NHS Digital Data Release Register - reformatted

NHS Cumbria Ccg

Project 1 — NIC-36767-G4H9Z

Opt outs honoured: N, Y

Sensitive: Sensitive

When: 2016/12 — 2017/11.

Repeats: Ongoing

Legal basis: Health and Social Care Act 2012, Section 251 approval is in place for the flow of identifiable data

Categories: Anonymised - ICO code compliant, Identifiable

Datasets:

  • SUS (Accident & Emergency, Inpatient and Outpatient data)
  • Local Provider Data - Acute, Ambulance, Community, Demand for Service, Diagnostic Services, Emergency Care, Experience Quality and Outcomes, Mental Health, Other not elsewhere classified, Population Data, Primary Care, Public Health & Screening services
  • Local Provider Data - Acute
  • Local Provider Data - Ambulance
  • Local Provider Data - Community
  • Local Provider Data - Demand for Service
  • Local Provider Data - Diagnostic Services
  • Local Provider Data - Emergency Care
  • Local Provider Data - Experience Quality and Outcomes
  • Local Provider Data - Public Health & Screening services
  • Local Provider Data - Mental Health
  • Local Provider Data - Other not elsewhere classified
  • Local Provider Data - Population Data
  • Local Provider Data - Primary Care
  • SUS Accident & Emergency data
  • SUS Admitted Patient Care data
  • SUS Outpatient data
  • Children and Young People's Health Services Data Set
  • Improving Access to Psychological Therapies Data Set
  • Maternity Services Dataset
  • Mental Health Services Data Set

Benefits:

Risk Stratification Risk stratification promotes improved case management in primary care and will lead to the following benefits being realised: 1. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these. 2. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care. 3. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required. 4. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework. 5. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics. All of the above lead to improved patient experience through more effective commissioning of services. Commissioning (Pseudonymised) – SUS and Local Flows 1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways. a. Analysis to support full business cases. b. Develop business models. c. Monitor In year projects. 2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types. 3. Health economic modelling using: a. Analysis on provider performance against 18 weeks wait targets. b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients. c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway. d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC). 4. Commissioning cycle support for grouping and re-costing previous activity. 5. Enables monitoring of: a. CCG outcome indicators. b. Non-financial validation of activity. c. Successful delivery of integrated care within the CCG. d. Checking frequent or multiple attendances to improve early intervention and avoid admissions. e. Case management. f. Care service planning. g. Commissioning and performance management. h. List size verification by GP practices. i. Understanding the care of patients in nursing homes. 6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers. 7. Provision of Morecambe Bay wide analysis to support the reconfiguration of services across a challenged health economy. Commissioning (Pseudonymised) – Mental Health, Maternity, IAPT, CYPHS and DIDS 1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, Integrated care and pathways. a. Analysis to support full business cases. b. Develop business models. c. Monitor In year projects. 2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types. 3. Health economic modelling using: a. Analysis on provider performance against 18 weeks wait targets. b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients. c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway. d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC). 4. Commissioning cycle support for grouping and re-costing previous activity. 5. Enables monitoring of: a. CCG outcome indicators. b. Non-financial validation of activity. c. Successful delivery of integrated care within the CCG. d. Checking frequent or multiple attendances to improve early intervention and avoid admissions. e. Case management. f. Care service planning. g. Commissioning and performance management. h. List size verification by GP practices. i. Understanding the care of patients in nursing homes. 6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers. 7. Provision of Morecambe Bay wide analysis to support the reconfiguration of services across a challenged health economy.

Outputs:

Risk Stratification 1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems. 2. Output from the risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk. 3. Record level output will be available for commissioners within the CCG pseudonymised at patient level as well as aggregated reports. 4. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient. Commissioning (Pseudonymised) – SUS and Local Flows 1. Commissioner reporting: a. Summary by provider view - plan & actuals year to date (YTD). b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD. c. Summary by provider view - activity & finance variance by POD. d. Planned care by provider view - activity & finance plan & actuals YTD. e. Planned care by POD view - activity plan & actuals YTD. f. Provider reporting. g. Statutory returns. h. Statutory returns - monthly activity return. i. Statutory returns - quarterly activity return. j. Delayed discharges. k. Quality & performance referral to treatment reporting. 2. Readmissions analysis. 3. Production of aggregate reports for CCG Business Intelligence. 4. Production of project / programme level dashboards. 5. Monitoring of acute / community / mental health quality matrix. 6. Clinical coding reviews / audits. 7. Budget reporting down to individual GP Practice level. 8. GP Practice level dashboard reports include high flyers. Commissioning (Pseudonymised) – Mental Health, Maternity, IAPT, CYPHS and DIDS 1. Commissioner reporting: a. Summary by provider view - plan & actuals year to date (YTD). b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD. c. Summary by provider view - activity & finance variance by POD. d. Planned care by provider view - activity & finance plan & actuals YTD. e. Planned care by POD view - activity plan & actuals YTD. f. Provider reporting. g. Statutory returns. h. Statutory returns - monthly activity return. i. Statutory returns - quarterly activity return. j. Delayed discharges. k. Quality & performance referral to treatment reporting. 2. Readmissions analysis. 3. Production of aggregate reports for CCG Business Intelligence. 4. Production of project / programme level dashboards. 5. Monitoring of mental health quality matrix. 6. Clinical coding reviews / audits. 7. Budget reporting down to individual GP Practice level. 8. GP Practice level dashboard reports include high flyers.

Processing:

North of England DSCRO will apply Type 2 objections before any identifiable data leaves the DSCRO. The CCG and any Data Processor will only have access to records of its own CCG. Access is limited to those administrative staff with authorised user accounts used for identification and authentication. Risk Stratification 1. Identifiable SUS data is sent from the SUS Repository to North of England Data Services for Commissioners Regional Office (DSCRO). 2. Data quality management and standardisation of data is completed by North of England DSCRO and the data identifiable at the level of NHS number is transferred securely to North of England CSU, who hold the SUS data within the secure Data Centre on N3. 3. Identifiable GP Data is securely sent from the GP system to North of England CSU. 4. SUS data is linked to GP data in the risk stratification tool held within North of England CSU. 5. As part of the risk stratification processing activity, GPs have access to the risk stratification tool within the data processor, which highlights patients with whom the GP has a legitimate relationship and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems. 6. North of England CSU who hosts the risk stratification system that holds SUS data is limited to those administrative staff with authorised user accounts used for identification and authentication. 7. Once North of England CSU has completed the processing, the CCG can access the online system via a secure N3 connection to access the data pseudonymised at patient level and aggregated reports. Commissioning (Pseudonymised) – SUS and Local Flows To support the pan CCG view of data across Morecambe Bay data will be exchanged between DSCRO North and DSCRO Midlands and Lancashire sharing their respective CCGs data with each other. The DSCROs will then pass these consolidated datasets to their CSUs and onward to Cumbria CCG and Lancashire North all fully Pseudonymised as follows: Data Processor 1 – North of England CSU a) Cumbria Data 1. North of England Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North of England DSCRO also receives identifiable local provider data for the CCG directly from Providers. 2. Data quality management and pseudonymisation of data is completed by the DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis. 3. North of England CSU then pass the processed, pseudonymised and linked data to Cumbria CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning. 4. Aggregation of required data for CCG management use can be completed by the CSU or Cumbria CCG 5. Patient level data will not be shared outside of Cumbria CCG and will only be shared within Cumbria CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression in line with the HES analysis guide. b) Lancashire North Data 1. Central Midlands Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. Central Midlands DSCRO also receives identifiable local provider data for the CCG directly from Providers. 2. Data is securely transferred from Central Midlands DSCRO to North of England DSCRO. 3. Data quality management and pseudonymisation of data is completed by the North of England DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis. 4. North of England CSU then pass the processed, pseudonymised and linked data to Cumbria CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning. 5. Aggregation of required data for CCG management use can be completed by the CSU or Cumbria CCG 6. Patient level data will not be shared outside of Cumbria CCG and will only be shared within Cumbria CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression in line with the HES analysis guide. Data Processor 2 – AQuA (via DP1) 1. North England Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North England DSCRO also receives identifiable local provider data for the CCG directly from Providers. 2. Data quality management and pseudonymisation of data is completed by North England DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis. 3. North of England CSU then passes the pseudonymised data securely to AQuA to provide support for a range of quality improvement programmes including the NW Advancing Quality Programme. AQuA identifies cohorts of patients within specific disease groups for further analysis to help drive quality improvements across the region. 4. AQuA produces aggregate reports only with small number suppression in line with the HES analysis guide. Only aggregate reports are sent to the CCG. Only substantive employees of Salford Royal NHS Foundation Trust will have access to the record level data and only for the purpose stated within the agreement. Data Processor 3 – Academic Health Sciences Network (Utilisation Management Team) (SUS Only) (via DP1):: 1. North England Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. 2. Data quality management and pseudonymisation of data is completed by North England DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data and analysis. 3. North of England CSU then passes the pseudonymised data securely to the Academic Health Service (Utilisation Management Team) (AHSN UMT) 4. The AHSN UMT receive pseudonymised SUS data. They analyse the data to look at processes rather than patients, for example, A&E performance, process times, bed days as well as ‘deep dives’ to support clinical reviews for CCGs. 5. AHSN UMT produces aggregate reports only with small number suppression in line with the HES analysis guide. Only aggregate reports are sent to the CCG. Only substantive employees of Salford Royal NHS Foundation Trust will have access to the record level data and only for the purpose stated within the agreement. Commissioning (Pseudonymised) – Mental Health, MSDS, IAPT, CYPHS and DIDS a) Cumbria Data 1. North of England Data Services for Commissioners Regional Office (DSCRO) receives a flow of data identifiable at the level of NHS number for Mental Health (MHSDS, MHMDS, MHLDDS) and Maternity (MSDS) North of England DSCRO also receive a flow of pseudonymised patient level data for each CCG for Improving Access to Psychological Therapies (IAPT), Child and Young People’s Health (CYPHS) and Diagnostic Imaging (DIDS) for commissioning purposes 2. Data quality management and pseudonymisation of data is completed by North of England DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis. 3. North of England CSU then pass the processed, pseudonymised and linked data to the CCG. 4. Cumbria CCG analyses the data to see patient journeys for pathway or service design, re-design and de-commissioning 5. Aggregation of required data for CCG management use can be completed by the CSU or Cumbria CCG 6. Patient level data will not be shared outside of Cumbria CCG and will only be shared within Cumbria CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression in line with the HES analysis guide. b) Lancashire North Data 1. Central Midlands Data Services for Commissioners Regional Office (DSCRO) receives a flow of data identifiable at the level of NHS number for Mental Health (MHSDS, MHMDS, MHLDDS), Maternity (MSDS), Improving Access to Psychological Therapies (IAPT), Child and Young People’s Health (CYPHS) and Diagnostic Imaging (DIDS) for commissioning purposes 2. Data is securely transferred from Central Midlands DSCRO to North of England DSCRO. 3. Data quality management and pseudonymisation of data is completed by North of England DSCRO and the pseudonymised data is then passed securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis. 4. North of England CSU then pass the processed, pseudonymised and linked data to the CCG. 5. Cumbria CCG analyses the data to see patient journeys for pathway or service design, re-design and de-commissioning 6. Aggregation of required data for CCG management use can be completed by the CSU or Cumbria CCG 7. Patient level data will not be shared outside of Cumbria CCG and will only be shared within Cumbria CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression in line with the HES analysis guide.

Objectives:

Risk Stratification To use SUS data identifiable at the level of NHS number according to S.251 CAG 7-04(a)2013 (and Primary Care Data) for the purpose of Risk Stratification. Risk Stratification provides a forecast of future demand by identifying high risk patients. This enables commissioners to initiate proactive management plans for patients that are potentially high service users. Risk Stratification enables GPs to better target intervention in Primary Care Commissioning (Pseudonymised) – SUS and Local Flows To use pseudonymised data to provide intelligence to support commissioning of health services. The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets. The CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers. Commissioning (Pseudonymised) – Mental Health, Maternity, IAPT, CYPHS and DIDS To use pseudonymised data for the following datasets to provide intelligence to support commissioning of health services : - Mental Health Minimum Data Set (MHMDS) - Mental Health Learning Disability Data Set (MHLDDS) - Mental Health Services Data Set (MHSDS) - Maternity Services Data Set (MSDS) - Improving Access to Psychological Therapy (IAPT) - Child and Young People Health Service (CYPHS) - Diagnostic Imaging Data Set (DIDS) The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets. Cumbria CCG and Lancashire North CCGs are undertaking a significant transformation exercise spanning the Morecambe Bay area. This is likely to result in changes in the makeup of each CCGs responsibility. It is possible, for example, that practices in the south of the Cumbria county will join with what is currently Lancashire North CCG to form a new CCG commissioning services across the Morecambe Bay area. The remaining practices within the current Cumbria CCG will potentially remain in smaller CCG commissioning services for the East, North and West of the County. As part of the exercise the BI Teams within both respective CSU’s (North of England CSU and Midlands & Lancashire CSU) are working jointly to support the process and therefore this application includes the pan CCG sharing of all Pseudonymised commissioning data between Cumbria and Lancashire North CCGs (and their respective CSU partners) in order to complete the transformation project. A Joint Working Team made of both Cumbria CCG and Lancashire North CCG are in place to develop this project and the CCGs wish to share information to be able to inform the Joint Working Team and assist in the transformation exercise. No record level data will be linked other than as specifically detailed within this application/agreement. Data will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from the NHS Digital will not be national data, but only that data relating to the specific locality of interest of the applicant.