NHS Digital Data Release Register - reformatted
NHS North East And North Cumbria ICB - 00l projects
- Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System (partially via "system access")
- GDPPR COVID-19 CCG - Pseudo
- DSfC - NHS Northumberland CCG IV RS Comm
334 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).
Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System — NIC-800987-T2X1J
Opt outs honoured: unknown (Excuses: Does not include the flow of confidential data)
Legal basis: Health and Social Care Act 2012 s261(2)(a)
Purposes: No (Sub ICB Location)
Sensitive: Non-Sensitive
When:DSA runs 2026-04 – 2029-04 2026.08 — 2026.08.
Access method: System Access
(System access exclusively means data was not disseminated, but was accessed under supervision on NHS Digital's systems)
Data-controller type: NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
Sublicensing allowed: No
AGD/predecessor discussions: AGD minutes - 10th October 2024 final.pdf, AGD minutes - 3 October 2024 final.pdf
Datasets:
- National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
Type of data: Anonymised - ICO Code Compliant (note: this information not disclosed for TRE projects )
Objectives:
This agreement is for the Northern Cancer Alliance (E56000029) to access Cancer Waiting Times data.
Improvements for Cancer patients
In 2015, the independent Cancer Taskforce set out an ambitious vision for improving services, care and outcomes for everyone with Cancer: fewer people getting Cancer, more people surviving Cancer, more people having a good experience of their treatment and care, whoever they are and wherever they live, and more people being supported to live as well as possible after treatment has finished. In 2019, the NHS Long Term Plan was published and it aims to improve how we diagnose and treat cancer. The plan included cancer care as one of its clinical priorities and aimed to boost cancer survival rates by focusing on early diagnosis. The plan set new targets that, by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise to 75% of cancer patients. Further, an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis.
Cancer Alliances:
Cancer Alliances have a crucial role to play by being the cancer arms of their ICSs and being the leaders for cancer within their ICB and ICS footprint. Their role is to lead the planning and delivery of the Long-Term Plan ambitions for cancer for their populations, to provide system oversight and co-ordination for cancer services and to oversee the delivery of critical programmes of work within that footprint. They do this by:
Collaborating with partners (ICSs, commissioners and providers) to provide system level oversight and co-ordination to deliver the operational standards for cancer and the Long Term plan ambitions across their cancer system;
Deploying service development funding in a way that supports their whole population, and which complements baseline investment so that it maximises the impact on improving cancer outcomes;
Providing clinical leadership for cancer services across their area to ensure the delivery of a consistently high level of service to patients and to drive the rapid adoption of new approaches; and
Working as part of the NHS Cancer Programme to share best practice and solutions, and to provide peer support to other Alliance teams.
Cancer Alliance boundaries encompass the range of providers that a cancer patient will typically use. This gives them an opportunity to organise services across organisation boundaries reducing variation and inequalities, and overall benefitting patients
Cancer Wait Times (CWT) system
The Cancer Wait Times (CWT) system collects and validates the National Cancer Waiting Times Monitoring Data Set (NCWTMDS), allowing performance to be measured against operational Cancer standards. Data is validated and records merged to the same pathway to cover the period from referral to first definitive treatment for Cancer and any additional subsequent treatments.
The CWT system then determines whether the operational standard(s) that apply were met or not for the patient and the accountable provider(s). The CWT system holds NCWTMDS in a series of pre-aggregated static reports. These reports are available monthly and quarterly data (aligned with the National Statistics for Cancer Waiting Times published by NHS England). Users can query the CWT system to generate reports to feedback on the progress towards meeting these targets.
Northern Cancer Alliance:
Northumbria Healthcare NHS Foundation Trust will directly access the Cancer Waiting Times System on behalf of The Northern Cancer Alliance, which covers a population of more than 3 million people.
Northumbria Healthcare NHS Foundation Trust works with health organisations across North East and North Cumbria including 8 acute and specialist providers, 1 Integrated Care Board (ICB) containing 8 sub-regions and 14 hospices.
Acute/Specialist Providers:
- Gateshead Health NHS Foundation Trust (Acute)
- Northumbria Healthcare NHS Foundation Trust (Acute)
- South Tyneside and Sunderland NHS Foundation (Acute)
- North Tees and Hartlepool NHS Foundation Trust (Acute)
- County Durham and Darlington NHS Foundation Trust (Acute)
- North Cumbria Integrated Care NHS Foundation Trust (Acute)
- The Newcastle upon Tyne Hospitals NHS Foundation Trust (Specialist)
- South Tees Hospitals NHS Foundation Trust (Specialist)
ICB:
- North East and North Cumbria ICB
ICB sub regions:
- 99C North Tyneside
- 00L Northumberland
- 00N South Tyneside
- 00P Sunderland
- 13T Newcastle Gateshead
- 01H North Cumbria
- 84H County Durham
- 16C Tees Valley
Hospices:
- Alice House
- Butterwick
- Eden Valley Hospice & Jigsaw Childrens Hospice
- Hospice at Home West Cumbria
- Hospice Care North Northumberland
- Hospice at Home Carlisle & North Lakeland
- Marie Curie Hospice, Newcastle
- St Benedict's Hospice
- St Cuthberts Hospice
- St Oswalds Hospice
- St Teresas Hospice
- Teesside Hospice
- Tynedale Hospice at Home
- Willow Burn Hospice
Data access:
The CWT system provides one organisation (NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST) representing each Cancer Alliance, with access to the following:
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) i-View Plus tool
Lead organisation (Northumbria Healthcare NHS Foundation Trust) will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients' ICB of responsibility. This Cancer Alliance is limited to North East and North Cumbria ICB Cancer Patients. CCGs no longer exist in statute but NHS England use the CCG field in the data as he geographical variable to split the CWT extracts that are sent to Cancer Alliances.
a) Aggregate reports including small numbers:
Aggregate data is available in the form of reports at Provider (Trust) and ICB level.
Small numbers may be included in the aggregate data reports and are essential for analyses carried out by Northumbria Healthcare NHS Foundation Trust.
Investigating breaches:
Northumbria Healthcare NHS Foundation Trust routinely monitor performance and standards using the CWT system, particularly in relation to breaches of the 62 day wait target. Due to the large number of potential Trust/ICB sub-region combinations, breach counts could result in small numbers as in some cases there are less than 6 breaches in a whole year. Given that financial penalties are linked to target breaches, counts must accurately reflect the true percentage without suppression.
Mitigating risk of re-identification:
Risk of disclosure is minimised as the dataset does not include patient demographics (increasing risk of re-identification) that may allow users to identify an individual, e.g., there are no age, ethnic categories, or geographic breakdowns based on patient postcode.
Additionally, the aggregation categories are such that the data is not at a lesser granular level, e.g., the source NCWTMDS data collects information at ICD diagnosis code level, but the CWT system aggregates at tumour group level e.g. Head & Neck, Upper GI, lower GI, Breast etc.
b) Pseudonymised record level extracts:
Northumbria Healthcare NHS Foundation Trust will access record level pseudonymised data which includes the system generated pseudo CWT patient ID.
Any record level data extracted from the system will not be processed outside of the authorised users of the system.
c) i-View Plus:
iView Plus uses cube functionality to allow Northumbria Healthcare NHS Foundation Trust to produce graphs, charts, and tabulations from the data through the construction of queries. The data in iView plus is split by operational standard being measured and can then be analysed against a range of dimensions collected in the data and measures such as count, percentage, and median. The outputs of iView Plus are aggregate, and no record level data can be obtained, however some queries may result in small numbers and these currently have limited disclosure control applied - see a) for further explanation.
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to ICB sub-region level and other health hierarchies.
Northumbria Healthcare NHS Foundation Trust will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider cancer pathway improvements.
Northumbria Healthcare NHS Foundation Trusts use of the data will fall into two separate categories, each requiring different levels of suppression, and onward sharing both within the Cancer Alliance and with wider NHS stakeholders;
Purpose One - Aggregate local reports:
Generation of routine Cancer Waiting Times reports at Provider (Trust) or ICB sub-region level. Northumbria Healthcare NHS Foundation Trust will access a summary of the totals for the Providers (Trust) and ICB sub-region's that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ICB they are aligned to). This analysis would then be shared with the providers and commissioners and used to inform service improvement by providing benchmarked comparable data. The format of this report would be in a tabulated or graphical form (i.e., not record level) but may contain small numbers. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful.
Examples of this type of analysis include:
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICB sub-regions across the geography
b. Analysis of Cancer Waiting Times performance by treatment modality
c. Grouping length of waits for standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g., orphan record identification, active monitoring proportions, and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks
h. Reviewing routes to diagnosis of patients
i. Quantifying treatment volumes by provider organisation including analysis treatment rates
Purpose Two - Sharing of record level data (including free text breach reasons) with providers and commissioners responsible for direct patient care for that patient. This will be for local audit purposes.
The two broad purposes for this would be:
1) To support audit work
2) Investigate individual outliers to the national standards
Pathway analysis will be undertaken, identifying trends in reasons for breaches. The analysis will inform system wide pathway improvements and compliance to the national standards. Examples of potential changes to achieve this could be to support trusts in additional resources and processes and also to facilitate discuss between trusts for example in reaching agreement for diagnostics between trusts.
Examples of the types of reasons for this include:
a. Patients waiting excessively long period of time to seen of received treatment
b. Free text breach reasons identifying areas of concern which require more detail or clarification from provider
c. Identification of 28 day standard exceptions - National guidance states patients who are diagnosed with cancer should be informed face to face, this would highlights numbers of patients who are not told in person by provider
d. Audits to review orphan records which require local providers to review local patients records
Record level data (pseudonymised) will be shared via NHS.net email accounts and access will be controlled by password protecting all files.
Expected Benefits:
1) Benefits type: Supporting delivery of CWT standards:
The Cancer Waiting Times standards are key operational standards for the NHS, which aim to reduce the waits for diagnosis and treatment for Cancer patients, which will support improvements to survival rates and improve patient experience. These include the 3 combined operational standards which came into existence in October 2023 (28 day Faster Diagnosis, 31 day Treatment and 62 day Standards).
A key enabler to achieve these standards, and thus improve survival and patient experience is the role of Cancer Alliances locally to work with providers and commissioners to improve patient pathways. Access to the Cancer Waiting Times data as detailed in the above will enable Cancer Alliances to have informed discussions and allocate resources optimally to improve performance against these standards. It will also enable Cancer Alliances to work with local providers and commissioners to identify outliers against the standards and mitigate the risk of similar delays for other patients.
Improvement would be expected on an on-going basis with the combined standards, based on the previous nine standards, being in place since October 2023: -
- 8-day Faster Diagnosis Standard (75%)
- 31-day decision to treat to treatment standard (96%)
- 62-day referral to treatment standard (85%)
2) Benefits type: Improvements beyond constitutional standards
This access and resulting analysis will enable Cancer Alliances to undertake local analysis beyond the Cancer Waiting times operational standards to support improvements to Cancer patients pathways beyond those already achieved by improving performance against standard set. This could include reviewing times between treatments, or treatment rates.
The overall aim of this type of additional analysis would be to support improvements to Cancer patients survival and experience. The NHS Long-Term plan built on the previous Cancer Taskforce recommendations relating to survival and early diagnosis, and has set out ambitions to improve early diagnosis (patients stage 1 or 2) to 75% and that an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis by 2028. For both of these improvements to the diagnostic and treatment pathways are key and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset to identify sub-optimum pathways and resulting improvements.
Outputs:
Outputs fall into the following categories:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact cancer patients outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve cancer pathways including reducing cancer incidence and mortality, improving cancer survival, improving patient experience, improving service efficiency, and meeting national constitution standards relating to cancer patients.
Processing:
Access to the Cancer Wait Times (CWT) System will enable Cancer Alliances to undertake a wide range of locally-determined and locally-specific analyses to support the Long-Term Plan ambitions for early diagnosis and survival and the previous Cancer Taskforce vision for improving services, care, and outcomes for everyone with cancer.
Only the Northumbria Healthcare NHS Foundation Trust will directly access the Cancer Waiting Times system. Extracts can be downloaded and will be stored on the Northumbria Healthcare NHS Foundation Trust servers. Role Based Access Control prevents access to data downloads to employees outside of the analytical team responsible for producing outputs.
The CWT system is hosted by NHS England, access to and usage of the system is fully auditable. Users must comply with the use of the data as specified in this agreement. The CWT system complies with the requirements of NHS England Code of Practice on Confidential Information, the Caldicott Principles, and other relevant statutory requirements and guidance to protect confidentiality.
Access to the CWT system will be granted to individual users only when a valid Data Usage Certificate (DUC) form is submitted to NHS England via the lead organisations Senior Information Risk Officer (SIRO), and where there is a valid Data Sharing Agreement between the lead organisation and NHS England.
Approved users will log into the system via an N3 connection and will use a Single Sign-On (users are prompted to create a unique username and password).
Northumbria Healthcare NHS Foundation Trust users will access:
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool (aggregated - access to produce graphs, charts/tabulations from the data through the construction of queries). This will give users access to run bespoke analysis on pre-defined measures and dimensions. It delivers the same data that is available through the reports and record level downloads (i.e., it will not contain patient identifiable data).
Any record level data extracted from the system will not be processed outside of the Northumbria Healthcare NHS Foundation Trust unless otherwise specified in this agreement. Following completion of the analysis the record level data will be securely destroyed.
Users are not permitted to upload data into the system.
Data will only be available for the Providers (Trust) and ICBs that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ICB that this Cancer Alliance is aligned to). Northern Cancer Alliance will only access data for patients within their geographical remit - namely in the North East and North Cumbria region.
The data will only be shared with other members of the Cancer Alliance in the format described in purpose 1 and purpose 2 of this agreement. The primary method for sharing outputs is via NHSmail.
Aggregate data/graphical outputs may be shared via e-mail, for example as part of Alliance meeting papers.
Where record level data is shared with individual trusts, these are shared only with trust(s) who were involved in the direct care of the patient, and only via NHS.net email accounts.
As part of partnership working to improve Cancer Waiting Times performance, outputs may be shared with national/regional bodies including NHS England, local ICBs, and Providers. Data will only be shared as described in purpose one and purpose two of this agreement and where recipient organisations hold a valid Data Sharing Agreement with NHS England to access Cancer Waiting Times data.
Training on the CWT system is not required as it is a data delivery system and it does not provide functionality to conduct bespoke detailed analysis. User guides are available for further assistance.
Access to the CWT system data is restricted to Cancer Alliance employees who are substantively employed by Northumbria Healthcare NHS Foundation Trust in fulfilment of their public health function.
The Cancer Alliances will use the data to produce a range of quantitative measures (counts, crude and standardised rates, and ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data.
Typical uses will include:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e., ICD10 code) level for Trusts and ICB sub-regions
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact cancer patients' outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
GDPPR COVID-19 CCG - Pseudo — NIC-404674-S3L8Y
Opt outs honoured: No - Statutory exemption to flow confidential data without consent (Excuses: Statutory exemption to flow confidential data without consent)
Legal basis: CV19: Regulation 3 (4) of the Health Service (Control of Patient Information) Regulations 2002, CV19: Regulation 3 (4) of the Health Service (Control of Patient Information) Regulations 2002; Health and Social Care Act 2012 - s261(5)(d)
Purposes: No (Clinical Commissioning Group (CCG), Sub ICB Location)
Sensitive: Sensitive
When:DSA runs 2020-09 – 2021-03 2021.01 — 2021.05.
Access method: One-Off, Frequent Adhoc Flow
Data-controller type: NHS NORTHUMBERLAND CCG, NHS NORTH EAST AND NORTH CUMBRIA ICB - 00L
Sublicensing allowed: No
AGD/predecessor discussions: List of projects wihtout minutes
Datasets:
- GPES Data for Pandemic Planning and Research (COVID-19)
- COVID-19 Ethnic Category Data Set
- COVID-19 Vaccination Status
- COVID-19 General Practice Extraction Service (GPES) Data for Pandemic Planning and Research (GDPPR)
Type of data: Anonymised - ICO Code Compliant
Objectives:
NHS Digital has been provided with the necessary powers to support the Secretary of State’s response to COVID-19 under the COVID-19 Public Health Directions 2020 (COVID-19 Directions) and support various COVID-19 purposes, the data shared under this agreement can be used for these specified purposes except where they would require the reidentification of individuals.
GPES data for pandemic planning and research (GDPPR COVID 19)
To support the response to the outbreak, NHS Digital has been legally directed to collect and analyse healthcare information about patients from their GP record for the duration of the COVID-19 emergency period under the COVID-19 Directions.
The data which NHS Digital has collected and is providing under this agreement includes coded health data, which is held in a patient’s GP record, such as details of:
• diagnoses and findings
• medications and other prescribed items
• investigations, tests and results
• treatments and outcomes
• vaccinations and immunisations
Details of any sensitive SNOMED codes included in the GDPPR data set can be found in the Reference Data and GDPPR COVID 19 user guides hosted on the NHS Digital website. SNOMED codes are included in GDPPR data.
There are no free text record entries in the data.
The Controller will use the pseudonymised GDPPR COVID 19 data to provide intelligence to support their local response to the COVID-19 emergency. The data is analysed so that health care provision can be planned to support the needs of the population within the CCG area for the COVID-19 purposes.
Such uses of the data include but are not limited to:
• Analysis of missed appointments - Analysis of local missed/delayed referrals due to the COVID-19 crisis to estimate the potential impact and to estimate when ‘normal’ health and care services may resume, linked to Paragraph 2.2.3 of the COVID-19 Directions.
• Patient risk stratification and predictive modelling - to highlight patients at risk of requiring hospital admission due to COVID-19, computed using algorithms executed against linked de-identified data, and identification of future service delivery models linked to Paragraph 2.2.2 of the COVID-19 Directions. As with all risk stratification, this would lead to the identification of the characteristics of a cohort that could subsequently, and separately, be used to identify individuals for intervention. However the identification of individuals will not be done as part of this data sharing agreement, and the data shared under this agreement will not be reidentified.
• Resource Allocation - In order to assess system wide impact of COVID-19, the GDPPR COVID 19 data will allow reallocation of resources to the worst hit localities using their expertise in scenario planning, clinical impact and assessment of workforce needs, linked to Paragraph 2.2.4 of the COVID-19 Directions:
The data may only be linked by the Data Controller or their respective Data Processor, to other pseudonymised datasets which it holds under a current data sharing agreement only where such data is provided for the purposes of general commissioning by NHS Digital. The Health Service Control of Patient Information Regulations (COPI) will also apply to any data linked to the GDPPR data.
The linked data may only be used for purposes stipulated within this agreement and may only be held and used whilst both data sharing agreements are live and in date. Using the linked data for any other purposes, including non-COVID-19 purposes would be considered a breach of this agreement. Reidentification of individuals is not permitted under this DSA.
LEGAL BASIS FOR PROCESSING DATA:
Legal Basis for NHS Digital to Disseminate the Data:
NHS Digital is able to disseminate data with the Recipients for the agreed purposes under a notice issued to NHS Digital by the Secretary of State for Health and Social Care under Regulation 3(4) of the Health Service Control of Patient Information Regulations (COPI) dated 17 March 2020 (the NHSD COPI Notice).
The Recipients are health organisations covered by Regulation 3(3) of COPI and the agreed purposes (paragraphs 2.2.2-2.2.4 of the COVID-19 Directions, as stated below in section 5a) for which the disseminated data is being shared are covered by Regulation 3(1) of COPI.
Under the Health and Social Care Act, NHS Digital is relying on section 261(5)(d) – necessary or expedient to share the disseminated data with the Recipients for the agreed purposes.
Legal Basis for Processing:
The Recipients are able to receive and process the disseminated data under a notice issued to the Recipients by the Secretary of State for Health and Social Care under Regulation 3(4) of COPI dated 20th March (the Recipient COPI Notice section 2).
The Secretary of State has issued notices under the Health Service Control of Patient Information Regulations 2002 requiring the following organisations to process information:
Health organisations
“Health Organisations” defined below under Regulation 3(3) of COPI includes CCGs for the reasons explained below. These are clinically led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area
The Secretary of State for Health and Social Care has issued NHS Digital with a Notice under Regulation 3(4) of the National Health Service (Control of Patient Information Regulations) 2002 (COPI) to require NHS Digital to share confidential patient information with organisations permitted to process confidential information under Regulation 3(3) of COPI. These include:
• persons employed or engaged for the purposes of the health service
Under Section 26 of the Health and Social Care Act 2012, CCG’s have a duty to provide and manage health services for the population.
Regulation 7 of COPI includes certain limitations. The request has considered these limitations, considering data minimisation, access controls and technical and organisational measures.
Under GDPR, the Recipients can rely on Article 6(1)(c) – Legal Obligation to receive and process the Disclosed Data from NHS Digital for the Agreed Purposes under the Recipient COPI Notice. As this is health information and therefore special category personal data the Recipients can also rely on Article 9(2)(h) – preventative or occupational medicine and para 6 of Schedule 1 DPA – statutory purpose.
Expected Benefits:
• Manage demand and capacity
• Reallocation of resources
• Bring in additional workforce support
• Assists commissioners to make better decisions to support patients
• Identifying COVID-19 trends and risks to public health
• Enables CCGs to provide guidance and develop policies to respond to the outbreak
• Controlling and helping to prevent the spread of the virus
Outputs:
• Operational planning to predict likely demand on primary, community and acute service for vulnerable patients due to the impact of COVID-19
• Analysis of resource allocation
• Investigating and monitoring the effects of COVID-19
• Patient Stratification in relation to COVID-19, such as:
o Patients at highest risk of admission
o Frail and elderly
o Patients that are currently in hospital
o Patients with prescriptions related to COVID-19
o Patients recently Discharged from hospital
For avoidance of doubt these are pseudonymised patient cohorts, not identifiable.
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.
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 i.e.: 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 of patient level data is not permitted under this agreement. Only aggregated reports with small number suppression can be shared externally.
The data disseminated will only be used for COVID-19 GDPPR purposes as described in this DSA, any other purpose is excluded.
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:
• Patients who are normally registered and/or resident within the CCG region (including historical activity where the patient was previously registered or resident in another commissioner area).
and/or
• Patients treated by a provider where the CCG is the host/co-ordinating commissioner and/or has the primary responsibility for the provider services in the local health economy.
and/or
• Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of the CCG.
The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets:
- GDPPR COVID 19 Data
Pseudonymisation is completed within the DSCRO and is then disseminated as follows:
1. Pseudonymised GDPPR COVID 19 data is securely transferred from the DSCRO to the Data Controller / Processor
2. Aggregation of required data will be completed by the Controller (or the Processor as instructed by the Controller).
3. Patient level data may not be shared by the Controller (or any of its processors).
DSfC - NHS Northumberland CCG IV RS Comm — NIC-134613-G2M6G
Opt outs honoured: No - consent provided by participants of research studYes - patient objections upheld, No - data flow is not identifiable (Excuses: Mixed, Section 251, Section 251 NHS Act 2006, 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(1) and s261(2)(b)(ii), National Health Service Act 2006 - s251 - 'Control of patient information'. , Health and Social Care Act 2012 - s261 - 'Other dissemination of information', Health and Social Care Act 2012 s261(1) and s261(2)(b)(ii), Health and Social Care Act 2012 s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'., Health and Social Care Act 2012 s261(2)(b)(ii)
Purposes: No (Clinical Commissioning Group (CCG), Sub ICB Location)
Sensitive: Sensitive
When:DSA runs 2018-12 – 2021-12 2018.10 — 2021.05.
Access method: Frequent Adhoc Flow, One-Off
Data-controller type: NHS NORTHUMBERLAND CCG, NHS NORTH EAST AND NORTH CUMBRIA ICB - 00L
Sublicensing allowed: No
AGD/predecessor discussions: igard_minutes_14_december_2017.pdf, igardminutes-3rddecember2020final.pdf, IGARD_Minutes_24.08.17.pdf
Datasets:
- Acute-Local Provider Flows
- Ambulance-Local Provider Flows
- Children and Young People Health
- Community Services Data Set
- Community-Local Provider Flows
- Demand for Service-Local Provider Flows
- Diagnostic Imaging Dataset
- Diagnostic Services-Local Provider Flows
- Emergency Care-Local Provider Flows
- Experience, Quality and Outcomes-Local Provider Flows
- Improving Access to Psychological Therapies Data Set
- Maternity Services Data Set
- Mental Health and Learning Disabilities Data Set
- Mental Health Minimum Data Set
- Mental Health Services Data Set
- Mental Health-Local Provider Flows
- National Cancer Waiting Times Monitoring DataSet (CWT)
- Other Not Elsewhere Classified (NEC)-Local Provider Flows
- Population Data-Local Provider Flows
- Primary Care Services-Local Provider Flows
- Public Health and Screening Services-Local Provider Flows
- SUS for Commissioners
- Civil Registration - Births
- Civil Registration - Deaths
- National Diabetes Audit
- Patient Reported Outcome Measures
- e-Referral Service for Commissioning
- Personal Demographic Service
- Summary Hospital-level Mortality Indicator
- National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
- Improving Access to Psychological Therapies Data Set_v1.5
- Adult Social Care
- Medicines dispensed in Primary Care (NHSBSA data)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DID)
- Improving Access to Psychological Therapies (IAPT) v1.5
- Mental Health and Learning Disabilities Data Set (MHLDDS)
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Services Data Set (MHSDS)
- Civil Registrations of Death
- Patient Reported Outcome Measures (PROMs)
- Summary Hospital-level Mortality Indicator (SHMI)
Type of data: Anonymised - ICO Code Compliant, Identifiable
Objectives:
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so they are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets and will not be used further.
Invoice Validation with be conducted by North of England Commissioning Support Unit.
The CCG are advised by North of England Commissioning Support Unit whether payment for invoices can be made or not.
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit (CSU)
Commissioning
To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area.
The CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers.
The following pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by North of England Commissioning Support Unit (CSU)
In addition, North of England Commissioning Support Unit also receive pseudonymised GP data, Social Care data and Consented Data. This is pseudonymised either at source or within North of England Commissioning Support Unit. This pseudonymisation tool is different to that held within the DSCRO. Also, each data source will use a variation of this tool so there is no linkage between these data until a common pseudonym has been applied via the DSCRO.
Yielded Benefits:
Expected Benefits:
Invoice Validation
1. Financial validation of activity
2. CCG Budget control
3. Commissioning and performance management
4. Meeting commissioning objectives without compromising patient confidentiality
5. The avoidance of misappropriation of public funds to ensure the ongoing delivery of patient care
Risk Stratification
Risk stratification promotes improved case management in primary care and will 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. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care.
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. 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 CCG Outcome Framework.
5. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
All of the above lead to improved patient experience through more effective commissioning of services.
Commissioning
1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
a. Analysis to support full business cases.
b. Develop business models.
c. Monitor In year projects.
d. Pooled health and social care budget reporting
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types and patient groups
3. Health economic modelling using:
a. Analysis on provider performance against 18 weeks wait targets.
b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients.
c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway.
d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC).
4. Commissioning cycle support for grouping and re-costing previous activity.
5. Enables monitoring of:
a. CCG outcome indicators.
b. Non-financial validation of activity.
c. Successful delivery of integrated care within the CCG.
d. Checking frequent or multiple attendances to improve early intervention and avoid admissions.
e. Case management.
f. Care service planning.
g. Commissioning and performance management.
h. List size verification by GP practices.
i. Understanding the care of patients in nursing homes and social care.
6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.
7. New commissioning and service delivery models delivered via joint health and social care teams reducing duplication
8. Reduction in variation of outcomes and quality of care through increased understanding of primary and secondary care interaction. E.g. if cancer treatment outcomes are poor in one area does the GP data indicate a delayed referral?
9. A complete understanding of service utilisation to aid capacity/demand planning across health and social care
10. Early warning of likely pressures in the wider health and system following increased activity in primary and social care giving other providers a chance to plan and react
Outputs:
Invoice Validation
1. Addressing poor data quality issues
2. Production of reports for business intelligence
3. Budget reporting
4. Validation of invoices for non-contracted events
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. Output from the risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
3. Record level output will be available for commissioners (of the CCG), pseudonymised at patient level.
4. 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.
5. The CCG will be able to target specific patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions. The CCG will also be able to:
o Stratify populations based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost
o Plan work for commissioning services and contracts
o Set up capitated budgets
o Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. All of the above segmented in to population groups
10. Analysis across health and social care by patient (outputs aggregated) providing a greater understand of service interdependencies and opportunities for a single service delivery model where overlap may exist currently
11. Variation reporting between primary and secondary care (e.g. where one care setting suggests the patient has a condition but the other does not potentially leading to inappropriate treatment)
12. Delayed transfers of care analysis
Processing:
Data must only be used as stipulated within this Data Sharing Agreement.
Data Processors must only act upon specific instructions from the Data Controller.
Data can only be stored at the addresses listed under storage addresses.
Patient level data will not be shared outside of the CCG 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.
All access to data is managed under Roles-Based Access Controls
No patient level data will be linked other than as specifically detailed within this agreement. Data will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from NHS Digital will not be national data, but only that data relating to the specific locality and that data required by the applicant.
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 DSCRO (part of NHS Digital) will apply Type 2 objections before any identifiable data leaves the DSCRO only for the purpose of Risk Stratification.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
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.
All access to data is auditable by NHS Digital.
Data for the purpose of Invoice Validation is kept within the CEfF, and only used by staff properly trained and authorised for the activity. Only CEfF staff are able to access data in the CEfF and only CEfF staff operate the invoice validation process within the CEfF. Data flows directly in to the CEfF from the DSCRO and from the providers – it does not flow through any other processors.
Data Minimisation
Data Minimisation in relation to the data sets listed within section 3 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 commissioner (including historical activity where the patient was previously registered or resident in another commissioner).
and/or
• Patients treated by a provider where the commissioner is 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 commissioner - this is only for commissioning and relates to both national and local flows.
For the purpose of Risk Stratification:
• Patients who are normally registered and/or resident within the commissioner (including historical activity where the patient was previously registered or resident in another commissioner
For the purpose of Invoice Validation:
• CCG of residence and/or registration.
The above relates to data requested only (Table 3B). Data currently held (Table 3A) will have the following Data Minimisation:
• CCG of residence and/or registration.
For clarity, any access by Pulsant to 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.
Invoice Validation
Identifiable SUS Data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
1. The DSCRO pushes a one-way data flow of SUS data into the Controlled Environment for Finance (CEfF) in the North of England Commissioning Support Unit (CSU).
2. The CSU carry out the following processing activities within the CEfF for invoice validation purposes:
o Checking the individual is registered to a particular Clinical Commissioning Group (CCG) and associated with an invoice from the SUS data flow to validate the corresponding record in the backing data flow
o Once the backing information is received, this will be checked against national NHS and local commissioning policies as well as being checked against system access and reports provided by NHS Digital to confirm the payments are:
In line with Payment by Results tariffs
are in relation to a patient registered with a CCG GP or resident within the CCG area.
The health care provided should be paid by the CCG in line with CCG guidance.
3. The CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between North of England CSU CEfF team and the provider meaning that no identifiable data needs to be sent to the CCG. The CCG only receives notification to pay and management reporting detailing the total quantum of invoices received pending, processed etc.
Risk Stratification
1. Identifiable SUS data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to North of England Commissioning Support Unit (CSU), who hold the SUS data within the secure Data Centre on N3.
3. Identifiable GP Data is securely sent from the GP system to North of England CSU.
4. SUS data is linked to GP data in the risk stratification tool by the data processor.
5. As part of the risk stratification processing activity, GPs have access to the risk stratification tool within the data processor, which highlights patients with whom the GP has a legitimate relationship 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.
6. Once North of England CSU has completed the processing, the CCG can access the online system via a secure N3 connection to access the data pseudonymised at patient level.
Commissioning
The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets:
1. SUS
2. Local Provider Flows (received directly from providers)
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o 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)
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
Data Processor – North of England Commissioning Support Unit (CSU)
1. Data quality management and pseudonymisation of data is completed by the DSCRO and the pseudonymised data is then held until completion of points 2 – 7.
2. North of England Commissioning Support Unit also receive GP Data. It is received as follows:
o Identifiable GP data is submitted to the CSU.
o The data lands in a ring-fenced area for GP data only.
o There is a Data Processing Agreement in place between the GP and the CSU. A specific named individual within the CSU acts on behalf on the GP. This person has been issued with a black box.
o The individual requests a pseudonymisation key from the DSCRO to the black box. The key can only be used once. The key is specific to that GP and the pseudonymisation request. The individual does not have access to the data once it has been passed on to the CSU.
o The GP data is then pseudonymised using the black box and DSCRO issued key – the clear data is then deleted from the ring-fenced area.
o The CSU are then sent the pseudo GP data with the pseudo key specific to them.
3. North of England Commissioning Support Unit receive a flow of social care data. Social Care data is received in one of the following 2 ways:
o Pseudonymised:
The social care organisation is issued with their own black box solution.
The social care organisation requests a pseudonymisation key from the DSCRO to the black box. The key can only be used once and is specific to that date.
The social care organisation submits the pseudonymised social care data to the CSU with the pseudo algorithm specific to them
o Identifiable:
Identifiable Social Care data is submitted to North of England Commissioning Support Unit
The data lands in a ring-fenced area for GP data only.
There is a Data Processing Agreement in place between the Local Authority and North of England Commissioning Support Unit A specific named individual within North of England Commissioning Support Unit on behalf on the Local Authority. This person has been issued with a black box.
The individual requests a pseudonymisation key from the DSCRO to the black box. The key can only be used once. The key is specific to the Local Authority and to that specific date.
Before North of England Commissioning Support Unit will receive the data from the ring-fenced area, they require confirmation that the identifiable data has been deleted.
North of England Commissioning Support Unit are then sent the pseudonymised GP data with the pseudo algorithm specific to them.
4. North of England Commissioning Support Unit receive a flow of consented data. It is received as follows:
o Identifiable consented data is submitted to the CSU.
o The data lands in a ring-fenced area for consented data only.
o There is a Data Processing Agreement in place between the CCG and the CSU. A specific named individual within the CSU acts on behalf on the CCG. This person has been issued with a black box.
o The individual requests a pseudonymisation key from the DSCRO to the black box. The key can only be used once. The key is specific to the CCG and the pseudonymisation request. The individual does not have access to the data once it has been passed on to the CSU.
o The consented data is then pseudonymised using the black box and DSCRO issued key – the clear data is then deleted from the ring-fenced area.
o The CSU are then sent the pseudo consented data with the pseudo key specific to them.
5. Once the pseudonymised GP data, social care data and consented data is received, the CSU make a request to the DSCRO.
6. The DSCRO then send a mapping table to the CSU
7. The CSU then overwrite the organisation specific keys with the DSCRO key.
8. The mapping table is then deleted.
9. The DSCRO then pass the pseudonymised SUS, local provider data, Mental Health (MHSDS, MHMDS, MHLDDS), Maternity (MSDS), Improving Access to Psychological Therapies (IAPT), Child and Young People’s Health (CYPHS) and Diagnostic Imaging (DIDS) securely to North of England CSU for the addition of derived fields, linkage of data sets and analysis.
10. Social care, GP and Consented data is then linked to the data sets listed within point 9 in the CSU. utilising algorithms and analysis
11. North of England Commissioning Support provide analysis to:
o See patient journeys for pathways or service design, re-design and de-commissioning.
o Check recorded activity against contracts or invoices and facilitate discussions with providers.
o Undertake population health management
o Undertake data quality and validation checks
o Thoroughly investigate the needs of the population
o Understand cohorts of residents who are at risk
o Conduct Health Needs Assessments
12. North of England Commissioning Support also apply an risk stratification algorithm to the pseudonymised SUS+, Local Provider flows and GP data.
13. Aggregation of required data for CCG management use will be completed by the CSU as instructed by the CCG.
14. Patient level data will not be shared outside of the Data Processor/Controller and will only be shared within the Data Processors 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.