NHS Digital Data Release Register - reformatted

NHS North Somerset Ccg projects

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

🚩 NHS North Somerset Ccg was sent multiple files from the same dataset, in the same month, both with optouts respected and with optouts ignored. NHS North Somerset Ccg may not have compared the two files, but the identifiers are consistent between datasets, and outside of a good TRE NHS Digital can not know what recipients actually do.

Project 1 — NIC-43354-B7P4H

Type of data: information not disclosed for TRE projects

Opt outs honoured: N, Y

Legal basis: Health and Social Care Act 2012, Section 251 approval is in place for the flow of identifiable data

Purposes: ()

Sensitive: Sensitive

When:2017.06 — 2017.05.

Access method: Ongoing

Data-controller type:

Sublicensing allowed:

Datasets:

  1. Children and Young People's Health Services Data Set
  2. Improving Access to Psychological Therapies Data Set
  3. Local Provider Data - Acute
  4. Local Provider Data - Ambulance
  5. Local Provider Data - Community
  6. Local Provider Data - Mental Health
  7. Local Provider Data - Population data
  8. Mental Health and Learning Disabilities Data Set
  9. Mental Health Minimum Data Set
  10. Mental Health Services Data Set
  11. SUS Accident & Emergency data
  12. SUS Admitted Patient Care data
  13. SUS Outpatient data
  14. SUS data (Accident & Emergency, Admitted Patient Care & Outpatient)
  15. Local Provider Data - Other not elsewhere classified
  16. SUS for Commissioners
  17. Population Data-Local Provider Flows
  18. Other Not Elsewhere Classified (NEC)-Local Provider Flows
  19. Mental Health-Local Provider Flows
  20. Maternity Services Data Set
  21. Diagnostic Imaging Dataset
  22. Community-Local Provider Flows
  23. Children and Young People Health
  24. Ambulance-Local Provider Flows
  25. Acute-Local Provider Flows
  26. SUS (Accident & Emergency, Inpatient and Outpatient data)
  27. Local Provider Data - Acute, Ambulance, Community, Mental Health, Population data

Objectives:

Invoice Validation
As an approved Controlled Environment for Finance (CEfF), the data processor receives SUS data identifiable at the level of NHS number according to S.251 CAG 7-07(a) and (c)/2013, to undertake invoice validation on behalf of the CCG. NHS number is only used to confirm the accuracy of backing-data sets and will not be shared outside of the CEfF. The CCG are advised by the CSU whether payment for invoices can be made or not.

Risk Stratification
This is an application to use SUS data identifiable at the level of NHS number for the purpose of Risk Stratification. Risk Stratification provides a forecast of future demand by identifying high risk patients. This enables commissioners to initiate proactive management plans for patients that are potentially high service users.

Pseudonymised – SUS and Local Flows
Application for the CCG to use pseudonymised data to provide intelligence to support commissioning of health services. 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.

Pseudonymised – Mental Health, Maternity, IAPT, CYPHS and DIDS
Application for the CCG to use MHSDS, MHMDS, MHLDDS, MSDS, IAPT, CYPHS and DIDs pseudonymised data to provide intelligence to support commissioning of health services. The linked, 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.


No record level data will be linked other than as specifically detailed within this application/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 the HSCIC will not be national data, but only that data relating to the specific locality of interest of the applicant.

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.

Pseudonymised – SUS and Local Flows
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.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
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.
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.

Pseudonymised – Mental Health, Maternity, IAPT, CYPHS and DIDS
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.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
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.
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.
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.

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 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.
Pseudonymised – SUS and Local Flows
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.

Pseudonymised – Mental Health, Maternity, IAPT, CYPHS and DIDS
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 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.
7) Budget reporting down to individual GP Practice level.

Processing:

Prior to the release of identifiable data by DSCRO South West, Type 2 objections will be applied and the relevant patient’s data redacted.
Invoice Validation
1. SUS Data is sent from the SUS Repository to South West DSCRO.
2. South West DSCRO pushes a one-way data flow of SUS data into the Controlled Environment for Finance (CEfF) in the South, Central and West CSU.
3. The CSU carry out the following processing activities within the CEfF for invoice validation purposes:
a. Checking the individual is registered to a particular Clinical Commissioning Group (CCG) and associated with an invoice from the national SUS data flow to validate the corresponding record in the backing data flow
b. 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 the HSCIC to confirm the payments are:
i. In line with Payment by Results tariffs
ii. are in relation to a patient registered with a CCG GP or resident within the CCG area.
iii. The health care provided should be paid by the CCG in line with CCG guidance. 
4. 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 the 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 sent from the SUS Repository to South West Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by South West DSCRO and the data identifiable at the level of NHS number is transferred securely to South, Central and West 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 South, Central and West 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. South, Central and West CSU who hosts the risk stratification system that holds SUS data is limited to those administrative staff with authorised user accounts used for identification and authentication.
7. Once South, Central and West 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.

Pseudonymised – SUS and Local Flows
1. South West Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. South West DSCRO also receives identifiable local provider data for the CCG directly from Providers.
2. Data quality management and pseudonymisation of data is completed by the DSCRO and the pseudonymised data is then passed securely to South, Central and West CSU for the addition of derived fields, linkage of data sets and analysis.
3. South, Central and West CSU then pass the processed, pseudonymised and linked data to the CCG who analyse the data to see patient journeys for pathways or service design, re-design and de-commissioning.
4. Aggregation of required data for CCG management use can be completed by the CSU or the CCG
5. Patient level data will not be shared outside of the CCG and will only be shared within the CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression in line with the HES analysis guide.

Pseudonymised – Mental Health, MSDS, IAPT, CYPHS and DIDS
1. South West Data Services for Commissioners Regional Office (DSCRO) receives a flow of data identifiable at the level of NHS number for Mental Health (MHSDS, MHMDS, MHLDDS) and Maternity (MSDS). South West DSCRO also receive a flow of pseudonymised patient level data for each CCG for Improving Access to Psychological Therapies (IAPT), Child and Young People’s Health (CYPHS) and Diagnostic Imaging (DIDS) for commissioning purposes
2. Data quality management and pseudonymisation of data is completed by South West DSCRO and the pseudonymised data is then passed securely to South, Central and West CSU for the addition of derived fields, linkage of data sets and analysis.
3. South, Central and West CSU then pass the processed, pseudonymised and linked data to the CCG.
4. The CCG analyses the data to see patient journeys for pathway or service design, re-design and de-commissioning
5. Aggregation of required data for CCG management use can be completed by the CSU or the CCG
6. Patient level data will not be shared outside of the CCG and will only be shared within the CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression.