client record held on the case management system. The recording of this unique identifier will enable the coordinated care of individuals across health and social care as described above.
As indicated above, within the Adult Social Care case management system the NHS Number will be used to ensure that information exchanges with healthcare colleagues (by whatever method) who are dealing with the same individual are indeed about the same individual, the NHS Number being an unambiguous identifier.
The current planned implementation date is 3 Apr 2017.
The System Process
The PDS will be accessed using a Spine Mini Service Provider (SMSP), supplied by Caremotive Limited. The SMSP is used for simple traces, meaning that only exact matches to the search criteria are supplied by the PDS. It is anticipated that the monthly volumes of traces will be about 200 - 600 per month.
There are four processes that will be implemented in the Adult Social Care case management system in order to match and validate NHS Numbers:
• Get NHS Number - this is an automated process that matches NHS Numbers from the PDS with case management system Client details. Only clients that meet the Legitimate Relationship criteria described in the Objective for Processing section above are selected for matching. The process is designed to operate to a pre-defined schedule at a frequency of 30 minutes or less.
• System Administration Screens - System Administration screens will be available to manage the PDS process and to identify where errors in NHS Number matching need to be corrected.
• Verify existing NHS Number - this process verifies the NHS Numbers stored in the case management system with the PDS.
• PDS Search - this process allows for a search of the PDS to take place based on specified search criteria. The screen will form part of the System Administration screens and therefore will only be accessible by Systems Administrators. The screen will be used to help rectify errors and mismatches in the case management system.
Each process will send Date of Birth, Surname, Forename, Gender, Address and Postcode to the PDS via a Spine Mini Service. The PDS will return a single matched NHS Number and associated patient demographics or an error code and description.
PDS tracing within the case management system is through an automated process that selects records for matching that meet the Legitimate Relationship criteria. Records that already contain an NHS Number will not be selected for matching. A PDS search screen is available but its use is limited to a small number of system administrators and data quality staff who use this screen to ensure accurate matching and the maintenance of data quality. This search screen has an easy to use graphical interface which validates data upon entry and allows a basic trace to be easily executed.
System administrators and data quality staff will work in conjunction with front line social care colleagues to try to resolve any discrepancies in NHS Number matching. Where this is not possible health colleagues will be contacted (GP etc.) to try to confirm details. The PDS National Back Office (NBO) is available to try to resolve difficult data quality cases.
Once retrieved from the PDS the NHS Number will be stored on the client’s record within the case management system, which is a secure system that implements a local standard for Role Based Access Control (RBAC). The RBAC process is administered by the system administration team with system functions being allocated dependent upon job role and team. Where required, social care client records are shielded by inclusion of the appropriate staff, the procedure is to give access to only the professionals involved with the case e.g. the social worker, team manager, occupational therapist etc. Strong passwords for access to the case management system are enforced and must be changed every 90 days.
System suppliers will not have routine access to the data in the case management system. However, occasional access may be required for maintenance and fault resolution purposes; this is covered in confidentiality clauses in supplier contracts.
Training for new users of the case management system specifically covers the use of the NHS Number. The training explains what the NHS Number is, who has an NHS Number and how it is used by adult social care in the authority.
The Business Process
Once stored in the case management system the NHS Number will be accessible by social work colleagues working with health colleagues in order to assess need, review existing service or support a client who is being jointly cared for by health and social care. In these circumstances the NHS Number will be used as an identifier to ensure all parties are using the correct information. Without the NHS Number the identification process relies on name, address, date of birth which are not always the most accurate and up to date pieces of information. The NHS Number will also be printed on all correspondence that flows from adult social care to health, again this acts as a means of ensuring accuracy of information.
In summary the process is as follows:
• Person presents to adult social care
• Person’s details are recorded as a contact in the case management system
• Person is either signposted to non-adult social care services or is allocated to a social worker for assessment and created as a client in case management system
• If allocated to a social worker the clients details are sent to the PDS for NHS Number matching
• The returned NHS Number is stored on the clients record
• The social work colleagues then use the NHS Number when contacting health colleagues in partner health organisations in order to carry out an holistic assessment of need, a review of current services or provide ongoing support and provision of service to the person
• The NHS Number is printed on correspondence to health organisations
As detailed previously the NHS Number will be used in support of the delivery of specific statutory functions within Adult Social Care.