NHS Digital Data Release Register - reformatted
Project 1 — DARS-NIC-14455-D2N8Z
Opt outs honoured: N
Sensitive: Non Sensitive
When: 2016/04 (or before) — 2016/08.
Legal basis: Health and Social Care Act 2012
Categories: Anonymised - ICO code compliant
- Hospital Episode Statistics Outpatients
- Hospital Episode Statistics Admitted Patient Care
- Hospital Episode Statistics Accident and Emergency
FTI Consulting requires Hospital Episode Statistics (HES) data to provide services to NHS organisations - specifically to undertake financial and economic analyses for NHS trusts, Foundation trusts, CCGs, Monitor and NHS England only. FTI Consulting’s services are normally through a public sector framework (e.g. Monitor framework, Elis Framework, or sometimes via a non-competitive tender). FTI Consulting works with NHS trusts and CCGs across England. Though to date, FTI Consulting has tended to work more with CCGs and NHS providers located in North West England, Essex and London, it does not focus on any particular region and hence needs access to a national database. Moreover, the work involves benchmarking across regions to help inform a particular CCGs or Trusts strengths and weaknesses – for which access to national data is a prerequisite. FTI Consulting also works with national bodies such as Monitor and NHS England and hence requires access to national HES data. In any financial year, FTI Consulting typically undertakes between 15 and 20 projects. Each project usually involves multiple CCGs and providers. For example, a recent piece of benchmarking performed for NHS England required the provision of benchmarking analysis for 32 CCGs. In another recent piece of work for Liverpool CCG, involved demand analysis for 9 NHS providers. This work is commissioned by these bodies when they are seeking a) analysis of performance improvement opportunities, b) analysis of options for service reconfiguration or c) new contracting arrangements to support new models of care. This work is typically commissioned in a two to four week procurement period and deadlines for completion of analysis are normally very short. FTI Consulting requires the latest three years of data on an ongoing basis in order to processes requests in a timely manner. Having the data enables FTI Consulting to provide these specified NHS organisations with the information that they need to plan for in-year service improvements. FTI Consulting also undertakes its own cleansing of the data which means that submitting new requests for each individual project is impractical. Typically, a client (such as an NHS trust) asks FTI Consulting to undertake an analysis of its performance improvement opportunities compared to that of peer trusts. The client is normally seeking to understand whether it is carrying out more or less activity than a peer organisation and therefore whether efficiencies can be made. For example, a trust may ask whether a patient stays in its hospital for longer after a particular operation than at a similar NHS Trust. The analysis provided by FTI Consulting provides the client with a graph comparing its hospital activity to an anonymised peer group. FTI Consulting also overlays cost information (based on reference cost data) to supply the NHS trust with an indicative cost saving figure. For reconfiguration planning, a hospital or CCG normally approaches FTI Consulting to undertake activity, demand and capacity analysis. For example, FTI Consulting was recently contracted by Liverpool CCG who wanted to consider hospital reconfiguration options. This required acute activity data across a multitude of providers and CCGS. FTI Consulting undertook analysis of a pseudonymised extract of SUS data, which was provided by the associated CSU. It would have been possible to analyse a greater number of data fields if FTI Consulting had access to HES data instead (rather than the subset provided by the CSU). It would also have been possible to undertake more comparative analysis (for example, for each of the providers in question it would have been possible to compare their activity patterns with peers nationwide). HES data is also naturally preferable to SUS data for most analysis and research since HES data is essentially collated SUS data that has been ‘cleaned’ of errors and validated with providers etc. The burden on local NHS stakeholders would also have been considerably lower. In the hospital reconfiguration scenario, FTI Consulting are able to use the activity information to tell the CCG how much activity it needs to plan for and therefore which hospitals may need to be included in any future reconfiguration planning. When supporting hospitals/CCGs to design new contractual arrangements for new models of care, FTI Consulting requires access to recent activity data in order to forecast the likely value of the contract. For example, if a hospital and a CCG are moving to a new contractual model for orthopaedics, HES or SUS data is required to analyse historical activity patterns and model the likely activity over the next 3 to 5 years. FTI Consulting has recently performed this type of work for Camden and West Essex CCGs. Whether assisting with performance improvement or service reconfiguration analysis, the outputs of FTI Consulting’s work allow NHS providers and commissioners to understand the opportunities for changing and improving services for patients.
Benefits would include enhanced forecasting of demand to enable the NHS and its components to more effectively invest in resources. It will allow providers to identify where they are under-performing compared to peers and therefore where there is potential for improvement (e.g. by reducing average length of stay for particular specialities down to the average of a comparable peer group). The provider organisation will need to change practices in line with FTI Consulting’s recommendations, based on the analysis FTI Consulting have carried out. Forecasting would be both long-term (5-10 years) and day-to-day (demand spikes). Where FTI Consulting has been commissioned to support a provider with analysis of their performance, FTI Consulting will charge for its work in line with procured rates. There will be no incremental charge for the use of HES data in FTI Consulting’s analyses. Each project will vary upon each request but typically organisations are looking for millions of pounds of potential savings over a three to five year period. FTI Consulting will therefore be able to support NHS organisations to compare their performance to other similar organisations, to understand the areas where they can improve and make recommendations for those improvements. Comparisons will show where the trusts are under-performing or over-performing compared to their peers. This therefore clarifies the areas where resources should be focussed. Finally, FTI Consulting’s work analysing demand and activity for new contractual models allows organisations to agree likely activity levels and carry out appropriate financial planning.
When providing benchmarking services, the output of the analysis will comprise financial and economic analysis, presented in tables and graphs to predict both current demand, future demand, and demand under alternative scenarios, and comparison to peers. These graphs allow NHS trusts and Foundation trusts to see where they are not performing as well as peer groups, and also how much a change in performance might allow them to save (in financial terms). The output of the analysis will include only aggregate level data (in line with the HES Analysis Guide), and predictions of demand at the trust-level and speciality level. FTI Consulting will not report predictions for particular individuals. For example, FTI Consulting may report that a trust should expect 500 patients for maternity within a year. FTI Consulting will be able to make recommendations to not only better determine the size of facilities and other resources needed to meet demand, but also, how to allocate resources. Where FTI Consulting has been commissioned to support a provider with analysis of their performance, FTI Consulting will charge for FTI Consulting’s work in line with procured rates. There will be no incremental charge for the use of HES data in FTI Consulting’s analyses. The outputs of FTI Consulting’s analysis will be provided to the commissioning organisation, in line with the target timelines agreed with that organisation at the outset.
The data will be stored at a single site within the UK, under encryption, on a securely kept hard drive on FTI Consulting’s own servers. It will be accessed only by FTI Consulting employees authorised to access it, and data will remain on site at all times. Analysis will be performed through the use of a single terminal, and remote access will not be possible. FTI Consulting’s process for responding to data requests from clients is as follows: 1. Clarification of client requirements through discussion. Written request outlining scope of request obtained. 2. Internal review of request by our data analyst (who is aware of his responsibilities in handling the data). 3. Sign-off of request by FTI Consulting’s lead responsible partner. 4. Processing of request. Data will only be shared with clients in the form of graphs and charts. No data will be shared in raw format or in tables. Small numbers will be suppressed in line with HES analysis guide. 5. Review of outputs by lead responsible partner before submission to client. Small numbers will be suppressed in line with the HES analysis guide. Patient level data will not be sold to, shown to, or shared with any 3rd party, or anyone within FTI Consulting not authorised to access it. In addition, the outputs generated will not be shared with FTI Consulting’s clients for their use in commercial purposes.