NHS Digital Data Release Register - reformatted
NHS Wandsworth Ccg projects
112 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).
🚩 NHS Wandsworth Ccg was sent multiple files from the same dataset, in the same month, both with optouts respected and with optouts ignored. NHS Wandsworth Ccg may not have compared the two files, but the identifiers are consistent between datasets, and outside of a good TRE NHS Digital can not know what recipients actually do.
Project 1 — DARS-NIC-43405-T5C4G
Type of data: information not disclosed for TRE projects
Opt outs honoured: Yes - patient objections upheld (Section 251)
Legal basis: Health and Social Care Act 2012 – s261(7)
Purposes: ()
Sensitive: Sensitive
When:2018.10 — 2019.05.
Access method: Frequent Adhoc Flow
Data-controller type:
Sublicensing allowed:
Datasets:
- SUS for Commissioners
Objectives:
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North & East London Commissioning Support Unit
Expected 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 thus allowing early intervention.
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. Supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework by allowing for more targeted intervention in primary care.
5. Better understanding of local population characteristics through analysis of their health and healthcare outcomes
All of the above lead to improved patient experience through more effective commissioning of services.
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 (of the CCG), pseudonymised at patient level.
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.
5. The CCG will be able to target specific patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions. The CCG will also be able to:
o Stratify populations based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost
o Plan work for commissioning services and contracts
o Set up capitated budgets
o Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
Processing:
Data must only be used as stipulated within this Data Sharing Agreement.
Data Processors must only act upon specific instructions from the Data Controller.
Data can only be stored at the addresses listed under storage addresses.
Patient level data will not be shared outside of the CCG unless it is for the purpose of Direct Care, where it may be shared only with those health professionals who have a legitimate relationship with the patient and a legitimate reason to access the data.
All access to data is managed under Roles-Based Access Controls
No patient level data will be linked other than as specifically detailed within this 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 NHS Digital will not be national data, but only that data relating to the specific locality and that data required by the applicant.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)
The DSCRO (part of NHS Digital) will apply Type 2 objections before any identifiable data leaves the DSCRO.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
Segregation
Where the Data Processor and/or the Data Controller hold both identifiable and pseudonymised data, the data will be held separately so data cannot be linked.
All access to data is auditable by NHS Digital.
Risk Stratification
1. Identifiable SUS+ data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to North & East London Commissioning Support Unit 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 & East London Commissioning Support Unit.
4. SUS+ data is linked to GP data in the risk stratification tool by the data processor.
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. Once North & East London Commissioning Support Unit has completed the processing, the CCG can access the online system via a secure connection to access the data pseudonymised at patient level.
Project 2 — NIC-43405-T5C4G
Type of data: information not disclosed for TRE projects
Opt outs honoured: N, Y ()
Legal basis: Health and Social Care Act 2012, Section 251 approval is in place for the flow of identifiable data
Purposes: ()
Sensitive: Sensitive
When:2017.06 — 2017.05.
Access method: Ongoing
Data-controller type:
Sublicensing allowed:
Datasets:
- Children and Young People's Health Services Data Set
- Improving Access to Psychological Therapies Data Set
- 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 - Population Data
- Local Provider Data - Primary Care
- Mental Health and Learning Disabilities Data Set
- Mental Health Minimum Data Set
- Mental Health Services Data Set
- SUS Accident & Emergency data
- SUS Admitted Patient Care data
- SUS Outpatient data
- Local Provider Data - Other not elsewhere classified
- Maternity Services Dataset
- SUS data (Accident & Emergency, Admitted Patient Care & Outpatient)
- SUS for Commissioners
- Public Health and Screening Services-Local Provider Flows
- Primary Care Services-Local Provider Flows
- Population Data-Local Provider Flows
- Other Not Elsewhere Classified (NEC)-Local Provider Flows
- Mental Health-Local Provider Flows
- Maternity Services Data Set
- Experience, Quality and Outcomes-Local Provider Flows
- Emergency Care-Local Provider Flows
- Diagnostic Services-Local Provider Flows
- Diagnostic Imaging Dataset
- Demand for Service-Local Provider Flows
- Community-Local Provider Flows
- Children and Young People Health
- Ambulance-Local Provider Flows
- Acute-Local Provider Flows
- 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, Population Data, Primary Care, Public Health & Screening services
Objectives:
ASH Status
This is an application to use SUS data identifiable at the level of NHS Number and local provider data identifiable at the level of NHS Number according to S.251 CAG 2-03(a)/2013.
The NHS number 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 analysis of patient data across health pathways.
The application also includes a request for MHSDS, MHMDS, MHLDDS and MSDS data identifiable at the level of NHS number to provide intelligence to support commissioning of health services.
Risk Stratification
This is an application to use SUS data identifiable at the level of NHS number 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.
Pseudonymised – SUS and Local Flows
This is an application for the CCG to use pseudonymised SUS and local provider data to provide intelligence to support commissioning of health services. The linked, 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.
Pseudonymised – IAPT, CYPHS and DIDS
This is an application for the CCG to use IAPT, CYPHS and DIDs 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.
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 HSCIC will not be national data, but only that data relating to the specific locality of interest of the applicant.
Expected Benefits:
ASH Status
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.
(b) 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) flows.
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. .
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.
Pseudonymised – IAPT, CYPHS and DIDS
1) Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management and pathways.
2) Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
3) Health economic modelling using:
(a) Analysis on provider performance.
(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.
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.
Outputs:
ASH Status
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.
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 pseudonymised at patient level
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.
ASH – 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.
Pseudonymised – 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 acute / community / mental health quality matrix.
6) Clinical coding reviews / audits.
7) Budget reporting down to individual GP Practice level.
Processing:
South London DSCRO will apply Type 2 objections (from 1st October 2016 onwards) before any identifiable data leaves the DSCRO.
ASH Status
For the purpose of commissioning activities, the CCG requires SUS data identifiable at the level of NHS Number. The CCG also requires local provider data identifiable at the level of NHS number.
South East CSU acts as the data processor on behalf of the CCG, receiving SUS and local provider data identifiable at the level of NHS number.
South London DSCRO has a legitimate relationship with the CCG, for the provision of data.
1. a) South London DSCRO– part of the HSCIC - receive identifiable SUS data from the SUS Repository at HSCIC. DSCRO also receives identifiable local provider data directly from Providers (as per Data Services for Commissioners Directions 2015).
b) South London DSCRO also receives MHMDS, MHSDS, MHLDDS and MSDS data with NHS number.
2. Data quality management and standardisation of the data is completed by South London DSCRO.
3. a) South London DSCRO then securely transfers the SUS data identifiable at the level of NHS number and Local Provider data identifiable at the level of NHS number to South East CSU.
4. South London DSCRO then securely transfers the MHMDS, MHSDS, MHLDDS and MSDS data identifiable at the level of NHS number to South East CSU.
5. South East CSU ensures the addition of derived fields and analysis takes place, including linkage of SUS and local provider data, then flows the data securely to the CCG.
Risk Stratification
1) SUS data identifiable at the level of NHS number regarding hospital admissions, A&E attendances and outpatient attendances is delivered securely from South London Data Services for Commissioners Regional Office (DSCRO) to the data processor.
2) Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to South East CSU, who hold the SUS data within the secure Data Centre on N3.
3) SUS data is linked to GP data in the risk stratification tool by the data processor.
4) 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.
5) South East 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.
6) Once South East CSU has completed the processing, the CCG can dial into the online system via N3 connection to access the data anonymised at patient level.
Pseudonymised – IAPT, CYPHS and DIDS
1) South London Data Services for Commissioners Regional Office (DSCRO) 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 of data is completed by the DSCRO and the pseudonymised data is then passed securely to South East CSU for the addition of derived fields and analysis.
3) South East CSU then pass the processed, pseudonymised data to the CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning.
4) The CCG analyses the data to see patient journeys for pathway or service design, re-design and de-commissioning
5) The CCG completes aggregation of required data for CCG management use – disclosing any outputs at the appropriate level.
6) Patient level data will not be shared outside of the CCG and will only be shared within the 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.