NHS Digital Data Release Register - reformatted
NHS Lincolnshire Integrated Care Board projects
- Lincolnshire Wearables Project - Consented
- DSfC - NHS Lincolnshire Integrated Care Board - Comm/IV/RS
5 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).
Lincolnshire Wearables Project - Consented — DARS-NIC-687867-Y7L9P
Type of data: information not disclosed for TRE projects
Opt outs honoured: Anonymised - ICO Code Compliant (Consent (Reasonable Expectation))
Legal basis: Health and Social Care Act 2012 s261(2)(c)
Purposes: Yes (ICB - Integrated Care Board)
When:DSA runs 2023-01-25 — 2024-01-24
Access method: One-Off
Data-controller type: NHS LINCOLNSHIRE INTEGRATED CARE BOARD
Sublicensing allowed: No
- SUS for Commissioners
The ICB intend to make assessments of the likely qualitative and economic benefits of the predictive system based on the data collected. These will be tested through data quality evaluation, model selection, training data categorisation, learning algorithm(s), sensitivity and specificity analyses. to help determine the confidence of the predictive systems (Ref: Longstaff 2010). The benefits can accrue in several parts of the services.
It is hoped that the results from the study will pave the future for how healthcare can be delivered and how vulnerable patients can be target before requiring hospital admission. Due to the ever increasing demands on the healthcare system, prevention of worse outcomes is a key target for the NHS.
Reporting and dissemination
Results will be fed back initially to the Study Steering Committee, and subsequently to any associated funding bodies. Results of any studies will be presented at scientific meetings and disseminated in the form of scientific papers. The completion date for this is expected to be March 2023
What will happen after the study ends
At the end of the study, I5 Health will write a report for Lincolnshire ICB with the findings and recommendations for how this new technology could be used to improve NHS services. Patients will not be mentioned personally in any report, and it will not be possible to find out that they were involved in the study from the study report. Within three months after the end of the study I5, will send the consented patients a copy of the report. This will only contain aggregated data with small number suppression.
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. All access to data is auditable by NHS Digital.
The Data Controller must keep a record of locations the data is processed and stored. These addresses must be within the UK. The Data Controller should minimise the number of processing and storage locations to prevent excessive processing. NHS Digital may request a record of processing and storage locations at any time.
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.
Data may only be processed and held as long as is required to carry out the purposes listed within this agreement.
Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be used for the purposes laid out in the application/agreement.
There will be no attempt to re-identify any of the data supplied under this agreement. The data processor / controller will not have access to the NHS Number to trial ID mapping table at any point.
Data processing is only carried out by substantive employees of the data processor(s) and or data controller(s) who have been appropriately trained in data protection and confidentiality.
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 i.e.: employees, agents and contractors of the Data Recipient who may have access to that data).
The former CCG(s) has submitted their Data Security Protection Toolkit (DSPT) for 21/22. The ICB will submit their DSPT in line with the 22/23 submission timetable, and the ICB commits to abide by the former DSPT assessments submitted under those CCG(s);
The following CCG(s) previously occupied the footprint of the ICB:
NHS Lincolnshire CCG
Data Processors must be listed in section 5b of this Data Sharing Agreement. These include Cloud and IT infrastructure providers.
The Data Controller should ensure appropriate data processing agreements with all data processors contracted to undertaking work referenced within this agreement.
Microsoft Limited provide Cloud Services for NHS Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Greater Manchester Shared Services (hosted by NHS Greater Manchester Integrated Care Board) and NHS Midlands and Lancashire Commissioning Support Unit supply IT infrastructure for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing 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.
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.
Pseudonymised Secondary Use Services (SUS) Data
Data will be limited to patients that have consented to the release of their data
NHS Arden and Gem Commissioning Support Unit
1. GPs identify patients who would be ideal for study and send them a letter inviting them to participate
2. Patient returns consent form to Optima (includes trial id)
3. Optima assign patients the wearable devices and forwards the patients details to the GP
4. GP sends NHS Number, trial id and demographic details of consented patients to the DSCRO. Where the GPs do not have the capacity due to workloads, Optima will submit demographics details and trial ID to the DSCRO themselves.
5. DSCRO sends pseudonymised SUS data with trial id for those patients to I5 Health
6. I5 Health link the SUS data to the data collected from the wearables
7. A report with small number suppressed is then shared with the ICB and the patients who consented to be in the study
8. The linked pseudonymised data is then sent to Arden and GEM Commissioning Support Unit who will store the data
DSfC - NHS Lincolnshire Integrated Care Board - Comm/IV/RS — DARS-NIC-616929-K6X7D
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)
When:DSA runs 2022-11-03 — 2025-11-02
Access method: Frequent Adhoc Flow
Data-controller type: NHS LINCOLNSHIRE INTEGRATED CARE BOARD
Sublicensing allowed: Yes
- Commissioning Datasets
- Invoice Validation Datasets
- Risk Stratification Datasets
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 patients 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 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.
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).
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.
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 patients responsible commissioner, but does have a written contract with another NHS commissioner/s.
5. Budget control of the ICB.
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.
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 patients 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.
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.