NHS Digital Data Release Register - reformatted

NHS West Suffolk CCG projects

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


🚩 NHS West Suffolk CCG was sent multiple files from the same dataset, in the same month, both with optouts respected and with optouts ignored. NHS West Suffolk 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.

DSfC - NHS West Suffolk CCG - RS — DARS-NIC-373042-Y8N7D

Type of data: information not disclosed for TRE projects

Opt outs honoured: Yes - patient objections upheld, Identifiable (Section 251 NHS Act 2006)

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

Purposes: No (Clinical Commissioning Group (CCG), Sub ICB Location)

Sensitive: Sensitive

When:DSA runs 2020-04-09 — 2023-04-08 2020.04 — 2021.05.

Access method: Frequent Adhoc Flow, One-Off

Data-controller type: NHS WEST SUFFOLK CCG, NHS SUFFOLK AND NORTH EAST ESSEX ICB - 07K

Sublicensing allowed: No

Datasets:

  1. SUS for Commissioners

Objectives:

RISK STRATIFICATION
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) 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 both individual and groups of vulnerable 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 Prescribing Services Ltd

Expected Benefits:

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 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 CCG 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 through more effective commissioning of services.

Outputs:

RISK STRATIFICATION
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.

CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.

Processing:

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

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

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

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

Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement.

NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)

The DSCRO (part of NHS Digital) will apply National Opt-outs 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.

The only identifier available in the data set is the NHS numbers. Any further identification of the patients will only be completed by the patient’s clinician on their own systems for the purpose of direct care with a legitimate relationship.


ONWARD SHARING:
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.

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


SEGREGATION:
Where the Data Processor and/or the Data Controller hold both identifiable and pseudonymised data, the data will be held separately so data cannot be linked.

Where the Data Processor and/or the Data Controller hold identifiable data with opt outs applied and identifiable data with opt outs not applied, the data will be held separately so data cannot be linked.

All access to data is auditable by NHS Digital.

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

For the purpose of Risk Stratification:
• Patients who are normally registered and/or resident within the NHS West Suffolk CCG region (including historical activity where the patient was previously registered or resident in another commissioner

The Bunker do not access data held under this agreement as they only supply the building. 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.

RISK STRATIFICATION

1. Identifiable SUS+ data is transferred 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 Prescribing Services Ltd, who securely hold the SUS+ data.
3. Identifiable GP Data is securely sent from the GP system to Prescribing Services Ltd.
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 Prescribing Services Ltd has completed the processing, the CCG can access the online system via a secure connection to access the data pseudonymised at patient level


Project 2 — DARS-NIC-39439-F6D6Y

Type of data: information not disclosed for TRE projects

Opt outs honoured: N, Yes - patient objections upheld (Section 251, Section 251 NHS Act 2006)

Legal basis: Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii), Section 251 approval is in place for the flow of identifiable data, National Health Service Act 2006 - s251 - 'Control of patient information'.

Purposes: ()

Sensitive: Sensitive

When:2018.06 — 2019.08.

Access method: Frequent adhoc flow, Frequent Adhoc Flow

Data-controller type:

Sublicensing allowed:

Datasets:

  1. Acute-Local Provider Flows
  2. Ambulance-Local Provider Flows
  3. Children and Young People Health
  4. Community-Local Provider Flows
  5. Demand for Service-Local Provider Flows
  6. Diagnostic Imaging Dataset
  7. Diagnostic Services-Local Provider Flows
  8. Emergency Care-Local Provider Flows
  9. Experience, Quality and Outcomes-Local Provider Flows
  10. Improving Access to Psychological Therapies Data Set
  11. Maternity Services Data Set
  12. Mental Health and Learning Disabilities Data Set
  13. Mental Health Minimum Data Set
  14. Mental Health Services Data Set
  15. Mental Health-Local Provider Flows
  16. Other Not Elsewhere Classified (NEC)-Local Provider Flows
  17. Population Data-Local Provider Flows
  18. Primary Care Services-Local Provider Flows
  19. Public Health and Screening Services-Local Provider Flows
  20. SUS for Commissioners

Objectives:

Risk Stratification
To use SUS data identifiable at the level of NHS number according to S.251 CAG 7-04(a) (and Primary Care Data) 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. Risk Stratification enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit

Commissioning
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 consisting of clinical and financial activity.
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
Acute
Ambulance
Community
Demand for Service
Diagnostic Service
Emergency Care
Experience, Quality and Outcomes
Mental Health
Other Not Elsewhere Classified
Population Data
Primary Care Services
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)
Diagnostic Imaging Data Set (DIDS)
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
Ensuring we do what we should
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 services/interactions 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

Expected Benefits:

Risk Stratification
Risk stratification promotes improved case management in primary care and will lead to the following benefits being realised:
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.
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.
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.
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.
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
Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
Analysis to support full business cases.
Develop business models.
Monitor In year projects.
Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
Health economic modelling using:
Analysis on provider performance against 18 weeks wait targets.
Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients.
Analysis of outcome measures for differential treatments, accounting for the full patient pathway.
Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC).
Commissioning cycle support for grouping and re-costing previous activity.
Enables monitoring of:
CCG outcome indicators.
Financial and Non-financial validation of activity.
Successful delivery of integrated care within the CCG.
Checking frequent or multiple attendances to improve early intervention and avoid admissions.
Case management.
Care service planning.
Commissioning and performance management.
List size verification by GP practices.
Understanding the care of patients in nursing homes.
Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.
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.
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.
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.
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.
Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
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
Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.

Outputs:

Risk Stratification
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.
Output from the risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
Record level output will be available for commissioners (of the CCG), pseudonymised at patient level.
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 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:
Stratify populations based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost
Plan work for commissioning services and contracts
Set up capitated budgets
Identify health determinants of risk of admission to hospital, or other adverse care outcomes.

Commissioning
Commissioner reporting:
Summary by provider view - plan & actuals year to date (YTD).
Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
Summary by provider view - activity & finance variance by POD.
Planned care by provider view - activity & finance plan & actuals YTD.
Planned care by POD view - activity plan & actuals YTD.
Provider reporting.
Statutory returns.
Statutory returns - monthly activity return.
Statutory returns - quarterly activity return.
Delayed discharges.
Quality & performance referral to treatment reporting.
Readmissions analysis.
Production of aggregate reports for CCG Business Intelligence.
Production of project / programme level dashboards.
Monitoring of acute / community / mental health quality matrix.
Clinical coding reviews / audits.
Budget reporting down to individual GP Practice level.
GP Practice level dashboard reports include high flyers.
Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
Data Quality and Validation measures allowing data quality checks on the submitted data
Contract Management and Modelling
Patient Stratification, such as:
Patients at highest risk of admission
Most expensive patients (top 15%)
Frail and elderly
Patients that are currently in hospital
Patients with most referrals to secondary care
Patients with most emergency activity
Patients with most expensive prescriptions
Patients recently moving from one care setting to another
Discharged from hospital
Discharged from community

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.

The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCG. Access is limited to those substantive employees with authorised user accounts used for identification and authentication.

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.

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.

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 NHS Digital will not be national data, but only that data relating to the specific locality of interest of the applicant.
The DSCRO (part of NHS Digital) will apply Type 2 objections before any identifiable data leaves the DSCRO.

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 audited


Risk Stratification
Identifiable SUS data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
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, who hold the SUS data within the secure Data Centre on N3.
Identifiable GP Data is securely sent from the GP system to North of England Commissioning Support Unit.
SUS data is linked to GP data in the risk stratification tool by the data processor.
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.
Access to the Risk Stratification system that North of England Commissioning Support Unit hosts is limited to those substantive employees with authorised user accounts used for identification and authentication.
Once North of England Commissioning Support Unit 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:
SUS
Local Provider Flows (received directly from providers)
Acute
Ambulance
Community
Demand for Service
Diagnostic Service
Emergency Care
Experience, Quality and Outcomes
Mental Health
Other Not Elsewhere Classified
Population Data
Primary Care Services
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)
Diagnostic Imaging Data Set (DIDS)
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
Data Processor 1 – North of England Commissioning Support Unit
Pseudonymised SUS, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS) and Diagnostic Imaging data (DIDS) only is securely transferred from the DSCRO to North of England Commissioning Support Unit.
North of England Commissioning Support Unit add derived fields, link data and provide analysis to:
See patient journeys for pathways or service design, re-design and de-commissioning (CSU or CCG).
Check recorded activity against contracts or invoices and facilitate discussions with providers (CSU or CCG).
Undertake population health management
Undertake data quality and validation checks
Thoroughly investigate the needs of the population
Understand cohorts of residents who are at risk
Conduct Health Needs Assessments
Allowed linkage is between the data sets contained within point 1.
North of England Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG.
Aggregation of required data for CCG management use will be completed by North of England Commissioning Support Unit or the CCG as instructed by the CCG.
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 can be shared.


Project 3 — NIC-39439-F6D6Y

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 - Demand for Service
  7. Local Provider Data - Diagnostic Services
  8. Local Provider Data - Emergency Care
  9. Local Provider Data - Experience Quality and Outcomes
  10. Local Provider Data - Public Health & Screening services
  11. Local Provider Data - Mental Health
  12. Local Provider Data - Other not elsewhere classified
  13. Local Provider Data - Population Data
  14. Local Provider Data - Primary Care
  15. Mental Health and Learning Disabilities Data Set
  16. Mental Health Minimum Data Set
  17. Mental Health Services Data Set
  18. SUS Accident & Emergency data
  19. SUS Admitted Patient Care data
  20. SUS Outpatient data
  21. Maternity Services Dataset
  22. SUS data (Accident & Emergency, Admitted Patient Care & Outpatient)
  23. SUS (Accident & Emergency, Inpatient and Outpatient data)
  24. Local Provider Data - Acute, Ambulance, Community, Demand for Service, Diagnostic Services, Emergency Care, Experience Quality and Outcomes, Mental Health, Other not elsewhere classified, Population Data, Primary Care, Public Health & Screening services

Objectives:

Risk Stratification
To use SUS data identifiable at the level of NHS number according to S.251 CAG 7-04(a) (and Primary Care Data) 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. Risk Stratification enables GPs to better target intervention in Primary Care

Pseudonymised – SUS and Local Flows
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.
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.

Pseudonymised – Mental Health, Maternity, IAPT, CYPHS and DIDS
To use pseudonymised data for the following datasets to provide intelligence to support commissioning of health services :
- 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)
- Diagnostic Imaging Data Set (DIDS)
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.

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 NHS Digital will not be national data, but only that data relating to the specific locality of interest of the applicant.

Expected Benefits:

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.

Outputs:

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.

Processing:

1. North of England Data Services for Commissioners Regional Office (DSCRO) receives a flow of SUS identifiable data for the CCG from the SUS Repository. North of England 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 North of England CSU for the addition of derived fields, linkage of data sets and analysis. Allowed linkage is between SUS data sets and local flows
3. North of England 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 as instructed by 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 can be shared where contractual arrangements are in place.