NHS Digital Data Release Register - reformatted

Dr. Foster projects

2 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).


Summary Hospital-level Mortality Indicator (SHMI) data — DARS-NIC-368020-R5L2K

Opt outs honoured: No - data flow is not identifiable, Anonymised - ICO Code Compliant, No (Does not include the flow of confidential data)

Legal basis: Section 42(4) of the Statistics and Registration Service Act (2007) as amended by section 287 of the Health and Social Care Act (2012), Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii), Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii), Health and Social Care Act 2012 - s261 - 'Other dissemination of information'

Purposes: (Supplier)

Sensitive: Sensitive, and Non Sensitive, and Non-Sensitive

When:2017.06 — 2021.11. DSA runs 2019-07-01 — 2020-06-30

Access method: Ongoing

Data-controller type: TELSTRA HEALTH UK LIMITED

Sublicensing allowed: No

Datasets:

  1. Summary Hospital-level Mortality Indicator (SHMI) data split by trust and diagnosis group
  2. Hospital Episode Statistics Admitted Patient Care
  3. Office for National Statistics Mortality Data
  4. Summary Hospital-level Mortality Indicator

Objectives:

To produce/analyse statistics using births/deaths data solely to help the NHS perform its duties.

Yielded Benefits:

With the SHMI data provided, Dr Foster have been able to help their customers: - uncover and investigate some of the potential root causes of differences between the various mortality indicators and to investigate variations against peers. - Understand any variation between SHMI and HSMR at a summary level and what drives that variation. - Gain the insight they need to embed SHMI within their mortality management programme, alongside other mortality indicators, such as HSMR and Deaths after Surgery. - investigate and understand the impact of the inclusion of post-discharge mortality data (only available through the SHMI mortality indicator). - The ability to drill down and investigate by SHMI supergroup, CCS group or user-defined basket of diagnoses.

Expected Benefits:

Dr Foster provides all of its NHS customers free of charge with a tool to allow them to monitor and improve the quality and safety of care they provide by comparing the two leading mortality indicators in England: SHMI and HSMR. It enables their customers to perform a root cause analysis of their SHMI, in line with the requirements of the NHS Operating Framework.

“All hospital trusts, regardless of whether they are outliers, need to examine, understand and explain their SHMI and identify and act where performance is falling short. Should a trust be an outlier on any mortality measure it should scrutinise the underlying data to understand the reason and take appropriate action.”
The Operating Framework for the NHS in England 2012/13

As identified in the commissioning letter, with SHMI data provided, Dr Foster have been able to help their customers:
- uncover and investigate some of the potential root causes of differences between the various mortality indicators and to investigate variations against peers.
- Understand any variation between SHMI and HSMR at a summary level and what drives that variation.
- Gain the insight they need to embed SHMI within their mortality management programme, alongside other mortality indicators, such as HSMR and Deaths after Surgery.
- investigate and understand the impact of the inclusion of post-discharge mortality data (only available through the SHMI mortality indicator).
- The ability to drill down and investigate by SHMI supergroup, CCS group or user-defined basket of diagnoses.

Expected measurable benefits include:
• Enable customers to measure, compare and benchmark mortality and alerting those who have higher than expected mortality levels to encourage efforts to investigate and address these. Dr Foster's independent position is beneficial as it supports customer focus on information and data as opposed to anecdotal evidence.
• Identify mortality trends across hospitals.
• Instigate clinical audit and inform investigations related to quality of care, such as highlighting poor clinical coding or quality/efficiency concerns.
• Validate other mortality indicators – such as HSMR and crude mortality.
• Understand and quickly visualise SHMI & HSMR indicators side by side.

How will these be measured:
• By their nature, Dr Foster analytical tools allow the performance of customers to be monitored and trended over time. It can indicate changes to quality and efficiency performance particularly in instances where trusts have been alerted and Dr Foster has worked with them to understand the causes of worse than expected performance.

When will these be achieved:
• It is not possible to outline a specific target date for achievement of the benefits outlined above as they are reliant on a range of factors outside of Dr Foster immediate control. However, whenever there are areas of particular concern about performance against key indicators, Dr Foster acts immediately to make their customers aware and offer assistance in better understanding and addressing them.
• In addition benefits are ongoing as these outputs are used within NHS Trusts internal monthly reporting and quality processes.

Outputs:

The Dr Foster Dashboard Tool Online application is available to NHS Acute Trusts, only which compares the two leading mortality indicators in England – the SHMI and the Dr Foster Hospital Standard Mortality Ratio (HSMR). All data is aggregated with small numbers suppressed in line with the HES analysis guide and there are no links to any identifiers. It enables users to uncover and investigate some of the potential root causes of differences between these indicators and to investigate variations against peers.

Key outputs:
• Overview of SHMI and Hospital Standard Mortality Ratio (HSMR) - summary charts, trends and breakdowns.
• Graphical Dashboard comparing mortality measures side-by-side.
• Analyse national position, regional comparisons and custom peer groups.
• The ability to drill down and investigate by SHMI supergroup, Clinical Classification System (CCS) group or user-defined basket of diagnoses.

Typical end users
• Chief Executives
• Medical Directors
• NHS Managers
• Information Analysts
• Clinicians
• Nurses

Processing:

Landing

On landing the SHMI dataset will be recorded on the Dr Foster Data Asset Register (DAR) and allocated a unique Asset Tag, in addition a Date of Destruction will be recorded along with Acknowledgements required in the publication of these data.

Processing

NOTE: Data will flow to Dr Foster Ltd only. Data will be accessed by the named users within this agreement, i.e. substantive employees of Dr Foster Limited.

Once logged in the Data Asset Register, it is handed over to a named individual who will load these data onto a secure central processing server located at Dorset Rise, a ‘SHMI’ Extract, Transform & Load process (documented) will then be run to transform record level data and then appended into a aggregated SQL database (aggregated at Provider & Diagnosis group level). Once processed the data will then be quality checked and upon completion published to the live client facing Dr Foster Dashboard Tool.

Publication

SHMI data, which has been available to Dr Foster since 2011, will only be made available to NHS Trusts via the Dr Foster Dashboard Tool.

Note: This tool is provided Free of Charge to all NHS Trusts

Destruction

Raw SHMI data will be Blancco (CESG approved) file shredded with certificated evidence when Date of Destruction is applicable (identified on Dr Foster’s Data Asset Register via a monthly process).

Telecity is listed as a storage address for recovery purposes only. Telecity do not have access to the Dr Foster Ltd. Server or Server passwords and will not be accessing/backing up the data provided within this agreement.