NHS Digital Data Release Register - reformatted

NHS Cheshire And Merseyside Integrated Care Board projects

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


NHS CHESHIRE AND MERSEYSIDE INTEGRATED CARE BOARD - IV, RS & Comm — DARS-NIC-615980-P3Y7N

Type of data: information not disclosed for TRE projects

Opt outs honoured: Anonymised - ICO Code Compliant, Identifiable (Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s))

Legal basis: Health and Social Care Act 2012 - s261(5)(d), Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'.

Purposes: No (ICB - Integrated Care Board)

Sensitive: Sensitive

When:DSA runs 2022-10-28 — 2023-01-27

Access method: Frequent Adhoc Flow

Data-controller type: NHS CHESHIRE AND MERSEYSIDE INTEGRATED CARE BOARD

Sublicensing allowed: Yes

Datasets:

  1. Commissioning Datasets
  2. Invoice Validation Datasets
  3. Risk Stratification Datasets

Expected Benefits:

INVOICE VALIDATION
The invoice validation process supports the ongoing delivery of patient care across the NHS and the ICB region by:
1. Ensuring that activity is fully financially validated.
2. Ensuring that service providers are accurately paid for the patient’s treatment.
3. Enabling services to be planned, commissioned, managed, and subjected to financial control.
4. Enabling commissioners to confirm that they are paying appropriately for treatment of patients for whom they are responsible.
5. Fulfilling commissioners duties to fiscal probity and scrutiny.
6. Ensuring full financial accountability for relevant organisations.
7. Ensuring robust commissioning and performance management.
8. Ensuring commissioning objectives do not compromise patient confidentiality.
9. Ensuring the avoidance of misappropriation of public funds.

RISK STRATIFICATION
Risk stratification promotes improved case management in primary care and may 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. Reduce emergency readmissions, especially avoidable emergency admissions by improving quality of services. 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 ICB 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 and health outcomes through more effective commissioning of services.

COMMISSIONING
1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
3. Health economic modelling to analyse provider performance and patient pathways.
4. Commissioning cycle support for grouping and re-costing previous activity.
5. Enables monitoring of commissioned services to ensure they are performing as expected.
6. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to identify priorities and identify commissioning plans to address these (pathways would be designed by service providers within the ICS with input from appropriate stakeholders including patient and public representation).
7. Reduced emergency readmissions, especially avoidable emergency admissions leading to improved quality of services. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care.
8. 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.
9. 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 ICB Outcome Framework.
10. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
11. 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.
12. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
13. Providing greater understanding of the underlying causes and look to commission improved supportive networks, this would be ongoing work which would be continually assessed.
14. Insight to understand the numerous factors that play a role in the outcome for patients in all datasets. The linkage allows the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice.
15. Provision of indicators of health problems, and patterns of risk within the commissioning region.
16. Support of benchmarking for evaluating progress in future years.
17. Assists commissioners to make better decisions to support patients and drive changes in health care.
18. Allows comparisons of providers performance to assist improvement in services – increase the quality.
19. Allow analysis of health care provision to be completed to support the needs of the health profile of the population within the ICB area based on the full analysis of multiple pseudonymised datasets.
20. To evaluate the impact of new services and innovations (e.g. if commissioners implement a new service or type of procedure with a provider, they can evaluate whether it improves outcomes for patients compared to the previous one).

DIRECT CARE
1. Enables clinical intervention to prevent worse outcomes, such as A&E attendance.
2. Allows the ICB to perform their statutory duty to protect patients.
3. Allows clinicians with direct care responsibilities to improve quality of care for patients identified. This may reduce the risk of unwanted emergency hospital admission, premature complications of disease and of premature death.

Outputs:

INVOICE VALIDATION
1. Accurate budget reports.
2. Enable a system of communication that will enable the ICB to challenge invoices and raise discrepancies and disputes.
3. Reports on the accuracy of invoices.
4. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
5. Budget control of the ICB.

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. 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.

The ICB will be provided with the pseudonymised outputs of the risk stratification tool for which they are able to:
1. Identify patient groups at risk of deterioration and providing effective care.
2. Set up capitated budgets – budgets based on care provided to the specific population.
3. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
4. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
5. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
6. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
7. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
8. Analyse based on specific diseases.
9. Aggregate reporting of number and percentage of population found to be at risk.

COMMISSIONING
1. Commissioner reporting on providers, finances, readmission analysis etc…
2. Production of aggregate reports for ICB Business Intelligence.
3. Production of project / programme level dashboards.
4. Monitoring of acute / community / mental health quality matrix.
5. Clinical coding reviews / audits.
6. Budget reporting down to individual GP Practice level.
7. GP Practice level dashboard reports.
8. Comparators of ICB performance with similar ICBs as set out by a specific range of care quality and performance measures detailed activity and cost reports.
9. Data Quality and Validation measures allowing data quality checks on the submitted data.
10. Contract Management and Modelling.
11. Patient Stratification dashboards to highlight cohorts of patients with similar conditions at risk.
12. Manage demand, by understanding the quantity of assessments required ICBs are able to improve the care service for patients by predicting the impact on certain care pathways and ensure the secondary care system has enough capacity to manage the demand.
13. Identify low priority procedures which could be directed to community-based alternatives and as such commission these services and deflect referrals for low priority procedures resulting in a reduction in hospital referrals.
14. Compare providers (trusts) mortality outcomes to the national baseline.
15. Identify medication prescribing trends and their effectiveness.
16. Linking prescribing habits to entry points into the health and social care system.
17. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy).
18. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.

DIRECT CARE
1. Reports and dashboards that highlight cohorts of patients that can be targeted for clinical intervention by direct health and care professionals.
2. Lists of at risk patients made available to direct health and care professionals that require direct care intervention.
3. Reports and dashboards to show the outcome of clinical intervention including patient outcomes and modelled transactional cost savings.


DSfC - CIPHA - CV19 — DARS-NIC-396095-H1P1D

Type of data: information not disclosed for TRE projects

Opt outs honoured: No - Statutory exemption to flow confidential data without consent, Anonymised - ICO Code Compliant, Identifiable (Statutory exemption to flow confidential data without consent)

Legal basis: CV19: Regulation 3 (4) of the Health Service (Control of Patient Information) Regulations 2002, Other-Regulation 3 of the Health Service (Control of Patient Information)

Purposes: No (Clinical Commissioning Group (CCG), Sub ICB Location, ICB - Integrated Care Board)

Sensitive: Sensitive

When:DSA runs 2020-10-13 — 2021-03-31 2021.01 — 2021.05.

Access method: One-Off, Frequent Adhoc Flow

Data-controller type: CHESHIRE EAST COUNCIL, CHESHIRE WEST AND CHESTER COUNCIL, HALTON BOROUGH COUNCIL, KNOWSLEY METROPOLITAN BOROUGH COUNCIL, LIVERPOOL CITY COUNCIL, NHS CHESHIRE CCG, NHS HALTON CCG, NHS KNOWSLEY CCG, NHS LIVERPOOL CCG, NHS SOUTH SEFTON CCG, NHS SOUTHPORT AND FORMBY CCG, NHS ST HELENS CCG, NHS WARRINGTON CCG, NHS WIRRAL CCG, SEFTON METROPOLITAN BOROUGH COUNCIL, ST HELENS COUNCIL, WARRINGTON BOROUGH COUNCIL, WIRRAL METROPOLITAN BOROUGH COUNCIL - PUBLIC HEALTH, CHESHIRE EAST COUNCIL, CHESHIRE WEST AND CHESTER COUNCIL, HALTON BOROUGH COUNCIL, KNOWSLEY METROPOLITAN BOROUGH COUNCIL, LIVERPOOL CITY COUNCIL, NHS CHESHIRE AND MERSEYSIDE ICB - 01F, NHS CHESHIRE AND MERSEYSIDE ICB - 01J, NHS CHESHIRE AND MERSEYSIDE ICB - 01T, NHS CHESHIRE AND MERSEYSIDE ICB - 01V, NHS CHESHIRE AND MERSEYSIDE ICB - 01X, NHS CHESHIRE AND MERSEYSIDE ICB - 02E, NHS CHESHIRE AND MERSEYSIDE ICB - 12F, NHS CHESHIRE AND MERSEYSIDE ICB - 27D, NHS CHESHIRE AND MERSEYSIDE ICB - 99A, SEFTON METROPOLITAN BOROUGH COUNCIL, ST HELENS COUNCIL, WARRINGTON BOROUGH COUNCIL, WIRRAL METROPOLITAN BOROUGH COUNCIL - PUBLIC HEALTH, CHESHIRE EAST COUNCIL, CHESHIRE WEST AND CHESTER COUNCIL, HALTON BOROUGH COUNCIL, KNOWSLEY METROPOLITAN BOROUGH COUNCIL, LIVERPOOL CITY COUNCIL, NHS CHESHIRE AND MERSEYSIDE ICB - 01F, NHS CHESHIRE AND MERSEYSIDE ICB - 01J, NHS CHESHIRE AND MERSEYSIDE ICB - 01T, NHS CHESHIRE AND MERSEYSIDE ICB - 01V, NHS CHESHIRE AND MERSEYSIDE ICB - 01X, NHS CHESHIRE AND MERSEYSIDE ICB - 02E, NHS CHESHIRE AND MERSEYSIDE ICB - 12F, NHS CHESHIRE AND MERSEYSIDE ICB - 27D, NHS CHESHIRE AND MERSEYSIDE ICB - 99A, SEFTON METROPOLITAN BOROUGH COUNCIL, ST HELENS COUNCIL, WARRINGTON BOROUGH COUNCIL, WIRRAL BOROUGH COUNCIL, NHS CHESHIRE AND MERSEYSIDE INTEGRATED CARE BOARD

Sublicensing allowed: No

Datasets:

  1. Acute-Local Provider Flows
  2. Ambulance-Local Provider Flows
  3. Children and Young People Health
  4. Civil Registration - Births
  5. Civil Registration - Deaths
  6. Community Services Data Set
  7. Community-Local Provider Flows
  8. Demand for Service-Local Provider Flows
  9. Diagnostic Imaging Dataset
  10. Diagnostic Services-Local Provider Flows
  11. Emergency Care-Local Provider Flows
  12. Experience, Quality and Outcomes-Local Provider Flows
  13. Improving Access to Psychological Therapies Data Set
  14. Maternity Services Data Set
  15. Mental Health and Learning Disabilities Data Set
  16. Mental Health Minimum Data Set
  17. Mental Health Services Data Set
  18. Mental Health-Local Provider Flows
  19. National Cancer Waiting Times Monitoring DataSet (CWT)
  20. National Diabetes Audit
  21. Other Not Elsewhere Classified (NEC)-Local Provider Flows
  22. Patient Reported Outcome Measures
  23. Population Data-Local Provider Flows
  24. Primary Care Services-Local Provider Flows
  25. Public Health and Screening Services-Local Provider Flows
  26. Shielded Patient List
  27. SUS for Commissioners
  28. National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
  29. Improving Access to Psychological Therapies Data Set_v1.5
  30. Civil Registrations of Death
  31. Community Services Data Set (CSDS)
  32. Diagnostic Imaging Data Set (DID)
  33. Improving Access to Psychological Therapies (IAPT) v1.5
  34. Mental Health and Learning Disabilities Data Set (MHLDDS)
  35. Mental Health Minimum Data Set (MHMDS)
  36. Mental Health Services Data Set (MHSDS)
  37. Patient Reported Outcome Measures (PROMs)

Objectives:

The overarching purpose for this agreement is to support a set of COVID related population health analytics designed to inform both population level planning for COVID recovery and to support the targeting of direct care to vulnerable populations across the Cheshire & Merseyside Sustainable Transformation Partnership (C&MSTP).

Data released will only be shared with those parties listed and will only be used for COVID-19 purposes as laid out in this agreement. Any non-COVID-19 purpose and any other COVID-19 purpose, except as set out in this agreement, is excluded.

Although CMSTP is made up of over 450 organisations (including more than 350 GP practices) for the purposes of this Data Sharing Agreements it has been determined that the 8 Clinical Commissioning Groups and 8 Local Authorities are the Joint Data Controllers. These organisations form the membership of the Data Access and Asset Group within the STP and so for the purpose of this agreement are deemed to be Joint Data Controllers.

The COVID related population health analytics will be achieved via analysis of the data requested in this agreement and the data sets listed in the Processing Activities section producing pseudonymised data for place-based local intelligence services. The proposal is to make a set of person level pseudonymised data available to the local placed based intelligence teams that being the CCG and Local Authorities. This will enable them to support the local system including the COVID recovery cells, public health teams, Hospital and Out of Hospital cells across the Cheshire and Merseyside patch as well as local with COVID planning, which includes support to General Practice and PCN’s in intelligence required.

A further example of analysis is a set of automated dashboards in the areas of COVID sit rep reporting, Capacity and Demand, Epidemiology, and Population Stratification.

These dashboards are required for:

Dashboard 1: COVID sit rep reporting: this suite of reports will show the daily situation of COVID in Cheshire and Mersey to aid the monitoring and management of outbreaks and incidents including cases, mortality, hospital admissions, testing and outbreaks. It’s audience is system wide including local Recovery Cells and Hospital and Out of Hospital cells, all designated by government to locally manage the pandemic. It will enable them to have the same up to date information on the spread and challenges in the pandemic so they can make informed population management decisions.

Dashboard 2 Capacity and Demand: This dashboard will assist in monitoring and managing demand across acute, community, mental health and local authority services in as near real time as possible, including the ability to understand if there are possible surges or subsequent ‘waves’ emerging by recognising changing trends. It will enable understanding of whether there is enough capacity to meet that demand and allow the Cells and STO described above to take informed actions to control and prevent the spread of COVID. This dashboard is targeted at those user groups that are responsible for planning system capacity including Cheshire and Merseyside region, sub regional teams i.e. North Mersey, individual CCG’s and Primary Care Networks.

Dashboard 3 Epidemiology: This dashboard will enable monitoring and recognition of trends in mortality and incidence over time at differing levels of geography. It will also provide insight in terms of demographic and health characteristics of individuals most affected by COVID. It will enable identification of geographical outbreaks or ‘hot spots’ of emerging infection. This dashboard is aimed at Public Health departments; The Out of Hospital and Acute Recovery Cells at Cheshire and Mersey Region that are responsible for planning and those responsible for planning a COVID response with PCN’s.

Dashboard 4 Population Stratification: This Dashboard enables GP practices to monitor and manage outbreaks and assist in controlling and preventing the spread of COVID by identifying individuals with certain characteristics that will be vulnerable to adverse outcomes as a result of COVID and target services/interventions appropriately to control and prevent the spread of COVID. (This is not the same as risk stratification in general practice that is most commonly used for stratifying the risk of unplanned admission to acute care)

The outputs of Dashboard 4 may also be used for Direct Care Purposes.


The 9 CCGs involved in this agreement also have a an existing agreement for commissioning purposes (NIC-140059)

Expected Benefits:

Benefits at Cheshire and Mersey Region, CCG and Local Authority level

The Cheshire and Merseyside Health Care partnership (C&M HCP) is made up of nine local authority areas (or “places”). The C&M HCP is responsible for planning enough system capacity to respond to any surges in demand due the COVID pandemic, whilst also reintroducing planned care capacity cross both acute, community and mental health providers. Demand and capacity reports will enable the C&M HCP and the nine places (eg Cheshire East, Liverpool, Warrington etc) to be sighted on system demand and respond with capacity accordingly.

• Implementation of the system will allow the production of bespoke real-time dashboards to present data in easy to understand visual displays that can then prompt further detailed analysis depending on issues highlighted as being of concern across Cheshire & Merseyside.
Available once data flows.

• C&M Covid dashboards including cases rates, testing rates and system metrics such as hospital admissions and local mortality rates will enable local health care systems within the C&M footprint to understand the current Covid situation and respond with appropriate policy.
Available within 3-6 months.

• An epidemiology dashboard will allow place-based decision makers to identify the population characteristics of people presenting for tests, cases and mortality to better understand the nature of the pandemic and identify if there are particular cohorts that are consuming testing at a greater rate than others to help manage testing capacity.
Available within 3-6 months.

• A specific testing dashboard will help place-based decision makers to identify geographical Covid hot spots and drill down to identify patterns and/or vulnerable cohorts for management. This may allow more targeted intervention at place-based or more local geographies.
Available within 3-6 months.

• Real-time detailed capacity and demand reporting across all sectors including hospital and out of hospital services will enable accurate reporting as stipulated in NHS England (NHSE) phase three planning guidance and it is hoped allow place-based decision makers to better manage demand and capacity.
Available within 3-6 months.

• The system will provide the data to enable the C&M HCP and place-based NHS organisations to follow the NHSE planning guidance which includes the following:

“Restore NHS services inclusively, so that they are used by those in greatest need. This will be guided by new, core performance monitoring of service use and outcomes among those from the most deprived neighbourhoods and from Black and Asian communities, by 31 October 2020.

Ensure datasets are complete and timely, to underpin an understanding of and response to inequalities. All NHS organisations should proactively review and ensure the completeness of patient ethnicity data by no later than 31 December 2020, with general practice prioritising those groups at significant risk of COVID-19 from 1 September 2020.

Collaborate locally in planning and delivering action to address health inequalities, including incorporating in plans for restoring critical services by 21 September; better listening to communities and strengthening local accountability; deepening partnerships with local authorities and the voluntary and community sector; and maintaining a continual focus on implementation of these actions, resources and impact, including a full report by 31 March 2021.”

https://www.england.nhs.uk/publication/implementing-phase-3-of-the-nhs-response-to-the-covid-19-pandemic/


What are the benefits for GP Practices and Primary Care Networks (PCNs)?


• Identification of vulnerable groups will give Practices and PCNs a better understanding of vulnerable populations and their needs. It is hoped that services can then be planned and targeted more appropriately.
Available within 3-6 months.

• Analysis of the characteristics of people affected by COVID in their populations and identification of local hotspots may allow targeted interventions based on specific risk factors, for example local shielding advice, patient remote monitoring and specific treatment interventions (such as early use of steroids in selected patients in community). This may lead to reduced morbidity and mortality and so better patient outcomes.
Available within 3-6 months.


What are the benefits for patients?

• It is hoped that the detailed data analysis will enable more effective targeted support and/or interventions from services that are available, to at risk individuals.
Available within 3-6 months.

• Local commissioners may identify service delivery gaps that could be addressed locally by re-organising current service provision or by commissioning additional service provision.
Available within 3-6 months.

• It is hoped the above will result in improved patient well-being and a reduction in morbidity and mortality associated with Covid infection.
Available over the course of the pandemic, may be seen within 3-6 months.

Outputs:

COVID National & Sitrep
This report shows COVID cases, mortality and admissions. It compares trends
over time and compares rates by different geographies and providers.


COVID Out of Hospital Capacity & Demand
This report shows capacity and demand for hospital, ready for discharge,
care homes, domiciliary care, mental health and community providers.


COVID Testing Report
This report shows numbers, rates, positivity rates of those testing positive.
Also homes, schools and organisations that have had an outbreak against
The national definitions.


COVID in Hospital Demand Prediction Tool (Manchester Model)
This report provides predicting short term, in hospital COVID bed occupancy
split by core and ICU beds.


Enhanced case Finder
This report enables the ability to identify vulnerable cohorts of the
population including those advised to shield, with the functionality to drill
down to identify patients for targeting of direct care.


COVID Epidemiology
This report shows stratified cases, suspected cases, mortality and people
receiving tests by characteristics including age, condition, deprivation and BAME,
and over time.

Processing:

PROCESSING CONDITIONS:
Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital.

Data Processors must only act upon specific instructions from the Data Controller.

Data can only be stored at the addresses listed under storage addresses.

All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role and the tasks that they are required to undertake.

Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement.

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 Recipients will take all required security measures to protect the disseminated data and they will not generate copies of their cuts of the disseminated data unless this is strictly necessary. Where this is necessary, the Recipients will keep a log of all copies of the disseminated data and who is controlling them and ensure these are updated and destroyed securely.

ONWARD SHARING:
Patient level data will not be shared outside of the Data Controllers / Data Processors 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.

Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital guidance applicable to each data set.

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.

AUDIT
All access to data is auditable by NHS Digital in accordance with the Data Sharing Framework Contract and NHS Digital terms.

Under the Local Audit and Accountability Act 2014, section 35, Secretary of State has power to audit all data that has flowed, including under COPI.

DATA MINIMISATION:
Data Minimisation in relation to the data sets listed within the application are listed below. This also includes the purpose on which they would be applied -

For the purpose of Commissioning:
• Patients who are normally registered and/or resident within the CCG regions (including historical activity where the patient was previously registered or resident in another commissioner).
and/or
• Patients treated by a provider where the CCG are the host/co-ordinating commissioner and/or has the primary responsibility for the provider services in the local health economy – this is only for commissioning and relates to both national and local flows.
and/or
• Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of the CCG - this is only for commissioning and relates to both national and local flows.

The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets:
1. SUS+
2. Local Provider Flows (received directly from providers)
a. Acute
b. Ambulance
c. Community
d. Demand for Service
e. Diagnostic Service
f. Emergency Care
g. Experience, Quality and Outcomes
h. Mental Health
i. Other Not Elsewhere Classified
j. Population Data
k. Primary Care Services
l. 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. Community Services Data Set (CSDS)
10. Diagnostic Imaging Data Set (DIDS)
11. National Cancer Waiting Times Monitoring Data Set (CWT)
12. Civil Registries Data (CRD) (Births)
13. Civil Registries Data (CRD) (Deaths)
14. National Diabetes Audit (NDA)
15. Patient Reported Outcome Measures (PROMs)
16. Shielded Patient List (SPL)

Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:

Data Processor 1 – Graphnet Health Ltd
1. 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), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT), Civil Registries Data (CRD) (Births and Deaths), National Diabetes Audit (NDA) Patient Reported Outcome Measures (PROMs) and Shielded Patient List (SPL) data only is pseudonymised using the Nottingham Open Pseudonymiser tool in the DSCRO with a specific SALT key for this project. The pseudonymised data is then securely transferred to Arden and GEM Commissioning Support Unit.
2. Arden and GEM Commissioning Support unit add derived fields by using existing data and then transfer the data to Graphnet Health Ltd
3. Graphnet Health Ltd also receive data directly from providers (see points i - v for details)
4. Graphnet Health Ltd link data and provide analysis
5. Allowed linkage is between the data sets contained within point 1 and 3.
6. Graphnet Health Ltd then pass the processed, pseudonymised and linked data to the Data Controllers.
7. Patient level data will not be shared outside of the Data Controllers / Data Processors unless it is for the purpose of direct care and will only be shared within 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 as set out within NHS Digital guidance applicable to each data set.

Data From Providers
i. Graphnet Health Ltd receives the following identifiable datasets directly from providers:
Acute HL7
Mental Health
Community
Primary Care
Ambulance 111
Ambulance 999
SDRA Spine
Social Care
Pathology
NPEX
Testing Data
ii. The identifiable data is landed in a segregated section of Graphnet Health Ltd with strict access controls
iii. The data is pseudonymised using the Nottingham Open Pseudonymiser tool and SALT key specific for this project that has been shared via the DSCRO
iv. The pseudonymised data is then sent to Graphnet Healthcare Ltd main system for linkage to other datasets
v. The identifiable data is then deleted from the segregated area

For clarity, the reidentification of individuals for GP Direct Care purposes is carried out by the DSCRO.