LAPH HES via NHS England’s Secure Environment

Royal Borough of Greenwich · Local Authority

In term In term in the September 2026 edition: the latest version runs to 9 April 2027.

Reference: DARS-NIC-10929-K8H5K
Current version: v7.2
Term of current version: 12 April 2024 to 9 April 2027
Start date: Before 1 April 2019
Data controller: Sole Data Controller
Commercial purposes: No
Sublicensing: No
Files released to date: 0

Why the data was released

Objective for processing

The Health Episode Statistics (HES) Data accessed through the NHS England’s Secure Environment will be used by the Local Authority in fulfilment of its public health function, specifically to support and improve:

1. the local responsiveness, targeting and value for money of commissioned public health services;

2. the statutory ‘core offer’ public health advice and support provided to local NHS commissioners;

3. the local specificity and relevance of the Joint Strategic Needs Assessments and Health and Wellbeing Strategies produced in collaboration with NHS and voluntary sector partners on the Health and Wellbeing Board;

4. the local focus, responsiveness and timeliness of health impact assessments; and, among other benefits

5. the capability of the local public health intelligence service to undertake comparative longitudinal analyses of patterns of and variations in:

a) the incidence and prevalence of disease and risks to public health;

b) demand for and access to treatment and preventative care services;

c) variations in health outcomes between groups in the population;

d) the level of integration between local health and care services; and

e) the local associations between causal risk factors and health status and outcomes.

The main statutory duties and wider public health responsibilities supporting these processing objectives are as follows:

1. Statutory public health duties that the data will be used to support

a) Duty to improve public health: Analyses of the data will be used to support the duty of the Local Authority under Section 12 of the Health and Social Care Act 2012 to take appropriate steps to improve the health of the population, for example by providing information and advice, services and facilities, and incentives and assistance to encourage and enable people to lead healthier lives;

b) Duty to support Health and Wellbeing Boards: Analyses of the data will be used to support the duty of the Local Authority and the Integrated Care Board (ICB)-led Health and Wellbeing Board under Section 194 of the 2012 Act to improve health and wellbeing, reduce health inequalities, and promote the integration of health and care services; the data will also be used to support the statutory duty of Health and Wellbeing Boards under Section 206 of the 2012 Act to undertake Pharmaceutical Needs Assessments;

c) Duty to produce Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWBs): Analyses of the data will be used to support the duty of the Local Authority under Sections 192 and 193 of the 2012 Act to consult on and publish JSNAs and JHWSs that assess the current and future health and wellbeing needs of the local population;

d) Duty to commission specific public health services: Analyses of the data will be used to support the Local Authority to discharge its duty under the Local Authorities Regulations 2013 to plan and provide NHS Health Check assessments, the National Child Measurement Programme, and open access sexual health services;

e) Duty to provide public health advice to NHS commissioners: Analyses of the data will be used by Local Authorities to discharge its duty under the 2013 Regulations to provide a public health advice service to NHS commissioners;

f) Duty to publish an annual public health report: Analyses of the data will be used by Directors of Public Health to support their duty to prepare and publish an annual report on the health of the local population under Section 31 the 2012 Act;

g) Public Health responses on behalf of the Local Authority to licensing applications and other statutory Local Authority functions requiring public health input: Analyses of the data will be used by the Director of Public Health to support their duty under Part 3 of the National Health Services Act 2006 (as amended by Section 30 of the Health and Social Care Act 2012) to provide the Local Authority’s public health response (as the responsible authority under the Licensing Act 2003, as amended by the Health and Social Care Act 2012 Schedule 5 – Part 1) to licensing applications.

2. Wider public health responsibilities supported by analysis of the data

a) Health impact assessments and equity audits: Analyses of the data will be used to assess the potential impacts on health and the wider social economic and environmental determinants of health of Local Authority strategic plans, policies and services;

b) Local health profiles: Analyses of the data will be used to support the production of locally-commissioned health profiles to improve understanding of the health priorities of local areas and guide strategic commissioning plans by focusing, for example, on:

i. bespoke local geographies (based on the non-standard aggregation of LSOAs);

ii. specific demographic, geographic, ethnic and socio-economic groups in the population;

iii. inequalities in health status, access to treatment and treatment outcomes;

c) Surveillance of trends in health status and health outcomes: Analyses of the data will be used for the longitudinal monitoring of trends in the incidence, prevalence, treatment and outcomes for a wide range of diseases and other risks to public health;

d) Responsive and timely local health intelligence service: Analyses of the data will be used to respond to ad hoc internal and external requests for information and intelligence on the health status and outcomes of the local population generated and received by the Director of Public Health and their team.

These lists of the statutory duties and wider public health responsibilities of the Local Authority are not exhaustive but set the broad parameters for how the data will be used by the Local Authority to help improve and protect public health, and reduce health inequalities. All such use would be in fulfilment of the public health function of the Local Authority.

No Identifiable data can be accessed through the NHS England’s Secure Environment. The data provided would include, the standard non-sensitive HES fields, and a common (across all Local Authorities) pseudo ID to enable admissions to be linked over time.

Legal Basis for Processing Data:

GDPR:

Article 6(1)(e)

(processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller)

Public Authority: The Data Protection Act 2018 s7(1)(a) defines ‘public bodies’ for the purpose of the GDPR as “a public authority as defined by the Freedom of Information Act 2000”.

The FOI Act 2000 Part 1, section 3 (1)(a)(i) specifies that a public authority means any body which is listed in Schedule 1.

Schedule 1 of the FOI Act 2000 lists Local authorities within the meaning of the Local Government Act 1972 as public authorities.

‘Public Task’

Local Authorities

Local Authorities have a legal responsibility under Section (1)(2)(3)(4)(5)(6)(7) of the Care Act 2014 to conduct tasks that are in the public interest to:

(1) Promoting individual well-being

(2) Preventing needs for care and support

(3) Promoting integration of care and support with health services etc.

(4) Providing information and advice

(5) Promoting diversity and quality in provision of services

(6) Co-operating generally

(7) Co-operating in specific cases

(8) Duty to meet needs for care and support

The task(s) are necessary (but are by no means an exhaustive list), but provides an indication of the many tasks required under Part 1 of the Care Act 2014 as the council has an obligation to the public to deliver services that are a necessity to the local population - from whom funding is provided to deliver these services/tasks in the form of Council Tax.

Local Authorities have a duty under Section 74 (1)(2)(3)(4) of the NHS Act 2006 to supply goods and services:

(1) In the Local Authorities (Goods and Services) Act 1970 (c. 39) the expression “public body” includes—

(a) any Strategic Health Authority, Special Health Authority or Primary Care Trust, and

(b) so far as relates to his functions under this Act, the Secretary of State.

(2) Subsection (1) has effect as if made by an order under section 1(5) of the Local Authorities (Goods and Services) Act 1970 and may be varied or revoked by such an order.

(3) Each local authority must make services available to each NHS body acting in its area, so far as is reasonably necessary and practicable to enable the NHS body to discharge its functions under this Act.

(4) “Services” means the services of persons employed by the local authority for the purposes of its functions under the Local Authority Social Services Act 1970 (c. 42).

As part of the application process, the requirement for the data requested has been assessed and NHS England is content that it is appropriate, necessary and proportionate for the performance of the task described in the Purpose statement.

‘Necessity’: Throughout the application process, the necessity of the processing for the performance of the task has been assessed. This included but was not limited to ensuring appropriate minimisation of the data to ensure that only the minimum amount of data required are processed. During the application process it has been considered whether the information that the processing aims to determine is already available from other sources or whether the task could be performed using publicly available data or data from alternative sources than NHS England. Consideration has been given to whether the volume of data being requested is proportionate to the expected benefit and, through examination of the expected benefits consideration has been given to whether the task is itself necessary.

Therefore, we are satisfied that this request is appropriate, necessary and proportionate for the performance of the task described in the Purpose statement and that there is no other reasonable means for the data processor to achieve their purpose that is less intrusive to the data subjects.

Article 9(2)(h)

(processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3)

• The data are required for the purpose of commissioning.

• The data required by the data controllers is the least intrusive to the data subject possible to be able to conduct their functions.

• The data required for commissioning purposes is pseudonymised by NHS England to minimise the risk of identification.

As part of the standard Data Access Request Service application process:

• the applicant’s technical and organisational measures to safeguard the data have been assessed and meets NHS England’s acceptance criteria;

• the requested data has been assessed as proportionate to the aim pursued;

• respect to the essence of the right to data protection has been assessed (e.g. security assurance, data retention, controls and processing activities, etc.);

• measures to protect the rights and freedoms of data subjects have been assessed including transparency (fair processing) publishing subject’s rights to withdraw consent and/or have their data erased or rectified, etc.

Article 9(3)

(Personal data referred to in paragraph 1 may be processed for the purposes referred to in point (h) of paragraph 2 when those data are processed by or under the responsibility of a professional subject to the obligation of professional secrecy under Union or Member State law or rules established by national competent bodies or by another person also subject to an obligation of secrecy under Union or Member State law or rules established by national competent bodies.)

Existing DAE users will migrate to NHS England’s Secure Environment.

NHS England’s Controlled Environment is a data storage and access platform that enables approved users to access de-identified data and analytical tools for approved projects. Users must identify themselves via a multi-factor authentication mechanism and are only able to access the datasets detailed within this agreement. Users can request that aggregated outputs are exported from the system following approval by trained NHS England staff. The access and use of the system is fully auditable, and all users must comply with the use of the data as specified in this agreement.

Processing activities

Access to the Pseudonymised HES data sets will enable the Local Authority to undertake a wide range of locally-determined and locally-specific analyses to support the effective and efficient discharge of its statutory duties in relation to public health, and wider public health responsibilities.

This application/agreement is for online access to the record level HES database via the NHS England’s Secure Environment. The system is hosted and audited by NHS England meaning that large transfers of data to on-site servers is reduced and NHS England has the ability to audit the use and access to the data.

The NHS England’s Secure Environment is accessed via a two-factor secure authentication method to approved users who are in receipt of an encryption token ID. Users have to attend training before the account is set up and users are only permitted to access the data sets that are agreed within this agreement. Users log onto the NHS England’s Secure Environment and are presented with a SAS software application called Enterprise Guide which presents the users with a list of available data sets and available reference data tables so that they can return appropriate descriptions to the coded data.

The access and use of the system is fully auditable and all users have to comply with the use of the data as specified in this agreement. The software tool also provides users with the ability to perform full data minimisation and filtering of the HES data as part of processing activities. Users are not permitted to upload data into the system.

Users of NHS England’s Secure Environment are able to produce outputs from the system in a number of formats. The system has the ability to be able to produce small row count extracts for local analysis in Excel or other local analysis software. Users are also able to produce tabulations, aggregations, reports, charts, graphs and statistical outputs for viewing on screen or export to a local system.

Any record level data extracted from the system will not be processed outside of the Public Health team. Only registered NHS England’s Secure Environment users will have access to record level data downloaded from the NHS England’s Secure Environment.

Following completion of the analysis the record level data will be securely destroyed.

Access to the data is provided to the Local Authority only, and will only be used for the public health purposes outlined above. The data will only be processed by Local Authority employees in fulfilment of their public health function, and will not be transferred, shared, or otherwise made available to any third party, including any organisations processing data on behalf of the Local Authority or in connection with their legal function. Such organisations may include Commissioning Support Units, Data Services for Commissioners Regional Offices, any organisation for the purposes of health research, or any Business Intelligence company providing analysis and intelligence services (whether under formal contract or not).

The Local Authority will use the data to produce a range of quantitative measures (counts, crude and standardised rates and ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data. Typical uses will include:

1. Analyses of disease incidence, prevalence and trends: The age, sex, LSOA, ethnic group, Indices of Deprivation and diagnosis fields typically will be used to produce directly standardised coronary heart disease admission rates for the Local Authority, and for appropriate benchmark and comparator areas. Confidence intervals will then be produced for these rates, and the rates analysed using statistical process control methods, to determine whether there are any significant variations in the prevalence of heart disease with the Local Authority. The data will also be used to analyse changes over time in the prevalence of heart disease. The results of these analyses will then be used to inform the production of local health profiles, JSNAs and JHWSs; support the ‘core offer’ public health advice provided by the Director of Public Health to NHS commissioners; and advise any enquiries into health inequalities requested by the Health and Wellbeing Board.

2. Analyses of hospital admission rates: The data will also be used, for example, to produce comparative and longitudinal hospital admission rates among children and young people, particularly for injury and self-harm, to support the overarching responsibility of the Local Authority to safeguard and promote the health and welfare of all children and young people under the 1989 and 2004 Children Acts. Statistics based on these analyses will be used by the Director of Public Health to advise the Director of Children’s Services and Lead Member for Children’s Services, and inform and guide the provision of safeguarding services by the Local Authority.

Conditions of supply and controls on use

In addition to those outlined elsewhere within this application, the Local Authorities will:

1. only use the HES/ECDS data for the purposes as outlined in this agreement;

2. comply with the requirements of NHS England Code of Practice on Confidential Information, the Caldicott Principles and other relevant statutory requirements and guidance to protect confidentiality;

3. not attempt any record-level linkage of HES data with other data sets held by the Local Authority, or attempt to identify any individuals from the HES data;

4. not transfer and disseminate record-level HES data to anyone outside the Local Authority;

5. not publish the results of any analyses of the HES data unless safely de-identified in line with the anonymisation standard; and

6. comply with the guidelines set out in the HES Analysis Guide;

7. ensure role-based control access is in place to manage access to the HES data within the Local Authority.

The Director of Public Health will be the Information Asset Owner for the HES data and be responsible on behalf of the Local Authority to NHS England for ensuring that the data is only used in fulfilment of the approved public health purposes as set out in this application. The Local Authority confirms that the Director of Public Health is a contracted employee to the permanent role within the Local Authority, accountable to the Chief Executive.

Data retention

A maximum of ten full years data will be accessed through the NHS England’s Secure Environment at any point, such that as each new data year is available, access to the oldest year will be suppressed i.e. at any point in time only ten historic years of data plus the current year is available. The Local Authority will securely destroy any record level data downloaded for the year’s data within six weeks of receiving access to the latest annual data set and provide a data destruction certificate to NHS England.

The historic data will be used by the Local Authority in fulfilment of its public health function, and specifically to:

a) recognise and monitor trends in disease incidence and prevalence and other risks to public health;

b) recognise and monitor trends in treatment patterns, particularly hospital readmissions, and outcomes;

c) recognise and monitor trends in access to treatment and care between demographic, geographic, ethnic and socio-economic groups in the population; and

d) recognise and monitor trends in the association between the wider social, economic and environmental determinants of health and health outcomes for the purpose of informing the planning, commissioning and provision of effective health and care services at a local level.

Expected output

The results of the analyses of the data will be used by the Local Authority to support the discharge of its statutory duties in relation to public health, and wider public health responsibilities. Outputs will include (but not be limited to) the routine and ad hoc production of:

a) Joint Strategic Needs Assessments;

b) Joint Health and Wellbeing Strategies;

c) the annual report of the Director of Public Health;

d) reports commissioned by the Health and Wellbeing Board;

e) public health and wider Local Authority health and wellbeing commissioning strategies and plans;

f) public health advice to NHS commissioners;

g) responses to licensing applications and other statutory Local Authority functions requiring public health input;

h) local health profiles;

i) health impact assessments and equity audits; and, among other outputs

j) responses to internal and external requests for information and intelligence on the health and wellbeing of the population.

The specific content of and target dates for these outputs will be for the Local Authority to determine, although it is required to comply with national guidance published by the Department of Health, UK Health Security Agency (UKHSA) and others as appropriate, for example, on the timetable for publishing refreshed JSNAs.

All outputs shared outside of the Public Health Team will be of aggregated data with small numbers suppressed in line with the HES Analysis Guide.

Expected measurable benefits

Access to the data will enable the Local Authority to undertake locally-focused and locally-responsive analyses of health status and health outcomes. For example, the data will be used to produce analyses of health inequalities for non-standard geographies and for specific social or ethnic groups in the local population to help ensure that the health challenges facing the local population – particularly the most disadvantaged – have been identified and responded to appropriately by the Local Authority and its partners.

It is recognised that in fulfilling its public health duties using HES data, the Local Authority will deliver significant benefits. The Local Authority therefore commits in any renewal request to providing additional detail on benefits that relate to their local use of the data.

Benefits reported so far

January 2024

The overall benefit is that the results of analyses are used by the Local Authority to support the discharge of its statutory duties in relation to public health, and wider public health responsibilities, by producing routine and ad-hoc outputs such as the Joint Strategic Needs Assessments and other reports and strategies as listed on the previous section. Access to the data has allowed the Local Authority to undertake locally focused and locally responsive analyses of health status and health outcomes, which include analyses of health inequalities to help ensure that the health challenges facing the local population and communities are identified and responded to appropriately by the Local Authority and its partners.

Following the COVID-19 Pandemic Royal Borough of Greenwich has gradually returned to BAU analysis resulting in data access and analysis being increased. Examples of analyses that have been completed and partially completed include:

Number and rates of admissions of all persons due to COVID-19 looking at trends, and whether any particular underlying health issues, deprivation, age, sex and ethnicity were factors for outcome following admission

Maternity admissions: Number and rate of admissions (in a 5 year period) due to deliveries, miscarriages, ectopic pregnancies, etc. For Greenwich maternity review and the JSNA to provide context, identify areas of need and change, and any challenges to inform the commissioning process and priorities for the next period.

Mental Health Admissions - ongoing work including JSNA Chapter and housing needs

Children’s hospital activity: routes of admissions, and length of stay for all admissions compared with admissions for respiratory conditions. This was linked to air quality JSNA Chapter.

Alcohol admissions: LSOA level breakdown of admissions for both narrow and broad admissions as part of alcohol harm in the borough enabling a better understanding of alcohol-related issues in Greenwich.

Drug Admissions: As for alcohol related admission, linking to addictions needs analysis and strategy.

Falls admissions: Emergency admissions in over 65s - performance reporting for services.

Datasets on the current version

Legal basis for provision: Health and Social Care Act 2012 – s261(2)(a)

Datasets approved under DARS-NIC-10929-K8H5K-v7.2
Dataset	Type of data	Sensitivity	Frequency	Confidential data
Emergency Care Data Set (ECDS)	Anonymised - ICO Code Compliant	Sensitive	System Access	Does not include the flow of confidential data
Hospital Episode Statistics Accident and Emergency (HES A and E)	Anonymised - ICO Code Compliant	Non-Sensitive	System Access	Does not include the flow of confidential data
Hospital Episode Statistics Admitted Patient Care (HES APC)	Anonymised - ICO Code Compliant	Non-Sensitive	System Access	Does not include the flow of confidential data
Hospital Episode Statistics Critical Care (HES Critical Care)	Anonymised - ICO Code Compliant	Non-Sensitive	System Access	Does not include the flow of confidential data
Hospital Episode Statistics Outpatients (HES OP)	Anonymised - ICO Code Compliant	Non-Sensitive	System Access	Does not include the flow of confidential data

Files released

Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.

No files recorded as released under this agreement.

Version history

The register lists each renewal of this agreement as a separate row. This site has 5 versions — earlier versions existed before this site's records begin.

DARS-NIC-10929-K8H5K-v7.2 12 April 2024 to 9 April 2027

Title: LAPH HES via NHS England’s Secure Environment
Commercial: No
Sublicensing: No
Datasets: 5
Files released: 0

Datasets: Emergency Care Data Set (ECDS); Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Critical Care (HES Critical Care); Hospital Episode Statistics Outpatients (HES OP)

What changed from DARS-NIC-10929-K8H5K-v6.2

Text removed is ~~struck through~~; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Fields changed from DARS-NIC-10929-K8H5K-v6.2
Field	Was	Became
Title	~~LAPH HES via NHS Digital Portal~~	LAPH HES via NHS England’s Secure Environment
Start date	~~2021-03-18~~	2024-04-12
End date	~~2024-01-31~~	2027-04-09
Emergency Care Data Set (ECDS): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)
Hospital Episode Statistics Accident and Emergency (HES A and E): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)
Hospital Episode Statistics Admitted Patient Care (HES APC): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)
Hospital Episode Statistics Critical Care (HES Critical Care): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)
Hospital Episode Statistics Outpatients (HES OP): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)

Objective for processing

The Health Episode Statistics (HES) Data accessed through the NHS ~~Digital Portal~~ England’s Secure Environment will be used by the Local ~~Authorities~~ Authority in fulfilment of its public health function, specifically to support and improve: [13 paragraphs unchanged] b) Duty to support Health and Wellbeing Boards: Analyses of the data will be used to support the duty of the Local Authority and the ~~Clinical Commissioning Group (CCG)-led~~ Integrated Care Board (ICB)-led Health and Wellbeing Board under Section 194 of the 2012 Act to [32 words unchanged] under Section 206 of the 2012 Act to undertake Pharmaceutical Needs Assessments; [7 paragraphs unchanged] b) Local health profiles: Analyses of the data will be used to support the production of locally-commissioned health profiles to improve ~~understand~~ understanding of the health priorities of local areas and guide strategic commissioning plans by focusing, for example, on: [6 paragraphs unchanged] No ~~sensitive~~ Identifiable data can be accessed through the NHS ~~Digital Portal.~~ England’s Secure Environment. The data provided would include, the standard non-sensitive HES fields, and a common (across all Local Authorities) ~~TokenID~~ pseudo ID to enable admissions to be linked over time. Legal Basis for Processing Data: GDPR: Article 6(1)(e) (processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller) Public Authority: The Data Protection Act 2018 s7(1)(a) defines ‘public bodies’ for the purpose of the GDPR as “a public authority as defined by the Freedom of Information Act 2000”. The FOI Act 2000 Part 1, section 3 (1)(a)(i) specifies that a public authority means any body which is listed in Schedule 1. Schedule 1 of the FOI Act 2000 lists Local authorities within the meaning of the Local Government Act 1972 as public authorities. ‘Public Task’ Local Authorities Local Authorities have a legal responsibility under Section (1)(2)(3)(4)(5)(6)(7) of the Care Act 2014 to conduct tasks that are in the public interest to: (1) Promoting individual well-being (2) Preventing needs for care and support (3) Promoting integration of care and support with health services etc. (4) Providing information and advice (5) Promoting diversity and quality in provision of services (6) Co-operating generally (7) Co-operating in specific cases (8) Duty to meet needs for care and support The task(s) are necessary (but are by no means an exhaustive list), but provides an indication of the many tasks required under Part 1 of the Care Act 2014 as the council has an obligation to the public to deliver services that are a necessity to the local population - from whom funding is provided to deliver these services/tasks in the form of Council Tax. Local Authorities have a duty under Section 74 (1)(2)(3)(4) of the NHS Act 2006 to supply goods and services: (1) In the Local Authorities (Goods and Services) Act 1970 (c. 39) the expression “public body” includes— (a) any Strategic Health Authority, Special Health Authority or Primary Care Trust, and (b) so far as relates to his functions under this Act, the Secretary of State. (2) Subsection (1) has effect as if made by an order under section 1(5) of the Local Authorities (Goods and Services) Act 1970 and may be varied or revoked by such an order. (3) Each local authority must make services available to each NHS body acting in its area, so far as is reasonably necessary and practicable to enable the NHS body to discharge its functions under this Act. (4) “Services” means the services of persons employed by the local authority for the purposes of its functions under the Local Authority Social Services Act 1970 (c. 42). As part of the application process, the requirement for the data requested has been assessed and NHS England is content that it is appropriate, necessary and proportionate for the performance of the task described in the Purpose statement. ‘Necessity’: Throughout the application process, the necessity of the processing for the performance of the task has been assessed. This included but was not limited to ensuring appropriate minimisation of the data to ensure that only the minimum amount of data required are processed. During the application process it has been considered whether the information that the processing aims to determine is already available from other sources or whether the task could be performed using publicly available data or data from alternative sources than NHS England. Consideration has been given to whether the volume of data being requested is proportionate to the expected benefit and, through examination of the expected benefits consideration has been given to whether the task is itself necessary. Therefore, we are satisfied that this request is appropriate, necessary and proportionate for the performance of the task described in the Purpose statement and that there is no other reasonable means for the data processor to achieve their purpose that is less intrusive to the data subjects. Article 9(2)(h) (processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3) • The data are required for the purpose of commissioning. • The data required by the data controllers is the least intrusive to the data subject possible to be able to conduct their functions. • The data required for commissioning purposes is pseudonymised by NHS England to minimise the risk of identification. As part of the standard Data Access Request Service application process: • the applicant’s technical and organisational measures to safeguard the data have been assessed and meets NHS England’s acceptance criteria; • the requested data has been assessed as proportionate to the aim pursued; • respect to the essence of the right to data protection has been assessed (e.g. security assurance, data retention, controls and processing activities, etc.); • measures to protect the rights and freedoms of data subjects have been assessed including transparency (fair processing) publishing subject’s rights to withdraw consent and/or have their data erased or rectified, etc. Article 9(3) (Personal data referred to in paragraph 1 may be processed for the purposes referred to in point (h) of paragraph 2 when those data are processed by or under the responsibility of a professional subject to the obligation of professional secrecy under Union or Member State law or rules established by national competent bodies or by another person also subject to an obligation of secrecy under Union or Member State law or rules established by national competent bodies.) Existing DAE users will migrate to NHS England’s Secure Environment. NHS England’s Controlled Environment is a data storage and access platform that enables approved users to access de-identified data and analytical tools for approved projects. Users must identify themselves via a multi-factor authentication mechanism and are only able to access the datasets detailed within this agreement. Users can request that aggregated outputs are exported from the system following approval by trained NHS England staff. The access and use of the system is fully auditable, and all users must comply with the use of the data as specified in this agreement.

Processing activities

[1 paragraph unchanged] This application/agreement is for online access to the record level HES database via the NHS ~~Digital Portal system.~~ England’s Secure Environment. The system is hosted and audited by NHS ~~Digital~~ England meaning that large transfers of data to on-site servers is reduced and NHS ~~Digital~~ England has the ability to audit the use and access to the data. The NHS ~~Digital Portal system~~ England’s Secure Environment is accessed via a two-factor secure authentication method to approved users who [28 words unchanged] sets that are agreed within this agreement. Users log onto the NHS ~~Digital Portal system~~ England’s Secure Environment and are presented with a SAS software application called Enterprise Guide which [14 words unchanged] tables so that they can return appropriate descriptions to the coded data. [1 paragraph unchanged] Users of NHS ~~Digital Portal system~~ England’s Secure Environment are able to produce outputs from the system in a number of [37 words unchanged] statistical outputs for viewing on screen or export to a local system. Any record level data extracted from the system will not be processed outside of the Public Health team. Only registered NHS ~~Digital Portal system~~ England’s Secure Environment users will have access to record level data downloaded from the NHS ~~Digital Portal system.~~ England’s Secure Environment. [7 paragraphs unchanged] 1. only use the ~~HES~~ HES/ECDS data for the purposes as outlined in this agreement; 2. comply with the requirements of NHS ~~Digital~~ England Code of Practice on Confidential Information, the Caldicott Principles and other relevant statutory requirements and guidance to protect confidentiality; [5 paragraphs unchanged] The Director of Public Health will be the Information Asset Owner for the HES data and be responsible on behalf of the Local Authority to NHS ~~Digital~~ England for ensuring that the data is only used in fulfilment of the [25 words unchanged] the permanent role within the Local Authority, accountable to the Chief Executive. [1 paragraph unchanged] A maximum of ten full years data will be accessed through the NHS ~~Digital Portal system~~ England’s Secure Environment at any point, such that as each new data year is available, [49 words unchanged] latest annual data set and provide a data destruction certificate to NHS ~~Digital.~~ England. [4 paragraphs unchanged] d) recognise and monitor trends in the association between the wider social, economic and environmental determinants of health and health outcomes for the purpose of informing the planning, commissioning and provision of effective health and care services at a local level. ~~for the purpose of informing the planning, commissioning and provision of effective health and care services at a local level.~~

Expected output

[11 paragraphs unchanged] The specific content of and target dates for these outputs will be [9 words unchanged] required to comply with national guidance published by the Department of Health, ~~Public~~ UK Health ~~England~~ Security Agency (UKHSA) and others as appropriate, for example, on the timetable for publishing refreshed JSNAs. [1 paragraph unchanged]

Benefits reported

~~Feb 2021~~ January 2024 The overall benefit is that the results of analyses are used by the Local Authority to support the [38 words unchanged] section. Access to the data has allowed the Local Authority to undertake ~~locally-focused~~ locally focused and ~~locally-responsive~~ locally responsive analyses of health status and health outcomes, which include analyses of health [15 words unchanged] identified and responded to appropriately by the Local Authority and its partners. ~~Due to~~ Following the ~~current~~ COVID-19 Pandemic Royal Borough of Greenwich ~~have not undertaken as much~~ has gradually returned to BAU analysis resulting in data access and analysis being ~~limited.~~ increased. Examples of analyses that have been completed and partially completed include: Number and rates of admissions of all persons due to COVID-19 looking at trends, and whether any particular underlying ~~heath~~ health issues, deprivation, age, sex and ethnicity were factors for outcome following admission Maternity admissions: Number and rate of admissions (in a 5 year period) [16 words unchanged] context, identify areas of need and change, and any challenges to inform the commissioning process and priorities for the next period. Homeless and Housing Providers: to finding out what type of housing the patient was discharged to, whether they were identified as homeless, and whether there had been liaison with Royal Borough of Greenwich to arrange discharge. Looking to see if there had been an increase in people requiring support due to the effects of COVID. Mental Health Admissions - ongoing work including JSNA Chapter and housing needs ~~Eating Disorders: National reports suggested increased admissions nationally. Sought to see if this was replicated locally.~~ Children’s hospital activity: routes of admissions, and length of stay for all admissions compared with admissions for respiratory conditions. This was linked to air quality JSNA Chapter. ~~Mental Health Admissions - ongoing~~ Alcohol admissions: LSOA level breakdown of admissions for both narrow and broad admissions as part of alcohol harm in the borough enabling a better understanding of alcohol-related issues in Greenwich. ~~Children’s hospital activity: routes of admissions, and length of stay for all admissions compared with admissions for respiratory conditions. This was linked to air quality work.~~ Drug Admissions: As for alcohol related admission, linking to addictions needs analysis and strategy. Alcohol admissions: LSOA level breakdown of admissions for both narrow and broad admissions as part of alcohol harm in the borough. Used to contribute to work on the Statement of Licencing Policy (SoLP), where updated data can be provided to develop and review the Licencing objectives. Also, data used in two local tools - Alcohol Harm Dashboard and (in development) Alcohol Vulnerability Profile. Granularity of data has given the Licencing Team a better understanding of alcohol-related issues surrounding premises in Greenwich. Falls admissions: Emergency admissions in over 65s - performance reporting for services.

Unchanged: Expected measurable benefits.

DARS-NIC-10929-K8H5K-v6.2 18 March 2021 to 31 January 2024

Title: LAPH HES via NHS Digital Portal
Commercial: No
Sublicensing: No
Datasets: 5
Files released: 0

What changed from DARS-NIC-10929-K8H5K-v5.2

Text removed is ~~struck through~~; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Fields changed from DARS-NIC-10929-K8H5K-v5.2
Field	Was	Became
Start date	~~2020-06-26~~	2021-03-18
End date	~~2021-03-31~~	2024-01-31
Emergency Care Data Set (ECDS): legal basis	~~Health and Social Care Act 2012 – s261(2)(b)(ii)~~	Health and Social Care Act 2012 - s261 - 'Other dissemination of information'
Hospital Episode Statistics Accident and Emergency (HES A and E): legal basis	~~Health and Social Care Act 2012 – s261(2)(b)(ii)~~	Health and Social Care Act 2012 - s261 - 'Other dissemination of information'
Hospital Episode Statistics Admitted Patient Care (HES APC): legal basis	~~Health and Social Care Act 2012 – s261(2)(b)(ii)~~	Health and Social Care Act 2012 - s261 - 'Other dissemination of information'
Hospital Episode Statistics Critical Care (HES Critical Care): legal basis	~~Health and Social Care Act 2012 – s261(2)(b)(ii)~~	Health and Social Care Act 2012 - s261 - 'Other dissemination of information'
Hospital Episode Statistics Outpatients (HES OP): legal basis	~~Health and Social Care Act 2012 – s261(2)(b)(ii)~~	Health and Social Care Act 2012 - s261 - 'Other dissemination of information'

Objective for processing

[29 paragraphs unchanged] No sensitive data can be accessed through the NHS Digital Portal. The data provided would include, the standard non-sensitive HES fields, and a common (across all Local Authorities) ~~pseudoHESID~~ TokenID to enable admissions to be linked over time.

Expected measurable benefits

[2 paragraphs unchanged] ~~The expected benefits in 2020-21 will include (but not limited to):~~ ~~- supporting NHS Commissioners with PCN data packs in light of recent changes to Greenwich CCG~~ ~~- a total refresh of the Greenwich JSNA~~

Benefits reported

Feb 2021 [1 paragraph unchanged] Due to the ~~change from HDIS to DAE during 2019-20, and the complications that arose,~~ current COVID-19 Pandemic Royal Borough of Greenwich have not undertaken as much analysis resulting in data access and analysis ~~has been~~ being limited. Examples of analyses that have been completed and partially completed include: - Rates of emergency admissions of children at ward and children's centre areas were provided for the children's centre datapacks (refresh). These packs are provided to children's centres in Royal Borough of Greenwich to inform them of health and well-being issues within their patch and the wider borough, and to support them in choosing priorities to focus on. Number and rates of admissions of all persons due to COVID-19 looking at trends, and whether any particular underlying heath issues, deprivation, age, sex and ethnicity were factors for outcome following admission - emergency admissions and elective admissions by IMD quintile, comparing least and most affluent quintiles in Greenwich. Results provided to Greenwich CCG to help the CCG focus on how they best deliver improved health outcomes. Maternity admissions: Number and rate of admissions (in a 5 year period) due to deliveries, miscarriages, ectopic pregnancies, etc. For Greenwich maternity review and the JSNA to provide context, identify areas of need and change, and any challenges to inform commissioning process and priorities for the next period. ~~- Number of admissions of children and young people due to substance misuse, looking at trends, and whether any particular substances are highlighted (primary diagnosis). For use in JSNA.~~ Homeless and Housing Providers: to finding out what type of housing the patient was discharged to, whether they were identified as homeless, and whether there had been liaison with Royal Borough of Greenwich to arrange discharge. Looking to see if there had been an increase in people requiring support due to the effects of COVID. - The rate of diabetes admissions at MSOA level. This was provided, along with other relevant data, to assist the Greenwich traffic planning teams with a project aiming to increase physical activity, and improve air quality through the creation of low traffic neighbourhoods. Eating Disorders: National reports suggested increased admissions nationally. Sought to see if this was replicated locally. - Maternity admissions. Number and rate of admissions (in a 5 year period) due to deliveries, miscarriages, ectopic pregnancies, etc. For Greenwich maternity review and the JSNA to provide context, identify areas of need and change, and any challenges to inform commissioning process and priorities for the next period. Mental Health Admissions - ongoing Children’s hospital activity: routes of admissions, and length of stay for all admissions compared with admissions for respiratory conditions. This was linked to air quality work. Alcohol admissions: LSOA level breakdown of admissions for both narrow and broad admissions as part of alcohol harm in the borough. Used to contribute to work on the Statement of Licencing Policy (SoLP), where updated data can be provided to develop and review the Licencing objectives. Also, data used in two local tools - Alcohol Harm Dashboard and (in development) Alcohol Vulnerability Profile. Granularity of data has given the Licencing Team a better understanding of alcohol-related issues surrounding premises in Greenwich.

Unchanged: Processing activities, Expected output.

Objective for processing

The Health Episode Statistics (HES) Data accessed through the NHS Digital Portal will be used by the Local Authorities in fulfilment of its public health function, specifically to support and improve: