NHS Digital Data Release Register - reformatted

NHS Southport and Formby CCG

Project 1 — DARS-NIC-130735-P4Q6M

Opt outs honoured: No - data flow is not identifiable (Does not include the flow of confidential data)

Sensitive: Sensitive

When: 2018/06 — 2019/03.

Repeats: Frequent adhoc flow, Frequent Adhoc Flow

Legal basis: Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii)

Categories: Anonymised - ICO code compliant

Datasets:

  • Ambulance-Local Provider Flows
  • Children and Young People Health
  • Community-Local Provider Flows
  • Demand for Service-Local Provider Flows
  • Diagnostic Imaging Dataset
  • Diagnostic Services-Local Provider Flows
  • Emergency Care-Local Provider Flows
  • Experience, Quality and Outcomes-Local Provider Flows
  • Improving Access to Psychological Therapies Data Set
  • Maternity Services Data Set
  • Mental Health and Learning Disabilities Data Set
  • Mental Health Minimum Data Set
  • Mental Health Services Data Set
  • Mental Health-Local Provider Flows
  • Other Not Elsewhere Classified (NEC)-Local Provider Flows
  • Population Data-Local Provider Flows
  • Primary Care Services-Local Provider Flows
  • Public Health and Screening Services-Local Provider Flows
  • SUS for Commissioners
  • Acute-Local Provider Flows

Objectives:

Commissioning To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area. 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. The following pseudonymised datasets are required to provide intelligence to support commissioning of health services de intelligence to support commissioning of health services: - Secondary Uses Service (SUS) - Local Provider Flows o Acute o Ambulance o Community o Demand for Service o Diagnostic Service o Emergency Care o Experience, Quality and Outcomes o Mental Health o Other Not Elsewhere Classified o Population Data o Primary Care Services o Public Health Screening - 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 for the following purposes: § Population health management: • Understanding the interdependency of care services • Targeting care more effectively • Using value as the redesign principle § Data Quality and Validation – allowing data quality checks on the submitted data § Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them § Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs § Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated § Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another § Service redesign § Health Needs Assessment – identification of underlying disease prevalence within the local population § Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models 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. Processing for commissioning will be conducted by - - Arden and Greater East Midlands Commissioning Support Unit - Midlands and Lancashire Commissioning Support Unit - Advancing Quality Alliance (AQuA) - The Academic Health Sciences Network

Expected Benefits:

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. Financial and 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. 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. 8. 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. 9. 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. 10. 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. 11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics. 12. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts 13. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.

Outputs:

Commissioning 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. 9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports 10. Data Quality and Validation measures allowing data quality checks on the submitted data 11. Contract Management and Modelling 12. Patient Stratification, such as: o Patients at highest risk of admission o Most expensive patients (top 15%) o Frail and elderly o Patients that are currently in hospital o Patients with most referrals to secondary care o Patients with most emergency activity o Patients with most expensive prescriptions o Patients recently moving from one care setting to another i. Discharged from hospital ii. Discharged from community

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. The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCG. Access is limited to those substantive employees with authorised user accounts used for identification and authentication. 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. 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 NHS Digital will not be national data, but only that data relating to the specific locality of interest of the applicant. Commissioning The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets: 1. SUS 2. Local Provider Flows (received directly from providers) o Acute o Ambulance o Community o Demand for Service o Diagnostic Service o Emergency Care o Experience, Quality and Outcomes o Mental Health o Other Not Elsewhere Classified o Population Data o Primary Care Services o Public Health Screening 3. Mental Health Minimum Data Set (MHMDS) 4. Mental Health Learning Disability Data Set (MHLDDS) 5. Mental Health Services Data Set (MHSDS) 6. Maternity Services Data Set (MSDS) 7. Improving Access to Psychological Therapy (IAPT) 8. Child and Young People Health Service (CYPHS) 9. Diagnostic Imaging Data Set (DIDS) Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows: Data Processor 1 – Arden and Greater East Midlands Commissioning Support Unit 1) Pseudonymised SUS, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS) and Diagnostic Imaging data (DIDS) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. 2) Arden and Greater East Midlands Commissioning Support Unit add derived fields, link data and provide analysis to a. See patient journeys for pathways or service design, re-design and de-commissioning. b. Check recorded activity against contracts or invoices and facilitate discussions with providers. c. Undertake population health management d. Undertake data quality and validation checks e. Thoroughly investigate the needs of the population f. Understand cohorts of residents who are at risk g. Conduct Health Needs Assessments 3) Allowed linkage is between the data sets contained within point 1. 4) Arden and Greater East Midlands Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG. The CCG 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 will be completed by Arden and Greater East Midlands Commissioning Support Unit or the CCG as instructed by the CCG. 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 can be shared. Data Processor 2 – Midlands and Lancashire Commissioning Support Unit 1) Pseudonymised SUS, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS) and Diagnostic Imaging data (DIDS) only is securely transferred from the DSCRO to Midlands and Lancashire Commissioning Support Unit. 2) Midlands and Lancashire Commissioning Support Unit add derived fields, link data and provide analysis to a. See patient journeys for pathways or service design, re-design and de-commissioning. b. Check recorded activity against contracts or invoices and facilitate discussions with providers. c. Undertake population health management d. Undertake data quality and validation checks e. Thoroughly investigate the needs of the population f. Understand cohorts of residents who are at risk g. Conduct Health Needs Assessments 3) Allowed linkage is between the data sets contained within point 1. 4) Midlands and Lancashire Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG. The CCG 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 will be completed by Midlands and Lancashire Commissioning Support Unit or the CCG as instructed by the CCG. 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 can be shared Data Processor 3 – Advancing Quality Alliance (AQuA) via Arden and Greater East Midlands Commissioning Support 1) Pseudonymised SUS, Local Provider data and Mental Health data (MHSDS, MHMDS, MHLDDS) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support. 2) Arden and Greater East Midlands Commissioning Support add derived fields, link data and provide analysis to a. See patient journeys for pathways or service design, re-design and de-commissioning. b. Check recorded activity against contracts or invoices and facilitate discussions with providers. c. Undertake population health management d. Undertake data quality and validation checks e. Thoroughly investigate the needs of the population f. Understand cohorts of residents who are at risk g. Conduct Health Needs Assessments 3) Allowed linkage is between the data sets contained within point 1. 1. Arden and Greater East Midlands Commissioning Support then pass the processed, pseudonymised and linked data to Advancing Quality Alliance (AQuA). Advancing Quality Alliance (AQuA) provide support for a range of quality improvement programmes including the NW Advancing Quality Programme. Advancing Quality Alliance (AQuA) identifies cohorts of patients within specific disease groups for further analysis to help drive quality improvements across the region. 4) Aggregation of required data for CCG management use will be completed by Advancing Quality Alliance (AQuA). 5) 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 can be shared Data Processor 4 – The Academic Health Sciences Network via Arden and Greater East Midlands Commissioning Support 1) Pseudonymised SUS only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support. 2) Arden and Greater East Midlands Commissioning Support add derived fields, link data and provide analysis to a. See patient journeys for pathways or service design, re-design and de-commissioning. b. Check recorded activity against contracts or invoices and facilitate discussions with providers. c. Undertake population health management d. Undertake data quality and validation checks e. Thoroughly investigate the needs of the population f. Understand cohorts of residents who are at risk g. Conduct Health Needs Assessments 3) Allowed linkage is between the data sets contained within point 1. 4) Arden and Greater East Midlands Commissioning Support then pass the processed, pseudonymised and linked data to The Academic Health Sciences Network. The Academic Health Sciences Network 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) Aggregation of required data for CCG management use will be completed by The Academic Health Sciences Network. 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 can be shared


Project 2 — DARS-NIC-197584-N4S9C

Opt outs honoured: No - data flow is not identifiable, Yes - patient objections upheld (Does not include the flow of confidential data)

Sensitive: Sensitive

When: 2018/10 — 2019/03.

Repeats: Frequent Adhoc Flow

Legal basis: Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii), National Health Service Act 2006 - s251 - 'Control of patient information'.

Categories: Anonymised - ICO code compliant, Identifiable

Datasets:

  • Acute-Local Provider Flows
  • Ambulance-Local Provider Flows
  • Children and Young People Health
  • Community Services Data Set
  • Community-Local Provider Flows
  • Demand for Service-Local Provider Flows
  • Diagnostic Imaging Dataset
  • Diagnostic Services-Local Provider Flows
  • Emergency Care-Local Provider Flows
  • Experience, Quality and Outcomes-Local Provider Flows
  • Improving Access to Psychological Therapies Data Set
  • Maternity Services Data Set
  • Mental Health and Learning Disabilities Data Set
  • Mental Health Minimum Data Set
  • Mental Health Services Data Set
  • Mental Health-Local Provider Flows
  • Other Not Elsewhere Classified (NEC)-Local Provider Flows
  • Population Data-Local Provider Flows
  • Primary Care Services-Local Provider Flows
  • Public Health and Screening Services-Local Provider Flows
  • SUS for Commissioners

Objectives:

Commissioning To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area. The CCG commissions services from a range of providers covering a wide array of services. The CCG is part of the Cheshire and Merseyside Health and Care Partnership. This body is responsible for implementing large parts of the 5 year forward view from NHS England. The HCP is implementing several initiatives: 1. Putting the patient at the heart of the health system 2. Working across organisational boundaries to deliver care and including social care, public Health, providers and GPs as well as CCGs 3. Reviewing patient pathways to improve patient experience whilst reducing costs e.g. reduce the number of standard tests a patient may have and only have the ones they need 4. Planning the demand and capacity across the healthcare system across 6 CCGs to ensure we have the right buildings, services and staff to cope with demand whilst reducing the impact on costs 5. Working to prevent or capture conditions early as they are cheaper to treat 6. Introduce initiatives to change behaviours e.g. move more care into the community 7. Patient pathway planning for the above To ensure the patient is at the heart of care, the HCP is focussing on where services are required across the geographical region. This assists to ensure delivery of care in the right place for patients who may move and change services across CCGs. This amendment is for NHS Southport and Formby CCG and KPMG 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 pseudonymised datasets. This work is key in developing a service change proposal for Southport and Ormskirk Acute Services Sustainability. The service change proposal will set out the options and next steps for how each organisation will agree and implement a clinically sustainable, operationally practical and financially affordable solution for their hospitals. Southport and Ormskirk Acute Services Sustainability is one of 5 collaborations feeding into the Cheshire and Merseyside Acute Sustainability and Cheshire and Merseyside Place Based Care Systems programmes. The work is led by Cheshire & Merseyside Health Partnership supported by KPMG, the NHS Transformation Unit (TU), and members include all Acute, Community, Mental Health providers, Clinical Commissioning Groups, NHS England and Local Authorities from the Cheshire & Merseyside area. The Service Change proposal must contain key elements to be considered by NHS England nationally (as per the requirements of the NHS England’s guidance - Planning, Assuring and Delivering Service Change for Patients, November 2015). Pertinent elements to this DARS amendment include: • Analysis of the full range of potential service changes that can achieve the desired improvement in quality and outcomes; • The development of a range of options based on the above analysis; • An assessment against legal duties and obligations including the Public Sector Equality Duty11 (PSED) and the duty to have regard to the need to reduce inequalities; • Any potential financial implications (capital spend, transactional or transitional funds, savings, core costs etc.) which may impact on the range of options taken forward; • Analysis of demographic and other factors likely to influence future demand for the service; To complete these elements above, detailed information is required: Finance, activity and capacity modelling Net Present Value (NPV) analysis and support with assumptions What are the current patient flows and how do they change with each option proposed? What does the preferred option look like at system cost level and an individual provider level? Is there a knock-on impact on neighbouring providers? Is the preferred option affordable? Processing for this activity will be conducted by KPMG LLP.

Expected Benefits:

Commissioning Sharing this data is crucial to producing a service change proposal for Southport and Ormskirk Acute Services Sustainability. The service change proposal will set out the options and next steps for how each organisation will agree and implement a clinically sustainable, operationally practical and financially affordable solution for their hospitals: • Impacts will be identified over a five year forecast period • Finance impacts will cover both Southport & Ormskirk and the wider Cheshire & Merseyside footprint • Capacity requirements will include beds, theatres and staffing (by site for S&O) • Knock on impacts will include activity, capacity and finance for other C&M providers, and activity only for out of area providers

Outputs:

Commissioning SUS Data sets: A&E, Inpatients, Outpatients CCG: 01V NHS Southport & Formby CCG Time Period: 2015/16, 2016/17, 2017/18 financial years

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. The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCG. 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 of interest of 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) 1) North West Data Services for Commissioning Regional Office (DSCRO) receive a national feed of data for NHS Southport and Formby CCG from SUS 2) Data quality management of data is completed by the DSCRO and the data is then passed to Arden and GEM CSU for the addition of derived fields, linkage of relevant data sets and analysis. 3) Arden and GEM CSU then pass the processed, pseudonymised data to NHS Southport and Formby CCG. An extract of SUS data will be made, using only fields relevant to the project (see below, specific outputs) and securely transferred (via SFTP) to KPMG 4) KPMG will use the data to see patient journeys for pathway re-design and de-commissioning. Data will be fed into modelling tools with clinically approved assumptions allowing commissioners and providers (working under the Southport and Ormskirk Acute Services Sustainability group, a sub group of the Cheshire & Merseyside Health Partnership Acute Sustainability programme) understand a baseline ‘do nothing’ position, and model a number of options for clinical review (as detailed above) and ultimately contribute to the service change proposal 4) Patient level data will not be shared outside of the CCG other than to KPMG Health and only for the specified project they have been commissioned to undertake. Any other data shared externally will consist of aggregated reports only


Project 3 — DARS-NIC-47139-R5G3C

Opt outs honoured: Yes - patient objections upheld (Section 251)

Sensitive: Sensitive

When: 2018/06 — 2019/03.

Repeats: Frequent adhoc flow, Frequent Adhoc Flow

Legal basis: Section 251 approval is in place for the flow of identifiable data, National Health Service Act 2006 - s251 - 'Control of patient information'.

Categories: Identifiable

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. The legal basis for this to occur is under Section 251 of NHS Act 2006 (CAG 7-04(a)). Risk Stratification will be conducted by Arden and Greater East Midlands Commissioning Support Unit and Midlands & Lancashire Commissioning Support Unit

Expected Benefits:

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. The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCG. 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. Risk Stratification All access to data is auditable by NHS Digital. Risk Stratification - Arden and Greater East Midlands Commissioning Support Unit 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 Arden and Greater East Midlands 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 Arden and Greater East Midlands Commissioning Support Unit. 4. SUS data is linked to GP data in the risk stratification tool by the data processor. 5. Access to the Risk Stratification system that Arden and Greater East Midlands Commissioning Support Unit hosts is limited to those substantive employees with authorised user accounts used for identification and authentication. 6. Once Arden and Greater East Midlands Commissioning Support Unit has completed the processing, the CCG can access the online system via a secure N3 connection to access the data pseudonymised at patient level. Risk Stratification - Midlands & Lancashire Commissioning Support Unit 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 Midlands & Lancashire 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 Midlands & Lancashire 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. Access to the Risk Stratification system Midlands & Lancashire Commissioning Support Unit hosts is limited to those substantive employees with authorised user accounts used for identification and authentication. 7. Once Midlands & Lancashire Commissioning Support Unit has completed the processing, the CCG can access the online system via a secure N3 connection to access the data pseudonymised at patient level.


Project 4 — NIC-130735-P4Q6M

Opt outs honoured: N

Sensitive: Sensitive

When: 2017/12 — 2018/05.

Repeats: Ongoing

Legal basis: Health and Social Care Act 2012

Categories: Anonymised - ICO code compliant

Datasets:

  • SUS data (Accident & Emergency, Admitted Patient Care & Outpatient)
  • Improving Access to Psychological Therapies Data Set
  • Mental Health Minimum Data Set
  • Mental Health and Learning Disabilities Data Set
  • Children and Young People's Health Services Data Set
  • Maternity Services Dataset
  • Mental Health Services 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 - Mental Health
  • Local Provider Data - Other not elsewhere classified
  • Local Provider Data - Population Data
  • 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

Objectives:

Objective for processing: This is a new application for the following purposes: Commissioning 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. The following pseudonymised datasets are required to provide intelligence to support commissioning of health services: - Secondary Uses Service (SUS) - Local Provider Flows o Acute o Ambulance o Community o Demand for Service o Diagnostic Service o Emergency Care o Experience, Quality and Outcomes o Mental Health o Other Not Elsewhere Classified o Population Data o Primary Care Services o Public Health Screening - 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. Processing for commissioning will be conducted by - - Arden and Greater East Midlands Commissioning Support Unit - Midlands and Lancashire Commissioning Support Unit - Advancing Quality Alliance (AQuA) - The Academic Health Sciences Network

Expected Benefits:

Expected measurable benefits to health and/or social care, including target date(s): Commissioning 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.

Outputs:

Specific outputs expected, including target date(s): Commissioning 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.

Processing:

Processing activities: 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. The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCG. Access is limited to those substantive employees with authorised user accounts used for identification and authentication. 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. 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 NHS Digital will not be national data, but only that data relating to the specific locality of interest of the applicant. Commissioning The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets: 1. SUS 2. Local Provider Flows (received directly from providers) o Acute o Ambulance o Community o Demand for Service o Diagnostic Service o Emergency Care o Experience, Quality and Outcomes o Mental Health o Other Not Elsewhere Classified o Population Data o Primary Care Services o Public Health Screening 3. Mental Health Minimum Data Set (MHMDS) 4. Mental Health Learning Disability Data Set (MHLDDS) 5. Mental Health Services Data Set (MHSDS) 6. Maternity Services Data Set (MSDS) 7. Improving Access to Psychological Therapy (IAPT) 8. Child and Young People Health Service (CYPHS) 9. Diagnostic Imaging Data Set (DIDS) Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows: Data Processor 1 – Arden and Greater East Midlands Commissioning Support Unit 1) Pseudonymised SUS, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS) and Diagnostic Imaging data (DIDS) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. 2) Arden and Greater East Midlands Commissioning Support Unit add derived fields, link data and provide analysis. 3) Allowed linkage is between the data sets contained within point 1. 4) Arden and Greater East Midlands Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG. The CCG 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 will be completed by Arden and Greater East Midlands Commissioning Support Unit or the CCG as instructed by the CCG. 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 can be shared. Data Processor 2 – Midlands and Lancashire Commissioning Support Unit 1) Pseudonymised SUS, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS) and Diagnostic Imaging data (DIDS) only is securely transferred from the DSCRO to Midlands and Lancashire Commissioning Support Unit. 2) Midlands and Lancashire Commissioning Support Unit add derived fields, link data and provide analysis. 3) Allowed linkage is between the data sets contained within point 1. 4) Midlands and Lancashire Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG. The CCG 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 will be completed by Midlands and Lancashire Commissioning Support Unit or the CCG as instructed by the CCG. 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 can be shared Data Processor 3 – Advancing Quality Alliance (AQuA) via Arden and Greater East Midlands Commissioning Support 1) Pseudonymised SUS, Local Provider data and Mental Health data (MHSDS, MHMDS, MHLDDS) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support. 2) Arden and Greater East Midlands Commissioning Support add derived fields, link data and provide analysis. 3) Allowed linkage is between the data sets contained within point 1. 1. Arden and Greater East Midlands Commissioning Support then pass the processed, pseudonymised and linked data to Advancing Quality Alliance (AQuA). Advancing Quality Alliance (AQuA) provide support for a range of quality improvement programmes including the NW Advancing Quality Programme. Advancing Quality Alliance (AQuA) identifies cohorts of patients within specific disease groups for further analysis to help drive quality improvements across the region. 4) Aggregation of required data for CCG management use will be completed by Advancing Quality Alliance (AQuA). 5) 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 can be shared Data Processor 4 – The Academic Health Sciences Network via Arden and Greater East Midlands Commissioning Support 1) Pseudonymised SUS only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support. 2) Arden and Greater East Midlands Commissioning Support add derived fields, link data and provide analysis. 3) Allowed linkage is between the data sets contained within point 1. 4) Arden and Greater East Midlands Commissioning Support then pass the processed, pseudonymised and linked data to The Academic Health Sciences Network. The Academic Health Sciences Network 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) Aggregation of required data for CCG management use will be completed by The Academic Health Sciences Network. 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 can be shared


Project 5 — NIC-47139-R5G3C

Opt outs honoured: Y, N

Sensitive: Sensitive

When: 2016/12 — 2018/05.

Repeats: Ongoing

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

Categories: Identifiable, 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
  • Mental Health Minimum Data Set
  • Mental Health and Learning Disabilities Data Set
  • Mental Health Services Data Set
  • Improving Access to Psychological Therapies Data Set
  • Children and Young People's Health Services 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 - Mental Health
  • Local Provider Data - Other not elsewhere classified
  • Local Provider Data - Population Data
  • Local Provider Data - Public Health & Screening services
  • SUS Accident & Emergency data
  • SUS Admitted Patient Care data
  • SUS Outpatient data
  • Maternity Services Dataset
  • SUS data (Accident & Emergency, Admitted Patient Care & Outpatient)
  • SUS for Commissioners

Objectives:

Risk Stratification To use SUS data identifiable at the level of NHS number according to S.251 CAG 7-04(a) (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 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. Pseudonymised – Mental Health, MSDS, 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. 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:

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 – 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) 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. Pseudonymised – MHSDS, MHMDS, MHLDDS, MSDS, 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) 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.

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 risk stratification presents pseudonymised data to the GPs. GPs are able to re-identify information only for their own patients for the purpose of direct care. 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 and aggregated at patient level. 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. Pseudonymised – MHSDS, MHMDS, MHLDDS, MSDS, 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. GP Practice level dashboard reports include high flyers.

Processing:

Prior to the release of identifiable data by North West DSCRO, Type 2 objections will be applied and the relevant patient’s data redacted. Risk Stratification Data Processor 1 – Arden & GEM CSU: 1. SUS Data is sent from the SUS Repository to North West Data Services for Commissioners Regional Office (DSCRO) to the data processor. 2. SUS data identifiable at the level of NHS number regarding hospital admissions, A&E attendances and outpatient attendances is delivered securely from North West DSCRO to the data processor. 3. Data quality management and standardisation of data is completed by North West DSCRO and the data identifiable at the level of NHS number is transferred securely to Arden & GEM CSU, who hold the SUS data within the secure Data Centre on N3. 4. Identifiable GP Data is securely sent from the GP system to Arden & GEM CSU. 5. SUS data is linked to GP data in the risk stratification tool by the data processor. 6. Arden & GEM 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 Arden & GEM CSU has completed the processing, the data is passed to the CCG in pseudonymised form at patient level and as aggregated reports. Data Processor 2 – Midlands & Lancashire CSU: 1. SUS Data is sent from the SUS Repository to North West Data Services for Commissioners Regional Office (DSCRO) to the data processor. 2. SUS data identifiable at the level of NHS number regarding hospital admissions, A&E attendances and outpatient attendances is delivered securely from North West DSCRO to the data processor. 3. Data quality management and standardisation of data is completed by North West DSCRO and the data identifiable at the level of NHS number is transferred securely to Arden & GEM CSU, who hold the SUS data within the secure Data Centre on N3. 4. Identifiable GP Data is securely sent from the GP system to Arden & GEM CSU. 5. SUS data is linked to GP data in the risk stratification tool by the data processor. 6. 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 risk stratification presents pseudonymised data to the GPs. GPs are able to re-identify information only for their own patients for the purpose of direct care. 7. Arden & GEM 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. 8. Data identifiable at the level of NHS number is transferred securely to Midlands & Lancashire CSU who apply the data to the BI tool to analyse and produce reports. 9. Once Midlands & Lancashire 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. 10. 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. Pseudonymised – SUS and Local Flows Data Processor 1 – Arden & GEM CSU: 1. North West Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North West 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 Arden & GEM CSU for the addition of derived fields, linkage of data sets and analysis. 3. Arden & GEM CSU then pass the processed, pseudonymised and linked data to the CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning. 4. 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. Data Processor 2 – Midlands & Lancashire CSU: 1. North West Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North West DSCRO also receives identifiable local provider data for the CCG directly from Providers. 2. The identifiable SUS data and identifiable local provider flow data is securely transferred from North West DSCRO to Central Midlands DSCRO. 3. Data quality management and pseudonymisation of data is completed by Central Midlands DSCRO and the pseudonymised data is then passed securely to Midland & Lancashire CSU for the addition of derived fields, linkage of data sets and analysis. 5. Midland & Lancashire CSU then pass the processed, pseudonymised and linked data to the CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning. 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. Data Processor 3 - AQuA 1. North West Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North West 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 West DSCRO and the pseudonymised data is then passed securely to Arden & GEM CSU for the addition of derived fields, linkage of data sets and analysis. 3. Arden & GEM 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. Data Processor 4 – Academic Health Sciences Network (Utilisation Management Team) 1. North West Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North West 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 West DSCRO and the pseudonymised data is then passed securely to Arden & GEM CSU for the addition of derived fields, linkage of data sets and analysis. 3. Arden & GEM CSU then passes the pseudonymised data securely to the Academic Health Service (Utilisation Management Team) (AHSN UMT) 4. The AHSN UMT receives pseudonymised SUS data for Greater Manchester patients. 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. 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. Pseudonymised – Mental Health, MSDS, IAPT, CYPHS and DIDS Data Processor 1 – Arden & GEM CSU: 1. North West 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 West 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. The pseudonymised data is securely transferred from North West DSCRO to Central Midlands DSCRO. 3. Data quality management and pseudonymisation of data is completed by Central Midlands DSCRO and the pseudonymised data is then passed securely to Arden & GEM CSU for the addition of derived fields, linkage of data sets and analysis. 4. Arden & GEM CSU then pass the processed, pseudonymised and linked data to the CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning. 5. The 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 the CCG 7. 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. Data Processor 2 – Midlands & Lancashire CSU: 1. North West 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 West 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. The identifiable SUS data and identifiable local provider flow data is securely transferred from North West DSCRO to Central Midlands DSCRO. 3. Data quality management and pseudonymisation of data is completed by Central Midlands DSCRO and the pseudonymised data is then passed securely to Midland & Lancashire CSU for the addition of derived fields, linkage of data sets and analysis. 4. Midland & Lancashire CSU then pass the processed, pseudonymised and linked data to the 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 the CCG 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. Data Processor 3 - Advancing Quality Alliance (AQuA) 1. North West 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). 2. Data quality management and pseudonymisation of data is completed by North West DSCRO and the pseudonymised data is then passed securely to Arden & GEM CSU for the addition of derived fields, linkage of data sets and analysis. 3. Arden & GEM CSU then passes the pseudonymised data securely to Advancing Quality Alliance (AQuA). 4. AQuA receives pseudonymised SUS data for Greater Manchester patients. 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. AQuA produces aggregate reports only with small number suppression in line with the HES analysis guide. Only aggregate reports are sent to the CCG.