NHS Digital Data Release Register - reformatted
University Hospitals Of North Midlands NHS Trust
Project 1 — DARS-NIC-12406-X5D0K
Opt outs honoured: N
Sensitive: Non Sensitive
When: 2017/09 — 2018/02.
Legal basis: Health and Social Care Act 2012
Categories: Anonymised - ICO code compliant
- Hospital Episode Statistics Admitted Patient Care
- Hospital Episode Statistics Accident and Emergency
- Hospital Episode Statistics Outpatients
A merger has taken place between the former University Hospital of North Staffordshire (RJE) and Mid Staffordshire Foundation Trust (RJD) to create the University Hospital of North Midlands (RJE or ‘UHNM’). In line with UHMN’s core objective of becoming one of the top University Teaching Hospitals within the UK, this strategy means that UHNM will be a much more integrated and flexible provider within the local and regional health economies with a larger regional role and a changed service portfolio. UHNM provides acute hospital service across 23 CCGs across the Midlands and North West. In addition, UHNM also provides specialised services for 3 million people in a wider area include neighbouring counties and North Wales. The purpose of UHNM acquiring access to HDIS is to provide intelligence of the activity occurring within the regions in which the Trust operates, describing patient flows between organisations. For example, patients that are local to the former MSFT may now be being seen at the Royal Stoke hospital, creating pressure on those services. Alternatively, patients may be migrating to Wolverhampton or to the Private sector. UHNM analysis covers activity within inpatient and outpatient settings for a specific set of providers and commissioners. Access to HDIS allows UHNM to extract only the specific data required and thus minimises the data used to meet the objectives set out. One specific use of HDIS is the production of the UHNM's annual plan. This process runs annually from September through to January and is a requirement from NHS Improvement. Given the complexities facing NHS Trusts, it is vital that Trusts put in place a systematic planning process and in particular, ensure sufficient engagement with the local health economy in developing their plans. The objective of the planning process is to ensure the delivery of operational performance standards, including contractual and national targets and standards, and to ensure the Trusts longer term financial sustainability. The plan triangulates finance, activity and workforce plans to ensure they are aligned. UHNM uses HDIS as a key input into its annual activity planning process and to enable UHNM to produce its rolling 5 year integrated business plan. Key to this is the ability to understand key changes in activity to enable UHNM to plan the appropriate capacity of services across the wider health economy. The key components of the Board-approved, commissioner-aligned annual plan include consideration of: • strategic context and direction, including the impact of strategic commissioning intentions and service changes; • approach taken to improve quality and safety; • delivery of operational performance standards; • workforce plans; • Financial and investment strategy, including risk analysis and mitigation plan; and organisational relationships and capability Access to HDIS also has a number of additional benefits/purposes which include: i) Benchmarking with other trusts, target LOS reductions for appropriate clinical conditions, including reducing pre-operative LOS (ii) Benchmarking with other trusts, target appropriate reductions within new to follow up ratios and DNA rates Regarding benchmark information that UHNM retrieves, this relates to a defined set of Providers eg by Provider by Specialty by HRG by elective/non elective and therefore, the data extracted is what is required rather than extracting data that does not relate to the intended purpose. As described above, data extracted is only ever accessed and used for the purpose of improving health and social care services across Staffordshire. This is now under the overall co-ordination of the STP project. However, as part of the acquisition of Stafford Hospital as described above, the Trust is required to report regularly to its CCGs on the service and financial benefits of the acquisition, the targets for which were informed by this type of comparative data. 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 HSC Act 2012 as amended by the Care Act 2014.
The outputs are intended for use within UHNM to allow it to benchmark and improve its own performance. The intention is not for submission to external publications etc. and UHNM would never undertake commercial requests. The Trust does work within its local sustainability and transformation programme (STP) which covers the whole of Staffordshire and as part of this may share the outputs of the analyses. Any outputs will be aggregate data with small numbers supressed in line with the HES analysis guide . Given that UHNM are the biggest Trust in the area and a tertiary centre. UHNM access most aspects of the data and share it internally with directorate managers and senior clinicians. The key output of using HDIS is in production of the Trust annual Plan. The benefits of the plan are : • Clearly defined and understood objectives for the Trust all know the way UHNM are heading • A clearly defined ‘road map’ of how to get there • Clear measures and targets which will show if UHNM are on track • Staff engagement to see where the Trust is going and what part they and their department play in this • Other stakeholders can also see the vision on the Trust and can gain assurance of its direction • Assurance for the Local Healthcare Economy that the Trust has the capacity to deliver its plans • Assurance for all stakeholders and particularly NHS Improvement regarding the financial stability of the Trust Some specific examples: > To support business cases development of services > UHNM has recently approved a business case to build an additional laminar flow theatre at the County site. The HES data was extracted and analysed to enable the service line to understand the demand for orthopaedic services from patients within the local CCG’s and the trend over the last 3 years and this was used to justify the capital expenditure. The data demonstrated that without the additional capacity either patient’s would have to travel outside of the area for treatment or the waiting list would increase. The data was also used to decide the best location for the new theatre between the Royal Stoke site and the County site. The additional theatre is due to be operational in Mid 2017. > Within Cardiology, to support the further expansion of the heart centre this involves partnership working with other acute trusts to understand activity levels by geographic area. The anticipated benefits are expected to be the consolidation of activity into 1 Provider Trust in order than better outcomes for patients due to increased activity of complex cases by a centralised, highly skilled workforce. Please note that the activity data is not shared with other Trusts. This project is still on-going. > Investment in specialist dermatology and plastics unit at the UHNM County Site (at Stafford) to provide local services to the population within the South Staffordshire area. Activity data within HES was used to identify the service need and to correctly size the new unit. This unit is due to be operational in April 2017. > Analysing other comparable Trusts with HES data has identified length of stay opportunity savings of 19 beds within our General Surgery service. 11 of these beds are identified within elective work and a work stream is being brought together to understand how best to realise this benefit by understanding the procedures and to ascertain whether improvements can be made. > UHNM have also recently received a request from Leek town Council in the Staffordshire Moorlands requesting that more services were delivered locally in Leek for the local population. The HES data was summarised by GP practice (for the selected practices which were those based in Leek and surrounding areas). UHNM were then able to ascertain which services were the most beneficial for the population and to calculate the correct capacity to deliver an effective service.
The outputs are used within UHNM to allow it to benchmark and improve its own performance. The Trust does work within its local sustainability and transformation programme which covers the whole of Staffordshire. Given that UHNM are the biggest Trust in the area and a tertiary centre the team access most aspects of the data and share it internally with directorate managers and senior clinicians. Only the aggregate out puts with small numbers supressed in line with the HES analysis guide will ever be shared. One specific output of using HDIS is in production of the Trust annual plan. This process runs annually from September through to January and is a requirement from NHS Improvement. The production of this plan will entail: 1) Scenario modelling 2) Strategy Development 3) Productivity/efficiently and the use of HDIS data is integral to its production. The 2016/17 annual plan itself is available on the Trusts website to view, but with no underpinning data being shared externally (see link below for the annual plan). http://www.uhnm.nhs.uk/aboutus/Documents/AnnualReportsAndAccounts/160809%20One%20Year%20Annual%20Plan%20Summary%20April%202016.pdf All outputs that are produced from the system which are published or shared will be aggregate data with small numbers supressed in line with the HES analysis guide. The ‘direct’ outputs are only shared internally with managers as stated above, however the interpretation of how, for example, a service may change in the future is shared with external organisations and potentially the public.
All extracted data is stored with appropriate security controls including encryption. Data is kept and destroyed in accordance with good information governance practice. UHNM Trust will only be permitted to extract aggregated data from HDIS. There are two individuals with HDIS licences. Both individuals are substantive employees of UHNM. Aggregate data containing small numbers will only be accessed by the two HDIS licencees. All outputs produced using the extracted aggregate data will have small numbers supressed in line with the HES analysis guide. No output of the analysis will contain small numbers. Outputs from the analysis are summarised and shared at Executive level within UHNM. This supports the decision making strategy of the Trust. Data will not be stored, processed or in any other way accessible by a third party organisation or across different locations within this organisations.