NHS Digital Data Release Register - reformatted

3M United Kingdom Plc

Project 1 — DARS-NIC-91972-S9W9T

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

Sensitive: Non Sensitive

When: 2017/12 — 2020/08.

Repeats: Ongoing, One-Off

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 Critical Care
  • Hospital Episode Statistics Outpatients
  • Hospital Episode Statistics Admitted Patient Care


3M United Kingdom PLC is the largest provider of dedicated coding and grouping solutions to the NHS. 3M solutions are involved in the collection and validation of ICD, OPCS and HRG codes at the majority of UK NHS acute care trusts (>75%), in fact NHS clients form over 98% of their client base. 3M are currently working with a number of their NHS clients to implement in the UK a technology that has been successfully deployed by 3M in the US for over 15 years; namely 3M All Patient Refined (APR)-Diagnostic Related Grouper (DRG)s and 3M Clinical Risk Grouper (CRG)s. Quality and performance indicators derived from these 3M solution suites will help the NHS better perform its duties by highlighting actionable areas for clinical and process improvement; improved data leads to improved decisions. The pseudonymised data from this request will be used internally by 3M to anglicise the 3M APR-DRG and 3M CRG (grouper) solutions, specifically by supporting the development of crosswalk tables and algorithms between UK coding classifications (and other NHS Data Dictionary items) and their international equivalents. The volume of data requested and its longitudinal breadth is vital for 3M to develop, validate and modify the algorithms within their groupers to make sure they are tuned as accurately as possible to the NHS experience. The 3M groupers are continually being further developed and refined by 3M's clinical and technical teams, new versions are issued on a regular basis (e.g. a new version of 3M CRG (version 2.1) will be released on 16th February 2018) and a longitudinal view of national data is required to support the regression testing of these new versions. The 3M APR-DRG grouping methodology can group and adjust large volumes of data for local and international comparison, and to reflect the Severity of Illness (SoI) and Risk of Mortality (RoM) present in a given patient population. 3M CRGs grouping methodology is a clinically-based classification system for measuring a patient’s total burden of illness, as opposed to a regressive statistical system (which is more typical of the UK market at present). The benefit to 3M clients (98% of which are in the NHS) of having access to the output from the 3M APR-DRG and 3M CRG groupers is that they will have an enhanced data set that will better help them better plan and analyse: • Quality and cost improvement; • Outcomes and performance measurement; • Prospective reimbursement; • Comparative profiling; • Clinical and operational redesign and improvement; • Documentation and coding improvement; • Financial and strategic planning; • Evaluation of resource needs; • Provider/Commissioner negotiation for reimbursement that matches case mix complexity An additional benefit for 3M clients is that the clinical logic of the 3M APR DRG Classification System is the basis for other 3M specialised "preventables" grouping methodologies, hence access to this HES data will also deliver proven benefits to the NHS in the areas of : • Reduced initial admissions; • Reduced re-admissions; • Reduced A&E attendances; • Reduced Hospital Acquired Conditions All of which are key foci during the development of Sustainability and Transformation Programs (STPs) and Accountable Care Systems (ACSs) which many of 3M's existing clients are already involved with. Finally, 3M are actively working with NHS England to gain a place on the ACS and STP Development Partner Framework, on that framework 3M aim to support NHS England in the areas of "Insight" and "System Optimisation Support" specifically around the areas of population health management.

Yielded Benefits:

3M United Kingdom PLC launched their 3M APR-DRG and 3M CRG groupers on the UK on 13th February 2020). Whilst the launched version of the 3M APR-DRG and 3M CRG grouper is now available as with any tool further validation and continuous updates to coding is necessary as new areas of clinical data are made available. As such further data is still required to continue the ongoing building and validation of the product in addition to being able to amend the product with any data coding changes. 3M anticipate to continue to request annual updates of data from NHS Digital. Based on 3M experiences introducing this product into other countries (US, Canada, Spain, Italy etc.) 3M United Kingdom PLC knows that these solutions can yield benefits for UK health and social care organisations , • Quality and cost improvement; • Outcomes and performance measurement; • Prospective reimbursement; • Comparative profiling; • Clinical and operational redesign and improvement; • Documentation and coding improvement; • Financial and strategic planning; • Evaluation of resource needs; • Provider/Commissioner negotiation for reimbursement that matches case mix complexity In terms for specific examples of where 3M CRGs (for example) have played a significant role in driving down costs and improving care the following examples may be useful: United States: • Quality outcomes and total cost-of-care management for managed care and accountable care organisations (ACOs) in state Medicaid programs, such as Texas and New York • Outcomes-based payment programs used by commercial payers and regional/national health plans, including many Blue Cross® Blue Shield® organisations across America • Public performance reporting and all payer claims database analysis by state agencies, including the Utah Department of Health and the Texas Health and Human Services Commission • Population health and episodes-of-care analyses for the Medicare Payment Advisory Commission (MedPAC) • Comparisons of quality and utilisation in special needs delivery programs, such as HIV, mental health and substance abuse Spain: • CRGSs offer insight into the current and planned locations of primary care centres based on the geographic distribution of the chronic population within a given region. Areas where many chronic people live benefit from more primary physicians and resources. • Identify patients for specific interventions. CRGs are used in Spain to assign nurses to visit some frequent readmissions chronic population (e.g. Diabetes + COPD) each 10 days, decreasing the readmissions rate in those on the programme to half. • offer insight into the pharmacy costs for “high cost” patients. GPs have sight of the real cost of each patient and of the average cost of that type of patient (i.e. the ones with the same CRG) across the region. This information can be used to identify outliers of poor or exceptional performance.

Expected Benefits:

Overall the expected measurable benefit to the NHS (commissioners and providers) is the ability to identify potentially avoidable costs in the healthcare system/services. Performance and quality indicators and risk adjustment methodologies derived from the 3M APR-DRG and 3M CRG solution suites (developed and validated using HES data) will pinpoint specific opportunities where commissioners and providers can drive delivery system change, provide evidence for targeted improvements, and once those changes are implemented measure the progress and levels of success made in those priority areas by comparing performance against plan and encourage the engagement of all stakeholders in the healthcare system/services With specific reference to the expected measurable benefits this solution can bring to the NHS; they are genuine and can be support by numerous academic papers, case studies, white-papers. By way of example… • the introduction of 3M APR-DRGs to the Colorado Medicaid program (2012-14) generated savings of ca. $44 million, significant reductions in A&E visits and a 25 % reduction in high-cost imaging services. • the introduction of 3M CRGs to the North Carolina Medicaid program (2014) generated a 20% reduction in hospital readmission rates for patients with multiple chronic conditions. In terms of target date 3M are committed to having a fully tested UK version of the 3M APR-DRG & 3M CRG solutions implemented in the NHS within 4 months of receipt of the data necessary to validate the solution.


The pseudonymised data from this request will be used internally by 3M for analytical purposes to anglicise the 3M APR-DRG & 3M CRG (grouper) solution suites. The data requested will not be provided in record level form to any third party or in any other way onward transmitted. No individuals, doctors, consultants, or patients from this data will ever be identified in 3M products. The intent is to generate statistical data relative to frequency, utilization, patterns, etc. which would be subsequently used internally by 3M within the business logic of software applications and reports to effectively validate the crosswalk tables and associated algorithms developed between UK coding classifications (and other NHS Data Dictionary items) and their international equivalents. This validation would typically be based on aggregated attributes for example the average number of diagnosis and interventions by APR-DRG, region, length of stay, etc. The aggregated information only will be used embedded within the 3M content and surfaced within the products for the purposes of benchmarks or productivity/quality indicators for 3M's clients (providers and commissioners). Any outputs will contain only data that is aggregated, with small numbers suppressed, in line with the HES Analysis Guide. Since the data will be used for statistical, trending and validation purposes it would generally be necessary to hold it for 5 years, after which it will be destroyed.


The HES data from this request will be in pseudonymised form and never linked with other datasets which could allow re-identification of HES data. The data will remain in a secure environment within 3M's UK IT enterprise, it will not be accessed/processed by any other parties and will not be shipped as part of any solutions developed by 3M. The data provided will only be processed in the UK using 3M proprietary data processing software which will analyse and cleanse the data convert the codes contained to their US equivalents using 3M developed crosswalk tables and associated algorithms. This crosswalked data will then be processed through a number of 3M proprietary/internal groupers (essentially the individual components/building-blocks of the 3M APR-DRG and 3M CRG groupers) which will output quality and performance indicators into various and multiple categorical databases for comparison with International norms and other comparative output criteria by our clinical data experts. This is an iterative processes and will be repeated until the crosswalk tables and algorithms are deemed as accurate as possible for the NHS experience. 3M will use five years’ worth of HES data to produce the outputs required. This is to allow sufficient historic comparison of previous years quality and performance indicators. By way of example, once the 2017/18 annual refresh data has been received and processed 3M will delete the 2012/13 HES data. All organisations party to this agreement must 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).