NHS Digital Data Release Register - reformatted
National Institute for Health and Care Excellence (NICE)
Project 1 — DARS-NIC-11302-Q1L1F
Opt outs honoured: No - data flow is not identifiable (Does not include the flow of confidential data)
Sensitive: Non Sensitive
When: 2017/09 — 2020/07.
Repeats: Ongoing, System Access
Legal basis: Health and Social Care Act 2012, Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii)
Categories: Anonymised - ICO code compliant
- Hospital Episode Statistics Admitted Patient Care
- Hospital Episode Statistics Accident and Emergency
- Hospital Episode Statistics Outpatients
- Hospital Episode Statistics Critical Care
The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing evidence-based guidance on health and social care. NICE guidance, standards and other resources help health, public health and social care professionals deliver the best possible care within the resources available. Hospital Episode Statistics (HES) are used for the following: - during the scoping of guidance and standards; - at review; and - to develop resource impact assessment tools for commissioners/and providers. The data is used to evaluate activity both prior to and following publication of guidance/standards e.g. when developing guidance or deciding if it should be reviewed. This data allows NICE to establish current activity levels in the NHS and enables the resource impact of implementing guidance to be established with increased precision. NICE uses HES data during the development of general practice and CCG level indicators. This is work jointly completed by NICE and NHS Digital on behalf of NHS England. These indicators provide clear, comparative information about the quality of health services and may be included in national frameworks such as the QOF, CCGOIS and CCGIAF. Extract data at a national level but may need local level data for highly specialised technologies (small numbers of people) or for work associated with the cancer drugs fund. Data will only be used for purposes relating to the provision of healthcare or the promotion of health in line with the requirements of the Health and Social Care Act 2012 as amended by the Care Act 2014.
1. Use of data to support implementation tools for NICE guideline: Heavy menstrual bleeding: assessment and management (NG73) Benefits: NICE produces reports, templates and statements alongside guidance. They detail the potential impact of implementing guidance on NHS finances and other resources (workforce, capacity and demand, infrastructure and training and education). The resource impact statement sets out the implementation of this guidance has the potential to generate costs savings through reduced emergency department admissions. 2. Use of data to support implementation tools for NICE guideline: Pancreatic cancer in adults: diagnosis and management (NG85) Benefits: NICE produces reports, templates and statements alongside guidance. They detail the potential impact of guidance on finances and other resources (workforce, capacity and demand, infrastructure and training and education). The resource impact statement sets out the implementation of this guidance has the potential to generate costs savings through reduced number of pancreatectomies.
Evidence based guidance has clear benefits for the Health and Social Care sectors and for patients. The benefits of using the data extend beyond the term of the proposed contract. The uptake and impact of NICE guidance can be found here: https://www.nice.org.uk/About/What-we-do/Into-practice/Measuring-the-uptake-of-NICE-guidance. Measuring the impact of NICE guidance is complicated as many other factors also contribute to patient outcomes. Examples of benefits achieved using HDIS NICE uses HDIS HES data to support the development and implementation of NICE Guidance and Quality Standards in the following ways:- HES data are used to provide the NHS with information to help them understand the resource impact of implementing NICE guidance. NICE also uses the data to develop evidence based guidance. The data are used to understand the population likely to benefit from the introduction of new medicines and technologies. The following are two specific examples to illustrate how NICE uses this data: 1. Use of data to support implementation tools (NICE guidelines [NG59]) Output: Resource impact statement published November 2016 https://www.nice.org.uk/guidance/ng59/resources/resource-impact-statement-2726444413 The number of finished consultant episodes (FCEs), by age and gender, was extracted to establish how many spinal fusion procedures were completed for people with a diagnosis of lower back pain. The data were used to confirm low levels of activity and consequently the associated cost impact would not be significant. Summary statistics: At a national level the data were used to estimate the number of people undergoing a spinal fusion with a diagnosis of lower back pain. The number of FCEs by age and gender were used by NICE’s resource impact assessment team to calculate the population likely to be affected by the guideline. Published: The resource impact statement has been published on the NICE website and does not contain any data. The statement is freely available (see link above). Benefits: NICE produces reports, templates and statements alongside our guidance. They detail the potential impact of guidance on finances and other resources (workforce, capacity and demand, infrastructure and training and education. Health and care organisations (NHS trusts and commissioners) will be aware that implementation of this guidance has the potential to generate costs savings, although they are not expected to be significant. 2. Use of data to support the development of a quality standard statement (NICE quality standard [QS152]) Output: Minutes October 2016, advisory committee decisions: https://www.nice.org.uk/guidance/qs152/documents/minutes Aggregated data taken from the resource impact assessment tool for NG50, originally extracted from HDIS, were used to estimate the number of people who had an unplanned admission related to cirrhosis/fibrosis of the liver, excluding alcoholic fibrosis or cirrhosis, and who underwent a procedure (OPCS codes extracted). Summary statistics: At a national level the data were used to estimate the number of admissions for cirrhosis/fibrosis and of those the number expected to undergo a procedure. The data were used to confirm a low level of activity relative to the potential number of people who might be screened in primary care for liver disease. Published: A high level summary of the committee discussion was published. The minutes of the meeting do not reference the use of HES data but are freely available. Benefits: NICE quality standards set out the priority areas for quality improvement in health and social care. They cover areas where there is variation in care. Each standard gives a set of statements to help improve quality and information on how to measure progress. NICE quality standards are used by primary and secondary care providers, local authorities and social care providers. The identification of liver disease in primary care was not selected as priority area for quality improvement. Specifically, for adults, the committee felt that there was a lack of specific guideline recommendations to support a quality statement and it was therefore reluctantly agreed that there could not be a quality statement about identifying NAFLD in higher-risk groups. The data helped to explain the resource impact of testing for liver disease in primary care relative to those who would require an intervention.
The data is being used for the development of guidance/standards that: are independent and authoritative, are based on the best available evidence and set out the best ways to prevent, diagnose and treat disease and ill health, promote healthy living, and care for vulnerable people. The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. HES data are used during guidance development and to produce tools to support its implementation. Users of HDIS are able to produce outputs from the system in a number of formats. The system has the ability to be able to produce small row count extracts for local analysis in Excel or other local analysis software. Users are also able to produce tabulations, aggregations, reports, charts, graphs and statistical outputs for viewing on screen or export to a local system. Any outputs that are produced from the system that are to be published or shared will be small number suppressed outputs in line with the HES analysis guide. Users are not permitted to link data extracted from the system to any other data items which make the data identifiable. The results are provided to teams within NICE responsible for guidance/standard/indicator development. They are also discussed by guidance/indicator developing committees. Key documents used during the development of guidance/standards are published on NICE’s website. Only data in a format suitable for publication will be presented. These documents are available free of charge to the public. Outputs will contain only aggregate level of data and small numbers suppressed in line with the HES analysis guide/ small numbers policy. NICE publishes new guidance throughout the year and so this work is on-going. HES data is also used by NICE’s indicator development team during the development phase of QOF and CCG OIS indicators. This is work jointly undertaken by NICE and the NHS Digital, and is funded by NHS England. The data are discussed at indicator development committees but only once the small numbers policy has been applied (see above).
The data will be extracted from HDIS in an aggregated form and shared with guidance, guideline, indicator and tool developing teams within NICE. The data is shared using a secure distribution method (NICE Share is a HTTPS file sharing application based on Microsoft IIS. All communication is encrypted using HTTPS and authentication is required for any file access). The data will be used to: assess current activity levels in the NHS, in cost effectiveness analysis (economic modelling) and to cost the implementation (resource impact assessment) of NICE guidance. All data extracted from HDIS which includes small number are stored in network folders which have restricted access. The HDIS database and any extracted aggregate data which includes small numbers will only be access using the NICE network through desktop PCs. Any data held temporarily on portable equipment must be supported by a business case and must be encrypted to a minimum of AES25. To complete trend analysis NICE require access to the last five years of data. Analysis of the last full five years data enables patterns and trends to be established and allows NICE to assess the level of need/cost with increased precision. The data extracted from HDIS is compared to other datasets at a national level (England) e.g. prescribing data in the Innovation Scorecard. No data will be linked to record level patient data. The majority of the data extracted from HDIS is at a national level (England) however access to local level data (CCG or trust) is sometimes needed when developing resource impact assessment tools or during the scoping of guidance to establish if there is variation in practice across the country (England). Access to pseudonymised record level data is essential when considering guidance for rare conditions/diseases, as they often affect very small numbers of people. NICE has offices in Manchester and London, and the data extracted from HDIS will be stored and accessed using servers based onsite in these locations; each server is a mirror of the other. The security arrangements and policies are the same for both locations. HDIS is only accessed by Manchester based staff. Record level data will not be extracted from the database. All extracts taken from the database will be aggregate level which may contain small numbers. Data in format suitable for publication, after the small numbers policy has been applied (in line with the HES analysis guide) are shared with committee members. All committee members have signed confidentiality agreements. Outputs will contain only aggregate level data with small numbers suppressed in line with the HES analysis guide.