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Methods Analytics Ltd (“Methods”) is a company which uses data to help inform people and organisations so they can improve their performance. NHS Digital datasets have been used to inform Methods' work since 2009, initially as an NHS Organisation, subsequently working with the NHS and other partners since 2012 as a commercial organisation.

Data is processed to support the NHS either directly through the delivery of tools and bespoke analysis to an NHS user or indirectly, where analytics are provided to the NHS as the end beneficiary via a non-NHS organisation.

Methods require national patient event level data. The purpose is for data to be used to help inform improvement in NHS services. The effect of using these data, analysed securely and then provided to NHS decision makers and providers to the NHS in Methods' tools helps decision makers visualise and understand what changes they need to make to their organisations and services to enhance the quality, safety and efficiency of health and care.

The lawful basis for processing is covered under GDPR Article 6 Section 1 (F) – (“Processing is necessary for the purpose of the legitimate interests pursued by the controller or by a third party, except where such interests or fundamental rights and freedoms of the data subject which require protection of personal data , in particular where the subject is a child”) and Article 9 Section 2 (j). (“Processing is necessary for achieving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject”).

The legitimate interest being pursued by Methods is the business of processing data to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non NHS organisations (where analytics are provided to the NHS as the end beneficiary via a non NHS organization). This requirement is met as it is necessary to use these data in undertaking analysis and producing the outputs of analysis to identify good and bad practice, pathways and performance, to enable improvement in performance within the NHS.

The processing is proportionate to that purpose in that national healthcare data is needed in order to undertake benchmarking, demonstrate variation and allow comparison to inform improvement. Further suppression and aggregation is applied to ensure a national data picture, without unnecessary data or risk of identifying any individual person.

Data provided by NHS Digital is pseudonymised prior to dissemination to Methods.

This work is used to support national and local service improvement, policy and regulatory recommendations and peer reviewed scientific articles, contributing to improvement in quality, safety and efficiency of health and care. Without these data there is no other way to achieve the same outcome. It is in the public interest that NHS organisations, directly and through Method’s partners, should use the processed data to enable them to further improve the services they offer to the local and national public.

Clients of Methods require analysis of national data to undertake benchmarking and enable understanding of variation in care and outcomes of care. Through constant review of processes, alongside the additional training and education of the team, Methods are constantly aware of the responsibility of working with the data and continuously work to improve data quality by identifying any issues to NHS Digital. Data asset minimisation and control of the risk of function creep is at the forefront of this work. The datasets requested going forward have been reviewed and significantly reduced to Hospital Episode Statistics (APC and OP), ECDS and ONS Mortality data only, reflecting the change in work Methods are asked to undertake.

Methods require 6 full years of data to enable time series analysis. For example, in calculating Standardised Hospital Mortality (SHMI), presenting a time series of 36 months requires a model developed on the prior 36 months, so 6 full years in total.

Much of the analyses are at a national level, and where they are at a regional or local level, clients commonly require analysis of national data to be able to consider their outcomes and performance in context of benchmarking to enable the understanding of variation in care and outcomes of care. For example, GIRFT national reports require analysis at a national level. GIRFT data packs require analysis at trust or site level, but benchmarking against all other providers in England.

Methods Analytics is the sole Data Controller for data shared under this Data Sharing Agreement.

The data will be used to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non-NHS organisations, where the NHS is the end beneficiary. The organisations who would be considered as supporting the NHS directly are:

• Department of Health and other central government departments (e.g., Ministry of Defence to support Defence Medical Services)

• Care Quality Commission

• Monitor

• NHS Improvement

• NHS England

• NHSX

• NICE

• CCGs

• CSUs

• ICS/STPs (Only NHS bodies can be considered to support the NHS Directly)

• Local Authorities (for Public Health purposes only)

• Providers of NHS-funded care

• Professional bodies supporting the NHS (e.g., Association of General Surgeons of Great Britain and Ireland, Royal College of Surgeons of England)

Organisations who support the NHS indirectly include commercial, charitable, academic and other forms of body working within the health and care space. Analysis is provided to these organisations solely for the purpose of delivering benefit to NHS organisations and/or the public. Methods' target audience is NHS organisations, however the NHS is increasingly looking to industry to support it in the provision of evidence and implementation support for service improvement, and hence Methods offers the tools and services to non-NHS organisations based on their agreeing to license terms and conditions, which include submitting and evidencing training in information governance and the restriction of the use of the tool to the uses outlined in this document, with this purpose statement flowed down as a contract schedule. For clarity, the schedule will include the following:

• Only aggregated small number suppressed data may be used from the tool.

• No data is to be used for direct marketing to individuals or organisations.

• No data is to be used for direct sales activities

There are three objectives of processing.

1) Bespoke tools and analysis. Method’s deliver specialised healthcare analytics to clients through online and offline reporting, shaping outputs to deliver actionable intelligence to the user. Reports may contain standard or bespoke metric items, tables, maps, graphs as is most appropriate to enable the user to interpret the information presented.

2) The NHS Improvement Getting it Right First Time Programme (GIRFT). Methods Analytics supports GIRFT with a range of bespoke analytical products. This includes provider level data packs focused on an individual specialty. These are required to be provided to GIRFT with low numbers present, anonymised. Methods Analytics also undertakes analytics for GIRFT relating to National reports and additional bespoke research and analysis using NHS Digital data, all suppressed and anonymized in line with the HES analysis guide.

All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS England/Improvement GIRFT programme, where the Data Controller is required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by the Data Controller and shared securely with the GIRFT programme.

All users working on the GIRFT program (and any organisation receiving a report as outlined below), where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not seek to re-identify any individual from that data.

Reports containing unsuppressed data may only be shared by NHSE/I with :

a. individual organisations to whom the data relates, and/or

b. with other network members (with the agreement of the individual organisation to whom the data relates), and/or

c. within NHSE/I in order to achieve the benefits outlined within the GIRFT programme (whilst NHSE and NHSI have an active data sharing agreement with NHS Digital covering the source data, this is under agreement DARS-NIC-15814-C6W9R).

3) SWORD™ is a programme for a number of the specialist surgical societies (which are registered charities) providing an intelligence tool for only their Consultant Surgeons members. The SWORD™ Consultant view provides access to measures and metrics about their own performance, to inform reflective practice, service improvement and appraisal.

SWORD™ pathway view͛ demonstrates at an organisation-level comparative data for individual surgical pathways, such as cholecystectomy, groin hernia etc. with the ability to filter and investigate how behaviour varies for groups of patients (grouped by a common theme eg: treatment pathway, not by identifiers).

1 Bespoke analysis

• Bespoke analysis outputs are quite variable as the specific output is dependent on the requirement and use case. A range of output types are produced:

o Data tables

o Charts, graphs and other data visualisations

o Mapping with data overlays such as heat maps

• Outputs can be standalone or embedded in comprehensive reports either produced solely by Methods or as part of a wider product produced by clients and partners.

• Outputs can be static PDF documents or presentations or online interactive tools and solutions. These may be public or private.

• All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS Improvement GIRFT programme, where Methods are required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by Methods and shared securely with the GIRFT program.

o All users working on the GIRFT program, where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not :-

 Onwardly share any data with small numbers within

 Seek to re-identify any individual from that data.

Methods are continuing to use the data for this purpose, focused reporting for NHS and other clients as described, as well as academic research.

Examples of recent papers where Methods have used NHS Digital data assets include:

- Forecasting the Requirement for Nonelective Hospital Beds in the National Health Service of the United Kingdom: Model Development Study. Shah, K., Sharma, A., Moulton, C., Swift, S., Mann, C., & Jones, S. (2021). JMIR Medical Informatics, 9(9), e21990. https://doi.org/10.2196/21990

- Trends in Risk-Adjusted 28-Day Mortality Rates for Patients Hospitalized with COVID-19 in England. Simon Jones,PhD, Neil Mason, ACC, Tom Palser, DM, FRCS, Simon Swift, MRCS, MSc, Christopher M Petrilli, MD, Leora I Horwitz, MD, MHS. DOI: 10.12788/jhm.3599. J Hosp Med. May. 2021, Volume 16, Issue Number 5

A further paper modelling the impact of A&E waits across England on all-cause mortality is currently accepted for publication but has not yet been published.

2 NHS GIRFT programme

Methods Analytics supports GIRFT with delivery of specialty data packs, analytics for national reports and ad hoc reporting requirements. To date Methods Analytics Ltd have supported over twelve specialty data packs and their associated national reports, those that have progressed to publication are available here: https://www.gettingitrightfirsttime.co.uk/girft-reports/. One of the ad hoc reports Methods Analytics Ltd developed was an internal impact assessment of the programme to date which demonstrated savings to the NHS in excess of £1bn. As previously explained, Methods are not stating that this value is directly derived from our work; Methods have worked on a subset of GIRFT workstreams and the analytical input into the program is only a part of the GIRFT methodology. It is not possible to quantify what proportion of the impact of the program is due to Methods' work; it is intrinsic to the GIRFT approach. This impact analysis looked at nine completed GIRFT workstreams, of which Methods Analytics supported the analytical effort in five. Methods were asked to undertake a data driven review of the program impact, and doing so using NHS Digital data, Methods were able to demonstrate that across England GIRFT had delivered, to date, in excess of £1bn of savings to the NHS. This does not include projected savings.

3 SWORD

• The SWORD programme product set is an online portal that encompasses data visualisation tooling and reference data for users such as definition sets and other metadata information. There are two views of analysis:

o The consultant view presents the individual with information about their activity and outcomes, with standard metrics such as counts, readmission rates, length of stay and bespoke metrics for specific pathways. This is benchmarked against their organisation and the national cohort.

o The pathway view presents the same data but at an organisation level such that the user can compare their organisations performance against the rest of the country.

• SWORD data is used in a number of ways:

o To enable individual reflection and change in practice

o To support appraisal and revalidation

o To enable unit review of performance and service improvement

o As the input to original research and publication of scientific papers in peer reviewed journals and conference presentations.

• SWORD contains unsuppressed (low count) data and utilises the sensitive consultant ID field.

The SWORD tool has been re-commissioned again for 2021/22 by a number of Surgical Specialist Associations and is provided to their members to understand the outcomes they as individual surgeons achieve, compared to their peers as input into reflective practice and revalidation. This is regularly used with hundreds of downloads a year of summary information for revalidation portfolios.

Methods has worked with a large NHS Trust to model patient flow, where Methods used SUS data to demonstrate the impact of changes to internal pathways and processes and benchmark this against other organisations. This enabled the Trust to refine its plans and improve flow and capacity. The improved flow improved patients experience of care by reducing the end to end duration of their hospital care.

Methods works with the DH GIRFT programme, generating report across many specialty areas under Lord Carter’s NHS efficiency programme. These detailed data rich reports are shaped by national lead clinicians for each specialty and they then visit every provider in England to discuss their data with them in order to improve the quality and efficiency of care. This programme is currently being rolled out.

Methods has also supported the development and publication of GIRFT national reports (http://gettingitrightfirsttime.co.uk/girft-reports/) through use of NHS Digital data to enable the development of national level recommendations on policy and regulation of the services based on sound analysis. Across these reports many hundreds of millions of pounds of savings have been identified, with specific recommendations supporting the delivery of each savings opportunity. The GIRFT programme uses this analysis to identify changes that will help improve care and patient outcomes as well as delivering efficiencies across the NHS.

Methods Supported the GIRFT programme through a review of actual savings to date, that was used in developing their business case for further funding.

Methods used NHS Digital data assets supporting a set of CCGs that are forming into an Integrated Care System (ICS) in the process of transferring services from acute to community providers in their locality. The data was used to understand quality and performance of the services locally and benchmark these against similar services elsewhere in the NHS in England, to inform discussion and judgement on quality risks related to the transfer of services. This informed clinical senate review of the service transfers.

Methods have published a number of original scientific journal articles using NHS Digital data assets. The benefits yielded to the NHS from these publications are difficult to measure, though the intent and context is service and quality improvement.

Methods Analytics Ltd (“Methods”) is a company which uses data to help inform people and organisations so they can improve their performance. NHS Digital datasets have been used to inform Methods' work since 2009, initially as an NHS Organisation, subsequently working with the NHS and other partners since 2012 as a commercial organisation.

Data is processed to support the NHS either directly through the delivery of tools and bespoke analysis to an NHS user or indirectly, where analytics are provided to the NHS as the end beneficiary via a non-NHS organisation.

The aim is for data to be used to help inform improvement in NHS services. The effect of using these data, analysed securely and then provided to NHS decision makers and providers to the NHS in Methods' tools helps decision makers visualise and understand what changes they need to make to their organisations and services to enhance the quality, safety and efficiency of health and care.

The lawful basis for processing is covered under GDPR Article 6 Section 1 (F) – (“Processing is necessary for the purpose of the legitimate interests pursued by the controller or by a third party, except where such interests or fundamental rights and freedoms of the data subject which require protection of personal data , in particular where the subject is a child”) and Article 9 Section 2 (j). (“Processing is necessary for achieving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject”).

The legitimate interest being pursued by Methods is the business of processing data to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non NHS organisations (where analytics are provided to the NHS as the end beneficiary via a non NHS organization). This requirement is met as it is necessary to use these data in undertaking analysis and producing the outputs of analysis to identify good and bad practice, pathways and performance, to enable improvement in performance within the NHS.

The processing is proportionate to that purpose in that national healthcare data is needed in order to undertake benchmarking, demonstrate variation and allow comparison to inform improvement. Further suppression and aggregation is applied to ensure a national data picture, without unnecessary data or risk of identifying any individual person.

Data provided by NHS Digital is pseudonymised prior to dissemination to Methods.

This work is used to support national and local service improvement, policy and regulatory recommendations and peer reviewed scientific articles, contributing to improvement in quality, safety and efficiency of health and care. Without these data there is no other way to achieve the same outcome. It is in the public interest that NHS organisations, directly and through Method’s partners, should use the processed data to enable them to further improve the services they offer to the local and national public.

Clients of Methods require analysis of national data to undertake benchmarking and enable understanding of variation in care and outcomes of care. Through constant review of processes, alongside the additional training and education of the team, Methods are constantly aware of the responsibility of working with the data and continuously work to improve data quality by identifying any issues to NHS Digital. Data asset minimisation and control of the risk of function creep is at the forefront of this work.

Methods Analytics is the sole Data Controller for data shared under this Data Sharing Agreement.

The data will be used to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non-NHS organisations, where the NHS is the end beneficiary. The organisations who would be considered as supporting the NHS directly are:

• Department of Health

• Care Quality Commission

• Monitor

• NHS Improvement

• NHS England

• NHSX

• NICE

• CCGs

• CSUs

• ICS/STPs (Only NHS bodies can be considered to support the NHS Directly)

• Local Authorities (for Public Health purposes only)

• Providers of NHS-funded care

• Professional bodies supporting the NHS (e.g. the British Medical Association or the Royal College of General Practitioners)

Organisations who support the NHS indirectly include commercial, charitable, academic and other forms of body working within the health and care space. Analysis is provided to these organisations solely for the purpose of delivering benefit to NHS organisations and/or the public. Methods' target audience is NHS organisations, however the NHS is increasingly looking to industry to support it in the provision of evidence and implementation support for service improvement, and hence Methods offers the tools and services to non-NHS organisations based on their agreeing to license terms and conditions, which include submitting and evidencing training in information governance and the restriction of the use of the tool to the uses outlined in this document, with this purpose statement flowed down as a contract schedule. For clarity, the schedule will include the following:

• Only aggregated small number suppressed data may be used from the tool.

• No data is to be used for direct marketing to individuals or organisations.

• No data is to be used for direct sales activities

There are three objectives of processing.

1) Bespoke tools and analysis. Method’s deliver specialised healthcare analytics to clients through online and offline reporting, shaping outputs to deliver actionable intelligence to the user. Reports may contain standard or bespoke metric items, tables, maps, graphs as is most appropriate to enable the user to interpret the information presented.

2) The NHS Improvement Getting it Right First Time Programme (GIRFT). Methods Analytics supports GIRFT with a range of bespoke analytical products. This includes provider level data packs focused on an individual specialty. These are required to be provided to GIRFT with low numbers present, anonymised. Methods Analytics also undertakes analytics for GIRFT relating to National reports and additional bespoke research and analysis using NHS Digital data, all suppressed and anonymized in line with the HES analysis guide.

All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS England/Improvement GIRFT programme, where the Data Controller is required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by the Data Controller and shared securely with the GIRFT programme.

All users working on the GIRFT program (and any organisation receiving a report as outlined below), where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not seek to re-identify any individual from that data.

Reports containing unsuppressed data may only be shared by NHSE/I with :

a. individual organisations to whom the data relates, and/or

b. with other network members (with the agreement of the individual organisation to whom the data relates), and/or

c. within NHSE/I in order to achieve the benefits outlined within the GIRFT programme (whilst NHSE and NHSI have an active data sharing agreement with NHS Digital covering the source data, this is under agreement DARS-NIC-15814-C6W9R).

3) SWORD™ is a programme for a number of the specialist surgical societies (which are registered charities) providing an intelligence tool for only their Consultant Surgeons members. The SWORD™ Consultant view provides access to measures and metrics about their own performance, to inform reflective practice, service improvement and appraisal.

SWORD™ pathway view͛ demonstrates at an organisation-level comparative data for individual surgical pathways, such as cholecystectomy, groin hernia etc. with the ability to filter and investigate how behaviour varies for groups of patients (grouped by a common theme eg: treatment pathway, not by identifiers).

1 Bespoke analysis

• Bespoke analysis outputs are quite variable as the specific output is dependent on the requirement and use case. A range of output types are produced:

o Data tables

o Charts, graphs and other data visualisations

o Mapping with data overlays such as heat maps

• Outputs can be standalone or embedded in comprehensive reports either produced solely by Methods or as part of a wider product produced by clients and partners.

• Outputs can be static PDF documents or presentations or online interactive tools and solutions. These may be public or private.

• All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS Improvement GIRFT programme, where Methods are required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by Methods and shared securely with the GIRFT program.

o All users working on the GIRFT program, where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not :-

 Onwardly share any data with small numbers within

 Seek to re-identify any individual from that data.

Methods are continuing to use the data for this purpose, focused reporting for NHS and other clients as described, as well as academic research. Methods have a number of articles looking at urgent care particularly in late stage negotiations with journals and are due for publication shortly.

An example of a recent paper is published in the Journal of Hospital Medicine: Trends in Risk-Adjusted 28-Day Mortality Rates for Patients Hospitalized with COVID-19 in England, which used HES and linked civil deaths registration data, available here: https://lnkd.in/dmgnFzz.

2 NHS GIRFT programme

Methods Analytics supports GIRFT with delivery of specialty data packs, analytics for national reports and ad hoc reporting requirements. To date Methods Analytics Ltd have supported over twelve specialty data packs and their associated national reports, those that have progressed to publication are available here: https://www.gettingitrightfirsttime.co.uk/girft-reports/. One of the ad hoc reports Methods Analytics Ltd developed was an internal impact assessment of the programme to date which demonstrated savings to the NHS in excess of £1bn.

3 SWORD

• The SWORD programme product set is an online portal that encompasses data visualisation tooling and reference data for users such as definition sets and other metadata information. There are two views of analysis:

o The consultant view presents the individual with information about their activity and outcomes, with standard metrics such as counts, readmission rates, length of stay and bespoke metrics for specific pathways. This is benchmarked against their organisation and the national cohort.

o The pathway view presents the same data but at an organisation level such that the user can compare their organisations performance against the rest of the country.

• SWORD data is used in a number of ways:

o To enable individual reflection and change in practice

o To support appraisal and revalidation

o To enable unit review of performance and service improvement

o As the input to original research and publication of scientific papers in peer reviewed journals and conference presentations.

• SWORD contains unsuppressed (low count) data and utilises the sensitive consultant ID field.

The SWORD tool has been re-commissioned again for 2021/22 by a number of Surgical Specialist Associations and is provided to their members to understand the outcomes they as individual surgeons achieve, compared to their peers as input into reflective practice and revalidation. This is regularly used with hundreds of downloads a year of summary information for revalidation portfolios.

Methods has worked with a large NHS Trust to model patient flow, where Methods used SUS data to demonstrate the impact of changes to internal pathways and processes and benchmark this against other organisations. This enabled the Trust to refine its plans and improve flow and capacity. The improved flow improved patients experience of care by reducing the end to end duration of their hospital care.

Methods works with the DH GIRFT programme, generating report across many specialty areas under Lord Carter’s NHS efficiency programme. These detailed data rich reports are shaped by national lead clinicians for each specialty and they then visit every provider in England to discuss their data with them in order to improve the quality and efficiency of care. This programme is currently being rolled out.

Methods has also supported the development and publication of GIRFT national reports (http://gettingitrightfirsttime.co.uk/girft-reports/) through use of NHS Digital data to enable the development of national level recommendations on policy and regulation of the services based on sound analysis. Across these reports many hundreds of millions of pounds of savings have been identified, with specific recommendations supporting the delivery of each savings opportunity. The GIRFT programme uses this analysis to identify changes that will help improve care and patient outcomes as well as delivering efficiencies across the NHS.

Aim and Purpose of application

Methods Analytics Ltd (“Methods”) is a company which uses data to help inform people and organisations so they can improve their performance. NHS Digital datasets have been used to inform Methods' work since 2009, initially as an NHS Organisation, subsequently working with the NHS and other partners since 2012 as a commercial organisation.

Data is processed to support the NHS either directly through the delivery of tools and bespoke analysis to an NHS user or indirectly, where analytics are provided to the NHS as the end beneficiary via a non-NHS organisation.

The aim is for data to be used to help inform improvement in NHS services. The effect of using these data, analysed securely and then provided to NHS decision makers and providers to the NHS in Methods' tools helps decision makers visualise and understand what changes they need to make to their organisations and services to enhance the quality, safety and efficiency of health and care.

Legal Basis

The lawful basis for processing is covered under GDPR Article 6 Section 1 (F) – (“Processing is necessary for the purpose of the legitimate interests pursued by the controller or by a third party, except where such interests or fundamental rights and freedoms of the data subject which require protection of personal data , in particular where the subject is a child”) and Article 9 Section 2 (j). (“Processing is necessary for achieving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject”).

The legitimate interest being pursued by Methods is the business of processing data to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non NHS organisations (where analytics are provided to the NHS as the end beneficiary via a non NHS organization). This requirement is met as it is necessary to use these data in undertaking analysis and producing the outputs of analysis to identify good and bad practice, pathways and performance, to enable improvement in performance within the NHS.

The processing is proportionate to that purpose in that national healthcare data is needed in order to undertake benchmarking, demonstrate variation and allow comparison to inform improvement. Further suppression and aggregation is applied to ensure a national data picture, without unnecessary data or risk of identifying any individual person.

Data provided by NHS Digital is pseudonymised prior to dissemination to Methods.

Public Interest

This work is used to support national and local service improvement, policy and regulatory recommendations and peer reviewed scientific articles, contributing to improvement in quality, safety and efficiency of health and care. Without these data there is no other way to achieve the same outcome. It is in the public interest that NHS organisations, directly and through Method’s partners, should use the processed data to enable them to further improve the services they offer to the local and national public.

Data required and data management

Clients of Methods require analysis of national data to undertake benchmarking and enable understanding of variation in care and outcomes of care. Through constant review of processes, alongside the additional training and education of the team, Methods are constantly aware of the responsibility of working with the data and continuously work to improve data quality by identifying any issues to NHS Digital. Data asset minimisation and control of the risk of function creep is at the forefront of this work.

Who Methods work with

Methods Analytics is the data controller for data shared under this DSA.

The data will be used to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non-NHS organisations, where the NHS is the end beneficiary. The organisations who would be considered as supporting the NHS directly are:

• Department of Health

• Care Quality Commission

• Monitor

• NHS Improvement

• NHS England

• NICE

• CCGs

• CSUs

• Local Authorities (for Public Health purposes only)

• Providers of NHS-funded care

• Professional bodies

Organisations who support the NHS indirectly include commercial, charitable, academic and other forms of body working within the health and care space. Analysis is provided to these organisations solely for the purpose of delivering benefit to NHS organisations and/or the public. Methods' target audience is NHS organisations, however the NHS is increasingly looking to industry to support it in the provision of evidence and implementation support for service improvement, and hence Methods offers the tools and services to non-NHS organisations based on their agreeing to license terms and conditions, which include submitting and evidencing training in information governance and the restriction of the use of the tool to the uses outlined in this document, with this purpose statement flowed down as a contract schedule. For clarity, the schedule will include the following:

• Only aggregated small number suppressed data may be used from the tool.

• No data is to be used for direct marketing to individuals or organisations.

• No data is to be used for direct sales activities

There are three objectives of processing.

1) Stethoscope™ - a quality variation tool which provides local and national benchmarking of indicators derived from NHS Digital and other data, that is made available free to the public at an organisation roll-up level, and more granular information to subscribing organisations. Stethoscope™ is a complex analysis and visualisation platform that allows users to understand patterns in care provision, pathway and organisational performance and variation in these across the country. The aim is that users will be more able to understand the needs, demand, services and outcomes of care for the population they respond to and be able to make informed decisions to improve the efficiency and quality of care.

2) Bespoke tools and analysis. Method’s deliver specialised healthcare analytics to clients through online and offline reporting, shaping outputs to deliver actionable intelligence to the user. Reports may contain standard or bespoke metric items, tables, maps, graphs as is most appropriate to enable the user to interpret the information presented.

3) SWORD™ is a programme for a number of the specialist surgical societies (which are registered charities) providing an intelligence tool for only their Consultant Surgeons members. The SWORD™ Consultant view provides access to measures and metrics about their own performance, to inform reflective practice, service improvement and appraisal.

SWORD™ pathway view͛ demonstrates at an organisation-level comparative data for individual surgical pathways, such as cholecystectomy, groin hernia etc. with the ability to filter and investigate how behaviour varies for groups of patients (grouped by a common theme eg: treatment pathway, not by identifiers).

1 Stethoscope™

• The primary output is an online intelligence platform available to users containing over 500 benchmarked metrics on NHS activity. This is designed to be visually attractive to users but convey rich statistical intelligence.

• The platform includes domain dashboards, filtered views with users able to explore areas of interest and shape metric views to their requirements, users are able to create bespoke reports containing information relevant to them. Stethoscope™ contains alert reporting, algorithmically surfacing to users metrics and organisations that are outliers and might require consideration, for action.

• Views include graphs, maps and data tables representing national, peer group and regional organisations performance compared to each other for any metric or filtered metric.

• All Stethoscope output is suppressed as per NHS Digital disclosure rules and uses the sensitive consultant ID field to enable personal scorecard creation to inform reflective practice and appraisal.

2 Bespoke analysis

• Bespoke analysis outputs are quite variable as the specific output is dependent on the requirement and use case. A range of output types are produced:

o Data tables

o Charts, graphs and other data visualisations

o Mapping with data overlays such as heatmaps

• Outputs can be standalone or embedded in comprehensive reports either produced solely by Methods or as part of a wider product produced by clients and partners.

• Outputs can be static PDF documents or presentations or online interactive tools and solutions. These may be public or private.

• All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS Improvement GIRFT programme, where Methods are required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by Methods and shared securely with the GIRFT program.

o All users working on the GIRFT program, where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not :-

 Onwardly share any data with small numbers within

 Seek to re-identify any individual from that data.

3 SWORD™

• The SWORD™ programme product set is an online portal that encompasses data visualisation tooling and reference data for users such as definition sets and other metadata information. There are two views of analysis:

o The consultant view presents the individual with information about their activity and outcomes, with standard metrics such as counts, readmission rates, length of stay and bespoke metrics for specific pathways. This is benchmarked against their organisation and the national cohort.

o The pathway view presents the same data but at an organisation level such that the user can compare their organisations performance against the rest of the country.

• SWORD™ data is used in a number of ways:

o To enable individual reflection and change in practice

o To support appraisal and revalidation

o To enable unit review of performance and service improvement

o As the input to original research and publication of scientific papers in peer reviewed journals and conference presentations.

• SWORD™ contains unsuppressed (low count) data and utilises the sensitive consultant ID field.

Methods works with the DH GIRFT programme, generating report across many specialty areas under Lord Carter’s NHS efficiency programme. These detailed data rich reports are shaped by national lead clinicians for each specialty and they then visit every provider in England to discuss their data with them in order to improve the quality and efficiency of care. This programme is currently being rolled out. Methods Analytics have produced programme updates for the GIRFT team, using HES analysis to demonstrate the estimated programme impact to date at over £1bn.

Methods has also supported the development and publication of GIRFT national reports (http://gettingitrightfirsttime.co.uk/girft-reports/) through use of NHS Digital data to enable the development of national level recommendations on policy and regulation of the services based on sound analysis. Across these reports many hundreds of millions of pounds of savings have been identified, with specific recommendations supporting the delivery of each savings opportunity.

Aim and Purpose of application

Methods Analytics Ltd (“Methods”) is a company which uses data to help inform people and organisations so they can improve their performance. NHS Digital datasets have been used to inform Methods' work since 2009, initially as an NHS Organisation, subsequently working with the NHS and other partners since 2012 as a commercial organisation.

Data is processed to support the NHS either directly through the delivery of tools and bespoke analysis to an NHS user or indirectly, where analytics are provided to the NHS as the end beneficiary via a non-NHS organisation.

The aim is for data to be used to help inform improvement in NHS services. The effect of using these data, analysed securely and then provided to NHS decision makers and providers to the NHS in Methods' tools helps decision makers visualise and understand what changes they need to make to their organisations and services to enhance the quality, safety and efficiency of health and care.

Legal Basis

The lawful basis for processing is covered under GDPR Article 6 Section 1 (F) – (“Processing is necessary for the purpose of the legitimate interests pursued by the controller or by a third party, except where such interests or fundamental rights and freedoms of the data subject which require protection of personal data , in particular where the subject is a child”) and Article 9 Section 2 (j). (“Processing is necessary for achieving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject”).

The legitimate interest being pursued by Methods is the business of processing data to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non NHS organisations (where analytics are provided to the NHS as the end beneficiary via a non NHS organization). This requirement is met as it is necessary to use these data in undertaking analysis and producing the outputs of analysis to identify good and bad practice, pathways and performance, to enable improvement in performance within the NHS.

The processing is proportionate to that purpose in that national healthcare data is needed in order to undertake benchmarking, demonstrate variation and allow comparison to inform improvement. Further suppression and aggregation is applied to ensure a national data picture, without unnecessary data or risk of identifying any individual person.

Data provided by NHS Digital is pseudonymised prior to dissemination to Methods.

Public Interest

This work is used to support national and local service improvement, policy and regulatory recommendations and peer reviewed scientific articles, contributing to improvement in quality, safety and efficiency of health and care. Without these data there is no other way to achieve the same outcome. It is in the public interest that NHS organisations, directly and through Method’s partners, should use the processed data to enable them to further improve the services they offer to the local and national public.

Data required and data management

Clients of Methods require analysis of national data to undertake benchmarking and enable understanding of variation in care and outcomes of care. Through constant review of processes, alongside the additional training and education of the team, Methods are constantly aware of the responsibility of working with the data and continuously work to improve data quality by identifying any issues to NHS Digital. Data asset minimisation and control of the risk of function creep is at the forefront of this work.

Who Methods work with

Methods Analytics is the data controller for data shared under this DSA.

The data will be used to support the NHS either directly through the delivery of tools and bespoke analysis or indirectly through non-NHS organisations, where the NHS is the end beneficiary. The organisations who would be considered as supporting the NHS directly are:

• Department of Health

• Care Quality Commission

• Monitor

• NHS Improvement

• NHS England

• NICE

• CCGs

• CSUs

• Local Authorities (for Public Health purposes only)

• Providers of NHS-funded care

• Professional bodies

Organisations who support the NHS indirectly include commercial, charitable, academic and other forms of body working within the health and care space. Analysis is provided to these organisations solely for the purpose of delivering benefit to NHS organisations and/or the public. Methods' target audience is NHS organisations, however the NHS is increasingly looking to industry to support it in the provision of evidence and implementation support for service improvement, and hence Methods offers the tools and services to non-NHS organisations based on their agreeing to license terms and conditions, which include submitting and evidencing training in information governance and the restriction of the use of the tool to the uses outlined in this document, with this purpose statement flowed down as a contract schedule. For clarity, the schedule will include the following:

• Only aggregated small number suppressed data may be used from the tool.

• No data is to be used for direct marketing to individuals or organisations.

• No data is to be used for direct sales activities

There are three objectives of processing.

1) Stethoscope™ - a quality variation tool which provides local and national benchmarking of indicators derived from NHS Digital and other data, that is made available free to the public at an organisation roll-up level, and more granular information to subscribing organisations. Stethoscope™ is a complex analysis and visualisation platform that allows users to understand patterns in care provision, pathway and organisational performance and variation in these across the country. The aim is that users will be more able to understand the needs, demand, services and outcomes of care for the population they respond to and be able to make informed decisions to improve the efficiency and quality of care.

2) Bespoke tools and analysis. Method’s deliver specialised healthcare analytics to clients through online and offline reporting, shaping outputs to deliver actionable intelligence to the user. Reports may contain standard or bespoke metric items, tables, maps, graphs as is most appropriate to enable the user to interpret the information presented.

3) SWORD™ is a programme for a number of the specialist surgical societies (which are registered charities) providing an intelligence tool for only their Consultant Surgeons members. The SWORD™ Consultant view provides access to measures and metrics about their own performance, to inform reflective practice, service improvement and appraisal.

SWORD™ pathway view͛ demonstrates at an organisation-level comparative data for individual surgical pathways, such as cholecystectomy, groin hernia etc. with the ability to filter and investigate how behaviour varies for groups of patients (grouped by a common theme eg: treatment pathway, not by identifiers).

1 Stethoscope™

• The primary output is an online intelligence platform available to users containing over 500 benchmarked metrics on NHS activity. This is designed to be visually attractive to users but convey rich statistical intelligence.

• The platform includes domain dashboards, filtered views with users able to explore areas of interest and shape metric views to their requirements, users are able to create bespoke reports containing information relevant to them. Stethoscope™ contains alert reporting, algorithmically surfacing to users metrics and organisations that are outliers and might require consideration, for action.

• Views include graphs, maps and data tables representing national, peer group and regional organisations performance compared to each other for any metric or filtered metric.

• All Stethoscope output is suppressed as per NHS Digital disclosure rules and uses the sensitive consultant ID field to enable personal scorecard creation to inform reflective practice and appraisal.

2 Bespoke analysis

• Bespoke analysis outputs are quite variable as the specific output is dependent on the requirement and use case. A range of output types are produced:

o Data tables

o Charts, graphs and other data visualisations

o Mapping with data overlays such as heatmaps

• Outputs can be standalone or embedded in comprehensive reports either produced solely by Methods or as part of a wider product produced by clients and partners.

• Outputs can be static PDF documents or presentations or online interactive tools and solutions. These may be public or private.

• All output of bespoke analysis is suppressed as per NHS Digital disclosure rules other than work undertaken for the NHS Improvement GIRFT programme, where Methods are required to provide unsuppressed (low count) data in these outputs to enable national clinical leads, who are NHS employees, to explore and understand low volume activity in their conversations with providers as part of the picture of the service that is being considered. These outputs are produced by Methods and shared securely with the GIRFT program.

o All users working on the GIRFT program, where unsuppressed small numbers data may be visible, are informed of the terms of use which state that they must not :-

 Onwardly share any data with small numbers within

 Seek to re-identify any individual from that data.

3 SWORD™

• The SWORD™ programme product set is an online portal that encompasses data visualisation tooling and reference data for users such as definition sets and other metadata information. There are two views of analysis:

o The consultant view presents the individual with information about their activity and outcomes, with standard metrics such as counts, readmission rates, length of stay and bespoke metrics for specific pathways. This is benchmarked against their organisation and the national cohort.

o The pathway view presents the same data but at an organisation level such that the user can compare their organisations performance against the rest of the country.

• SWORD™ data is used in a number of ways:

o To enable individual reflection and change in practice

o To support appraisal and revalidation

o To enable unit review of performance and service improvement

o As the input to original research and publication of scientific papers in peer reviewed journals and conference presentations.

• SWORD™ contains unsuppressed (low count) data and utilises the sensitive consultant ID field.

Methods works with the DH GIRFT programme, generating report across many specialty areas under Lord Carter’s NHS efficiency programme. These detailed data rich reports are shaped by national lead clinicians for each specialty and they then visit every provider in England to discuss their data with them in order to improve the quality and efficiency of care. This programme is currently being rolled out. Methods Analytics have produced programme updates for the GIRFT team, using HES analysis to demonstrate the early impact the GIRFT programme has had across the NHS and supporting policy development, such as, realising over £4m of cashable saving and releasing over 50,000 bed days of surgical occupancy while improving the quality of care just in Orthopaedic Surgery.

Methods has also supported the development and publication of GIRFT national reports (http://gettingitrightfirsttime.co.uk/girft-reports/) through use of NHS Digital data to enable the development of national level recommendations on policy and regulation of the services based on sound analysis. Across these reports many hundreds of millions of pounds of savings have been identified, with specific recommendations supporting the delivery of each savings opportunity.