DSfC - 4 ICB's Comm - AQuA

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

Objective for processing

On 1 February 2023, NHS Digital merged with NHS England. NHS England has assumed responsibility for all activities previously undertaken by NHS Digital. The merger was completed by a statute change. Any reference made to NHS Digital within this Data Sharing Agreement is in reference to the merged organisation known as NHS England. [1 paragraph unchanged] The Health and Social Care Act 2022 has created 42 Integrated Care Boards (ICB). These are new legal entities which have replaced CCGs. The ICB will take on the NHS commissioning functions of CCGs as well as some of NHS England’s commissioning functions. It will also be accountable for NHS spend and performance within the system. Within each ICB geographical area, there will also be an Integrated Care Partnership (ICP), a joint committee which brings together the ICB and their partner local authorities, and other locally determined representatives (for example from health, social care, public health; and potentially others, such as social care or housing providers) to set local priorities and develop an integrated health and social care strategy. As a result of the 2022 ICB Transition, the number of Joint Data Controllers on this application has been reduced from 28 to 4. [44 paragraphs unchanged]

Processing activities

[1 paragraph unchanged] Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital. England All access to data is auditable by NHS Digital. England The Data Controller must keep a record of locations the data is [15 words unchanged] the number of processing and storage locations to prevent excessive processing. NHS Digital England may request a record of processing and storage locations at any time. [3 paragraphs unchanged] NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data). [14 paragraphs unchanged] Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital England guidance applicable to each data set. [37 paragraphs unchanged]

Changed only in punctuation, spacing or capitalisation: Benefits reported.

Unchanged: Expected output, Expected measurable benefits.

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

Objective for processing

On 1 February 2023, NHS Digital merged with NHS England. NHS England has assumed responsibility for all activities previously undertaken by NHS Digital. The merger was completed by a statute change. Any reference made to NHS Digital within this Data Sharing Agreement is in reference to the merged organisation known as NHS England. [1 paragraph unchanged] This larger group of CCGs act as a group of STP's (Sustainable Transformation Partnerships), all collaborating and supported by the North West Advancing Quality Programme. The Health and Social Care Act 2022 has created 42 Integrated Care Boards (ICB). These are new legal entities which have replaced CCGs. The ICB will take on the NHS commissioning functions of CCGs as well as some of NHS England’s commissioning functions. It will also be accountable for NHS spend and performance within the system. Within each ICB geographical area, there will also be an Integrated Care Partnership (ICP), a joint committee which brings together the ICB and their partner local authorities, and other locally determined representatives (for example from health, social care, public health; and potentially others, such as social care or housing providers) to set local priorities and develop an integrated health and social care strategy. The NHS and local councils have come together in 44 areas covering all of England to develop proposals to improve health and care. They have formed new partnerships – known as sustainability and transformation partnerships – to plan jointly for the next few years. As a result of the 2022 ICB Transition, the number of Joint Data Controllers on this application has been reduced from 28 to 4. Sustainability and transformation partnerships (STPs) build on collaborative work that began under the NHS Shared Planning Guidance for 2016/17 – 2020/21, to support implementation of the Five Year Forward View. They are supported by six national health and care bodies: NHS England; NHS Improvement; the Care Quality Commission (CQC); Health Education England (HEE); Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE). This group of ICB's act as a group of ICS's (Integrated Care Systems), all collaborating and supported by the North West Advancing Quality Programme. To ensure the patient is at the heart of care, the ICBs are focussing on where services are required across the geographical region. This ensures that the delivery of care is in the right place for patients that may move and change services across ICBs. The ICB's will work proactively and collaboratively with the other ICB's across the 4 ICS' to redesign services across boundaries to integrate services. Collaborative sharing is necessary for ICB's to understand these requirements. To ensure the patient is at the heart of care, the STP is focussing on where services are required across the geographical region. This ensures that the delivery of care is in the right place for patients that may move and change services across CCGs. The ICB's will use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the combined area. The CCGs will work proactively and collaboratively with the other CCGs in the STP to redesign services across boundaries to integrate services. Collaborative sharing is necessary for CCGs to understand these requirements. The ICB's commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers. The CCGs will use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the STP area. The CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers. As a result of the 2020 CCG Merger (4 CCGs merged into 1 NHS Cheshire CCG) the number of Joint Data Controllers on this application has been reduced from 31 to 28. The following CCGs are Joint Data Controllers and will receive data for the area of residence and registration for the CCGs listed: NHS Bolton CCG NHS Bury CCG NHS Cheshire CCG NHS Heywood, Middleton and Rochdale CCG NHS Manchester CCG NHS Oldham CCG NHS Salford CCG NHS Stockport CCG NHS Tameside & Glossop CCG NHS Trafford CCG NHS Wigan CCG NHS Halton CCG NHS Knowsley CCG NHS Liverpool CCG NHS South Sefton CCG NHS Southport & Formby CCG NHS St Helens CCG NHS Warrington CCG NHS Wirral CCG NHS Blackburn & Darwin CCG NHS Blackpool CCG NHS Chorley & South Ribble CCG NHS East Lancashire CCG NHS Fylde & Wyre CCG NHS Greater Preston CCG NHS Morecambe Bay CCG NHS West Lancashire CCG NHS North Cumbria CCG [6 paragraphs unchanged] -  Population health management: management • Understanding the interdependency of care services  Data Quality and Validation – allowing data quality checks on the submitted data • Targeting care more effectively  Thoroughly investigating the needs of the population, to inform the commissioning or appropriate services for that population’s health needs - Data Quality and Validation – allowing data quality checks on the submitted data  Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs - Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them  Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated - Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs  Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another - Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated  Service redesign - Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another  Health Needs Assessment – identification of disease prevalence within the local population - Service redesign - analysing Clinical Focus Areas (CFAs) across a large range of providers to discover and implement best practices.  Patient stratification and predictive modelling - to highlight cohorts of patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models - Health Needs Assessment – identification of underlying disease prevalence within the local population  Demand Management – ensuring enough capacity to manage the demand by predicting the impact on certain care pathways. - Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models  Support measuring the health and care needs of the total local population. The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.  Provide intelligence about the safety and effectiveness of medicines. Processing for commissioning will be conducted by NHS Arden and GEM Commissioning Support Unit, Salford Royal NHS Foundation Trust and Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England)  Allow analysis of patient pathways across healthcare and social care. Salford Royal NHS Foundation Trust in their capacity as Data Processor will, in addition, utilise internal teams as follows: The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the ICB area based on the full analysis of multiple pseudonymised datasets. Processing for commissioning will be conducted by NHS Arden and GEM Commissioning Support Unit, Northern Care Alliance NHS Foundation Trust and Greater Manchester Health and Social Care Partnership (Hosted by NHS Greater Manchester Integrated Care Board and NHS England) Northern Care Alliance NHS Foundation Trust in their capacity as Data Processor will, in addition, utilise internal teams as follows: [1 paragraph unchanged] Advancing Quality Alliance (AQuA) [a team within Salford Royal Northern Care Alliance NHS Foundation Trust] provide support for a range of quality improvement programmes across regions of CCGs, ICBs, (listed within the Data Sharing Agreement), undertaking analyses and producing aggregate reports for the CCGs. ICBs. AQuA includes the NW Advancing Quality (AQ) Programme, which was set up [36 words unchanged] conditions, orthopaedics (for example Hip and Knee replacement surgery) and respiratory conditions. The overarching aim of the AQ programme is to identify if specific treatment pathways commissioned by CCGs ICBs and delivered by the trusts are meeting recommended guidelines for quality, and through working with the trusts and CCGs, ICBs, improving the performance of the pathways and ensuring patients get the most appropriate treatment for their condition regardless of which hospital they are treated in. [6 paragraphs unchanged] Greater Manchester Health and Social Care Partnership (GMHSCP) (Hosted by NHS Greater Manchester CCG Integrated Care Board and NHS England) Providers are being supported to develop more consistent dataflows with dedicated resource, reducing burden with frequent ad-hoc requests for data or information both from the Region and STP. ICS. GHSCP GMHSCP are working across a range of projects to get sight of data from all trusts across the NW in unified online reports at NW and STP ICS level. GMHSCP is well placed to act in this role due to [25 words unchanged] apply those across the wider NW as well as providing NW-wide benchmarking. [1 paragraph unchanged] The NW Cancer Patient Tracking Lists (PTL) will provide oversight on the [59 words unchanged] this consistent view across the region would not easily be achieved by CCGs ICBs on their own. [3 paragraphs unchanged] NHS North Cumbria CCG is the only CCG that will not be a controller for this activity. [2 paragraphs unchanged]

Processing activities

Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital. PROCESSING CONDITIONS Data Processors must only act upon specific instructions from the Data Controller. Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital. All access to data is auditable by NHS Digital. Data can only be stored at the addresses listed under storage addresses. The Data Controller must keep a record of locations the data is processed and stored. These addresses must be within the UK. The Data Controller should minimise the number of processing and storage locations to prevent excessive processing. NHS Digital may request a record of processing and storage locations at any time. [1 paragraph unchanged] Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. Data may only be processed and held as long as is required to carry out the purposes listed within this agreement. NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data) Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be used for the purposes laid out in the application/agreement. NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data). The former CCG(s) has submitted their Data Security Protection Toolkit (DSPT) for 21/22. The ICB will submit their DSPT in line with the 22/23 submission timetable, and the ICB commits to abide by the former DSPT assessments submitted under those CCG(s); All data previously disseminated to the CCG(s) has been transferred to the ICB. The ICB has the responsibility for ensuring that any change in processor/locations/storage results in the appropriate data destruction. DATA PROCESSORS Data Processors must be listed in section 5b of this Data Sharing Agreement. These include Cloud and IT infrastructure providers. The Data Controller should ensure appropriate data processing agreements with all data processors contracted to undertaking work referenced within this agreement. NHS Midlands and Lancashire Commissioning Support Unit supply IT infrastructure for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. Microsoft Limited provide Cloud Services for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data Google UK Limited provide Cloud Services for Snowflake Computing U.K. Limited and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data Mersey Care NHS Foundation Trust and St Helens & Knowsley Hospital NHS Trust supply IT infrastructure for Cheshire and Merseyside Integrated Care Board and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. Bolton NHS Foundation Trust, Agilisys, Tameside and Glossop Integrated Care NHS Foundation Trust and Salford City Council supply IT infrastructure for NHS Greater Manchester Integrated Care Board and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. [1 paragraph unchanged] Patient level data will not be shared outside of the CCG unless it is for the purpose of Direct Care, where it may be shared only with those health professionals who have a legitimate relationship with the patient and a legitimate reason to access the data. Patient level data can only be shared outside the Data Controller / Processor in the following circumstances: • For the purpose of Direct Care, where it may be re-identified and shared only with those health or care. professionals who have a legitimate relationship with the patient and a legitimate reason to access the data. • Back to a provider to challenge data submissions. The data transferred to the provider is only that which relates directly to the data previously submitted by that particular provider. [4 paragraphs unchanged] All access to data is auditable by NHS Digital. COMMISSIONING Data Minimisation in relation to the data sets listed within section 3 are listed below. This also includes the purpose on which they would be applied - Datasets: For the purpose of Commissioning: • Secondary Uses Service (SUS+) • Patients that are normally registered and/or resident within the commissioner (including historical activity where the patient was previously registered or resident in another commissioner). • Local Provider Flows o Acute • Civil Registration Data (CRD) - Deaths Data Minimisation: • Activity for patients registered to GP practices within the responsibility of the ICB (Including historic activity where the patient may have been registered to another commissioner); and historical activity for patients previously registered to GP practices within the responsibility of the ICB or its predecessor organisations. [1 paragraph unchanged] • Patients treated by a provider where the commissioner is the host/co-ordinating commissioner and/or has the primary responsibility for the provider services in the local health economy – this only relates to both national and local flows. • Activity for patients resident in Output Areas located in the geographic boundary of the ICB (Including historic activity where the patient may have been resident in a different Output Area); and historical activity for patients previously resident in Output Areas located in the geographic boundary of the ICB or its predecessor organisations. [1 paragraph unchanged] • Activity identified by Patients under the care of a provider where ICB is the host/co-ordinating commissioner and/or has the primary responsibility for the provider services in the local health economy – this is only for commissioning and recorded as such within national systems (such as SUS+) as for the attention of the commissioner - this only relates to both national and local flows. This includes data that was previously under a different organisation name but has now merged into a new CCG (NHS Cheshire CCG). and/or Ilkeston Community Hospital (Part of Derbyshire Community Health Services NHS Foundation Trust) and Wrightington, Wigan and Leigh NHS Foundation Trust do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. • Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of ICB - this is only for commissioning and relates to both national and local flows. NHS Midlands and Lancashire Commissioning Support Unit supply IT infrastructure for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. and/or Microsoft Limited provide Cloud Services for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data • Patients under the care of a provider where ICB has joint responsibility for the provider services in the local health economy – this is only for Ambulance Trust data. Google UK Limited provide Cloud Services for Snowflake Computing U.K. Limited and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data Processing: Tameside and Glossop Integrated Care NHS Foundation Trust supply data storage infrastructure for Tameside CCG and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. 1. SUS, Acute - Local provider flows and Civil Registration - Deaths datasets are pseudonymised by the DSCRO using a non disclosed SALT key. Mersey Care NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.. This storage address is used by the following CCGs 2. Local patient identifiers are permitted to be included for the purpose of challenging data submissions with providers. - NHS Liverpool CCG 3. The pseudonymised datasets are securely transferred from the DSCRO to the Data Controller / Processor. - NHS South Sefton CCG 4. Data is processed for the purpose of commissioning as stipulated within this agreement. - NHS Southport & Formby CCG Processors: St Helens & Knowsley Hospital NHS Trust supply IT infrastructure and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.. This storage address is used by the following CCGs • NHS Arden and GEM Commissioning Support Unit - Knowsley CCG • Snowflake Computing U.K. Limited - Halton CCG • Greater Manchester Health and Social Care Partnership (GMHSCP) (Hosted by NHS Greater Manchester Integrated Care Board and NHS England) - Warrington CCG • AQua (Hosted by Northern Care Alliance NHS Foundation Trust) Bolton NHS Foundation Trust supply data storage infrastructure for Bolton CCG and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. DIRECT CARE Agilisys supply data storage infrastructure for Wigan CCG and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. The Re-identification process for direct care is as follows: Salford City Council supply data storage infrastructure for Salford CCG and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. 1. The ICB identifies a patient cohort to be re-identified for the purpose of direct care. The Data Controller and any Data Processor will only have access to records of patients of residence and registration within the CCGs as follows: 2. The ICB sends a re-id request to the DSCRO. This may be done through the ICB or CSU’s Business Intelligence (BI) Tool, or through a manual form. NHS Bolton CCG 3. The DSCRO assesses as to whether the request passes the specified re-identification process checks. Checks include if the requester is authorised to access identifiable data, if the number of patients in the cohort is appropriate, and that the request does not seem inappropriate or outside of expected parameters, including for example around timings and the requestor’s relationship with patients in the data. These checks are carried out either by DSCRO staff using pre-approved information (timing’s, requester’s identity etc) or via an automated system. NHS Bury CCG 4. For automated systems, steps 1 - 3 wouldn’t apply in most cases as it would be the direct care professional who identifies the cohort and as long as they are an approved re-id user and have gone through security checks initially, they will be able to re-id without further checks. NHS Cheshire CCG 5. If successful/approved, the DSCRO re-identifies the relevant data item(s) for the appropriate patients and returns the identifiable fields to Health or Care professional(s) with a legitimate relationship to the patient. The ICB does not see the identifiable record. NHS Heywood, Middleton and Rochdale CCG 6. DSCROs retain an audit trail of all re-id requests. NHS Manchester CCG NHS Oldham CCG NHS Salford CCG NHS Stockport CCG NHS Tameside & Glossop CCG NHS Trafford CCG NHS Wigan CCG NHS Halton CCG NHS Knowsley CCG NHS Liverpool CCG NHS South Sefton CCG NHS Southport & Formby CCG NHS St Helens CCG NHS Warrington CCG NHS Wirral CCG NHS Blackburn & Darwin CCG NHS Blackpool CCG NHS Chorley & South Ribble CCG NHS East Lancashire CCG NHS Fylde & Wyre CCG NHS Greater Preston CCG NHS Morecambe Bay CCG NHS West Lancashire CCG NHS North Cumbria CCG The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets: 1. SUS+ 2. Local Provider Flows (received directly from providers) a. Acute 3. Civil Registration Deaths Data Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows: NHS Arden and Gem Commissioning Support Unit and Advancing Quality Alliance (AQuA) 1. Pseudonymised SUS+, Civil Registration Deaths, and Local Provider acute data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. 2. Arden and Greater East Midlands Commissioning Support Unit add further derived fields and perform additional checks for data quality issues such as local duplication of records, or adjustments for known data recording issues, and prepare the data for further use. 3. Allowed linkage is between the data sets contained within point 1. 4. Arden and Greater East Midlands Commissioning Support Unit then pass the processed, pseudonymised and linked data to Salford Royal NHS Foundation Trust. 5. Salford Royal NHS Foundation Trust analyse the data to: a. See patient journeys for pathways or service design, re-design and de-commissioning. b. Check recorded activity against contracts or invoices and facilitate discussions with providers. c. Undertake population health management d. Undertake data quality and validation checks e. Thoroughly investigate the needs of the population f. Understand cohorts of residents who are at risk g. Conduct Health Needs Assessments 6. Data is accessed by the following team within Salford Royal NHS Foundation Trust: - Advancing Quality Alliance (AQuA) 7. Access is via team specific role-based access only and is specific to each team as: - Advancing Quality Alliance (AQuA) team members have access to SUS+, Civil Registration Deaths, and local provider flow data only. 8. Aggregation of the data will be completed by Arden and Greater East Midlands Commissioning Support Unit, or Advancing Quality Alliance (AQuA) within Salford Royal NHS Foundation Trust. 9. The processed data is transferred from Advancing Quality Alliance (AQuA) to the CCGs 10. Patient level data will not be shared outside of the CCGs and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England) 1. Pseudonymised Local Provider data (Acute) and SUS+ data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit 2. Arden and Greater East Midlands Commissioning Support Unit add derived fields and then transfer the data to Greater Manchester Health and Social Care Partnership 3. Greater Manchester Health and Social Care Partnership process the data and provide analysis 4. The data is then transferred to the data controllers (except for NHS North Cumbria CCG) 5. Patient level data will not be shared outside of the CCGs and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set. Snowflake Computing U.K. Limited Snowflake host a tool used by Greater Manchester Health and Social Care Partnership for dataset landing and structuring. This uses Google Cloud processing. There is no requirement for the analytical teams to re-identify patients, but in the cases of the development of risk stratification or other similar primary use tools, the data controllers may need the facility to provide identifiable results back to direct healthcare professionals or local authority direct care staff only for the purpose of direct care. All re-id requests will be processed and authorised by the DSCRO on a case by case basis. National data opt outs are not applied in these cases as they are for the purposes of direct care which follows the legal basis of implied consent. An example of a request for the re-id of patients for direct care may be; A&E High Attendance usage Practices can filter data to show for example the number of A&E attendances in a given period for each patient. The Practice would then look into these patients to review their care and try and reduce A&E attendances and/or sign post the patients to community services/MH Services. An outcome of this is earlier intervention in the patient(s) care thus potentially reducing future costs and minimising future risk. Risk Stratification-type re-IDs Practices can re-ID a list of patients with a high number of medications (ingredient count) and review the medication for these patients. This can help address the risk of polypharmacy which is recognised as an adverse risk factor for patient safety. A by-product of such reviews may be to reduce costs of medication.

Expected output

[5 paragraphs unchanged] 3) Monthly benchmarking reports using the collected local CFA data to evaluate [7 words unchanged] The purpose of this report is to allow the provider trusts and CCGs ICBs to see the percentage of the AQ population receiving each AQ measure within each trust and compare the performance to other participating trusts. [1 paragraph unchanged] 1. Commissioner reporting: 1. Commissioner reporting on providers, finances, readmission analysis etc… a. Summary by provider view - plan & actuals year to date (YTD). 2. Production of aggregate reports for ICB Business Intelligence. b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD. 3. Production of project / programme level dashboards. c. Summary by provider view - activity & finance variance by POD. 4. Monitoring of acute / community / mental health quality matrix. d. Planned care by provider view - activity & finance plan & actuals YTD. 5. Clinical coding reviews / audits. e. Planned care by POD view - activity plan & actuals YTD. 6. Budget reporting down to individual GP Practice level. f. Provider reporting. 7. GP Practice level dashboard reports. g. Statutory returns. 8. Comparators of ICB performance with similar ICBs as set out by a specific range of care quality and performance measures detailed activity and cost reports. h. Statutory returns - monthly activity return. 9. Data Quality and Validation measures allowing data quality checks on the submitted data. i. Statutory returns - quarterly activity return. 10. Contract Management and Modelling. j. Delayed discharges. 11. Patient Stratification dashboards to highlight cohorts of patients with similar conditions at risk. k. Quality & performance referral to treatment reporting. 12. Manage demand, by understanding the quantity of assessments required ICBs are able to improve the care service for patients by predicting the impact on certain care pathways and ensure the secondary care system has enough capacity to manage the demand. 2. Readmissions analysis. 13. Identify low priority procedures which could be directed to community-based alternatives and as such commission these services and deflect referrals for low priority procedures resulting in a reduction in hospital referrals. 3. Production of aggregate reports for CCG Business Intelligence. 14. Compare providers (trusts) mortality outcomes to the national baseline. 4. Production of project / programme level dashboards. 15. Identify medication prescribing trends and their effectiveness. 5. Monitoring of acute / community / mental health quality matrix. 16. Linking prescribing habits to entry points into the health and social care system. 6. Clinical coding reviews / audits. 17. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy). 7. Budget reporting down to individual GP Practice level. 18. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers. 8. GP Practice level dashboard reports. Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester ICB and NHS England) 9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports 10. Data Quality and Validation measures allowing data quality checks on the submitted data 11. Contract Management and Modelling 12. Patient Stratification, such as: o Patients at highest risk of admission o High cost activity uses (top 15%) o Frail and elderly o Patients that are currently in hospital o Patients with most referrals to secondary care o Patients with most emergency activity o Patients with most expensive prescriptions o Patients recently moving from one care setting to another i. Discharged from hospital ii. Discharged from community 13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services. 14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die. 15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support. 16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust. 17. Removal of patients from Risk Stratification reports. 18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity. Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England) [7 paragraphs unchanged]

Expected measurable benefits

[6 paragraphs unchanged] Ongoing benefits for the CCGs ICBs therefore include ensuring equitable standards of care for their patients. In addition, [49 words unchanged] networking and support underpinned by excellent data collection with regular robust reporting. [1 paragraph unchanged] a. Analysis to support full business cases. b. Develop business models. c. Monitor In year projects. [1 paragraph unchanged] 3. Health economic modelling using: to analyse provider performance and patient pathways. a. Analysis on provider performance against 18 weeks wait targets. b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients. c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway. d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC). [1 paragraph unchanged] 5. Enables monitoring of: 5. Enables monitoring of commissioned services to ensure they are performing as expected. a. CCG outcome indicators. 6. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to identify priorities and identify commissioning plans to address these (pathways would be designed by service providers within the ICS with input from appropriate stakeholders including patient and public representation). b. Financial and Non-financial validation of activity. 7. Reduced emergency readmissions, especially avoidable emergency admissions leading to improved quality of services. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care. c. Successful delivery of integrated care within the CCG. 8. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required. d. Checking frequent or multiple attendances to improve early intervention and avoid admissions. 9. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the ICB Outcome Framework. e. Case management. 10. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics. f. Care service planning. 11. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts. g. Commissioning and performance management. 12. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities. h. List size verification by GP practices. 13. Providing greater understanding of the underlying causes and look to commission improved supportive networks, this would be ongoing work which would be continually assessed. i. Understanding the care of patients in nursing homes. 14. Insight to understand the numerous factors that play a role in the outcome for patients in all datasets. The linkage allows the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice. 6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers. 15. Provision of indicators of health problems, and patterns of risk within the commissioning region. 7. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these. 16. Support of benchmarking for evaluating progress in future years. 8. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care. 17. Assists commissioners to make better decisions to support patients and drive changes in health care. 9. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required. 18. Allows comparisons of providers performance to assist improvement in services – increase the quality. 10. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework. 19. Allow analysis of health care provision to be completed to support the needs of the health profile of the population within the ICB area based on the full analysis of multiple pseudonymised datasets. 11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics. 20. To evaluate the impact of new services and innovations (e.g. if commissioners implement a new service or type of procedure with a provider, they can evaluate whether it improves outcomes for patients compared to the previous one). 12. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts 13. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities. 14. Providing greater understanding of the underlying courses and look to commission improved supportive networks, this would be ongoing work which would be continually assessed. 15. Insight to understand the numerous factors that play a role in the outcome for both datasets. The linkage will allow the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice. 16. Provision of indicators of health problems, and patterns of risk within the commissioning region. 17. Support of benchmarking for evaluating progress in future years.

Benefits reported

[4 paragraphs unchanged] --- [2 paragraphs unchanged]

Applicant organisation: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Organisation type: renamed from Sub ICB Location to ICB - Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Cheshire and Merseyside ICB to NHS Cheshire and Merseyside Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Greater Manchester ICB to NHS Greater Manchester Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS Lancashire and South Cumbria ICB to NHS Lancashire and South Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

Data controllers: renamed from NHS North East and North Cumbria ICB to NHS North East and North Cumbria Integrated Care Board. The same organisation under a new name, so not counted as a change.

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

Objective for processing

[1 paragraph unchanged] This larger group of CCG's CCGs act as a group of STP's (Sustainable Transformation Partnerships), all collaborating and supported by the North West Advancing Quality Programme. [2 paragraphs unchanged] To ensure the patient is at the heart of care, the STP [13 words unchanged] that the delivery of care is in the right place for patients who that may move and change services across CCGs. [3 paragraphs unchanged] As a result of the 2020 CCG Merger (4 CCGs merged into 1 NHS Cheshire CCG) the number of Joint Data Controllers on this application has been reduced from 31 to 28. [38 paragraphs unchanged] • Using value as the redesign principle [5 paragraphs unchanged] - Service redesign - Service redesign - analysing Clinical Focus Areas (CFAs) across a large range of providers to discover and implement best practices. [3 paragraphs unchanged] Processing for commissioning will be conducted by NHS Arden and GEM Commissioning Support Unit Unit, Salford Royal NHS Foundation Trust and Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England) [1 paragraph unchanged] AQuA [2 paragraphs unchanged] AQuA runs a series of programmes to support improvement in the quality of patient care across a range of clinical focus areas including sepsis care, hip fracture and COPD. The programme develops a quality framework for each clinical focus area, incorporating clinical engagement, national guidelines and best practice standards. [5 paragraphs unchanged] Greater Manchester Health and Social Care Partnership (GMHSCP) (Hosted by NHS Manchester CCG and NHS England) Providers are being supported to develop more consistent dataflows with dedicated resource, reducing burden with frequent ad-hoc requests for data or information both from the Region and STP. GHSCP are working across a range of projects to get sight of data from all trusts across the NW in unified online reports at NW and STP level. GMHSCP is well placed to act in this role due to the existing GM-wide reports typically collected from the GM providers. The NW-wide work aims to capture the benefits already gained at a GM level and apply those across the wider NW as well as providing NW-wide benchmarking. Specific projects include; The NW Cancer Patient Tracking Lists (PTL) will provide oversight on the safety netting mechanisms deployed, backlogs and the number of patients awaiting diagnostics and assessment. Providing daily information will help provide the best care possible for patients during this challenging time, and in the months to come during COVID recovery. As cancer pathways generally span more than one provider, and with The Christie being the regional centre of excellence, expanding this consistent view across the region would not easily be achieved by CCGs on their own. NW Urgent and Emergency Care – Both as part of recovery from covid and a bid to ensure patient care across multiple providers is of high quality as we direct patients away from A&E’s towards more community led care it is vital to observe these patient flows. Joining up the data from 111 / 999, clinical assessment services and A&E is the only way to observe how patients are flowing through the complex urgent care system. In a bid for both consistency and efficiency across the NW a standard collection of data from all CAS and ambulance providers has been developed, against the Greater Manchester work so far, therefore best placed to support this work. One direct example of this is in suicide prevention, knowing self-harm is an early warning of suicide and are currently unable to observe repeat calls which increase the risk again. By joining up the data we reduce the risk of missing cross provider contacts and can arrange our preventative offer to reduce escalation of self-harm to suicide. This work is one of a number of work steams across the region where this work is supported with a working group. GMHSCP will utilise Snowflake Computing U.K. Limited who provide an advanced tool for landing and structuring of the datasets. NHS North Cumbria CCG is the only CCG that will not be a controller for this activity. NHS Arden and GEM Commissioning Support Unit Arden and GEM add derived fields and perform additional checks for data quality issues such as local duplication of records, or adjustments for known data recording issues, and prepare the data for further use.

Processing activities

[15 paragraphs unchanged] • Patients who that are normally registered and/or resident within the commissioner (including historical activity where the patient was previously registered or resident in another commissioner). [5 paragraphs unchanged] For clarity, any access by Ilkeston Community Hospital (Part of Derbyshire Community Health Services NHS Foundation Trust) and Wrightington, Wigan and Leigh NHS Foundation Trust do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. [1 paragraph unchanged] Microsoft Limited provide Cloud Services for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data Google UK Limited provide Cloud Services for Snowflake Computing U.K. Limited and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data [1 paragraph unchanged] Mersey Care NHS Foundation Trust supply IT infrastructure and are therefore listed [40 words unchanged] database[s] containing the data.. This storage address is used by the following CCG's CCGs [3 paragraphs unchanged] St Helens & Knowsley Hospital NHS Trust supply IT infrastructure and are [42 words unchanged] database[s] containing the data.. This storage address is used by the following CCG's CCGs [5 paragraphs unchanged] Salford City Council supply data storage infrastructure for Salford CCG and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database(s) containing the data. [35 paragraphs unchanged] 1. Pseudonymised SUS+, Civil Registration Deaths, and Local Provider data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. NHS Arden and Gem Commissioning Support Unit and Advancing Quality Alliance (AQuA) 1. Pseudonymised SUS+, Civil Registration Deaths, and Local Provider acute data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. [15 paragraphs unchanged] 8. Aggregation of the data will be completed by Arden and Greater East Midlands Commissioning Support Unit, or (Advancing Advancing Quality Alliance (AQuA) within Salford Royal NHS Foundation Trust. 9. Patient level data will not be shared outside of (Advancing Quality Alliance (AQuA) within Salford Royal NHS Foundation Trust and will only be shared within the individual teams on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. 9. The processed data is transferred from Advancing Quality Alliance (AQuA) to the CCGs 10. Patient level data will not be shared outside of the CCGs and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England) 1. Pseudonymised Local Provider data (Acute) and SUS+ data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit 2. Arden and Greater East Midlands Commissioning Support Unit add derived fields and then transfer the data to Greater Manchester Health and Social Care Partnership 3. Greater Manchester Health and Social Care Partnership process the data and provide analysis 4. The data is then transferred to the data controllers (except for NHS North Cumbria CCG) 5. Patient level data will not be shared outside of the CCGs and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set. Snowflake Computing U.K. Limited Snowflake host a tool used by Greater Manchester Health and Social Care Partnership for dataset landing and structuring. This uses Google Cloud processing. There is no requirement for the analytical teams to re-identify patients, but in the cases of the development of risk stratification or other similar primary use tools, the data controllers may need the facility to provide identifiable results back to direct healthcare professionals or local authority direct care staff only for the purpose of direct care. All re-id requests will be processed and authorised by the DSCRO on a case by case basis. National data opt outs are not applied in these cases as they are for the purposes of direct care which follows the legal basis of implied consent. An example of a request for the re-id of patients for direct care may be; A&E High Attendance usage Practices can filter data to show for example the number of A&E attendances in a given period for each patient. The Practice would then look into these patients to review their care and try and reduce A&E attendances and/or sign post the patients to community services/MH Services. An outcome of this is earlier intervention in the patient(s) care thus potentially reducing future costs and minimising future risk. Risk Stratification-type re-IDs Practices can re-ID a list of patients with a high number of medications (ingredient count) and review the medication for these patients. This can help address the risk of polypharmacy which is recognised as an adverse risk factor for patient safety. A by-product of such reviews may be to reduce costs of medication.

Expected output

[46 paragraphs unchanged] Greater Manchester Health and Social Care Partnership (Hosted by NHS Manchester CCG and NHS England) This data will be used to develop dashboards that will help the commissioners gain sight of all cancer patients awaiting diagnosis or treatment across the NW footprint so that patient care and clinical capacity can be managed efficiently. This data will drive performance reporting and long-term planning to optimise cancer services across the NW. • Clinical Prioritisation o Essential for managing treatment capacity, especially during the COVID-19 pandemic. • Delay Reason o Essential for understanding where and when patients have been delayed, or even suspended, within their cancer pathway. • Alternative Treatment o Essential for understanding how treatment has been impacted by COVID-19.

Benefits reported

[1 paragraph unchanged] The effectiveness of the programme and benefits to patients is well documented - see below for examples of two papers focussed on reduced mortality (2012 and 2020 respectively). https://www.nejm.org/doi/pdf/10.1056/nejmsa1114951 https://onlinelibrary.wiley.com/doi/full/10.1111/apt.15781 --- It is recognised that many of the benefits may be achieved in the early stages of implementing the AQ programme in each clinical focus area (CFA) and once the programme is more established in that CFA, the benefits become more established as good practice becomes more embedded. Therefore, the list of CFAs does not remain fixed but CFAs may be retired, or new ones introduced in areas that would benefit. Most recently Advancing Quality introduced a formal measure set for Hospital Acquired Pneumonia and introduced this in 2020 as a new CFA.

Unchanged: Expected measurable benefits.

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

Objective for processing

[1 paragraph unchanged] To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the North West region, detailed within the data minimisation. This larger group of CCG's act as a group of STP's (Sustainable Transformation Partnerships), all collaborating and supported by the North West Advancing Quality Programme. The NHS and local councils have come together in 44 areas covering all of England to develop proposals to improve health and care. They have formed new partnerships – known as sustainability and transformation partnerships – to plan jointly for the next few years. Sustainability and transformation partnerships (STPs) build on collaborative work that began under the NHS Shared Planning Guidance for 2016/17 – 2020/21, to support implementation of the Five Year Forward View. They are supported by six national health and care bodies: NHS England; NHS Improvement; the Care Quality Commission (CQC); Health Education England (HEE); Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE). To ensure the patient is at the heart of care, the STP is focussing on where services are required across the geographical region. This ensures that the delivery of care is in the right place for patients who may move and change services across CCGs. The CCGs will work proactively and collaboratively with the other CCGs in the STP to redesign services across boundaries to integrate services. Collaborative sharing is necessary for CCGs to understand these requirements. The CCGs will use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the STP area. The CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers. The following CCGs are Joint Data Controllers and will receive data for the area of residence and registration for the CCGs listed: NHS Bolton CCG NHS Bury CCG NHS Cheshire CCG NHS Heywood, Middleton and Rochdale CCG NHS Manchester CCG NHS Oldham CCG NHS Salford CCG NHS Stockport CCG NHS Tameside & Glossop CCG NHS Trafford CCG NHS Wigan CCG NHS Halton CCG NHS Knowsley CCG NHS Liverpool CCG NHS South Sefton CCG NHS Southport & Formby CCG NHS St Helens CCG NHS Warrington CCG NHS Wirral CCG NHS Blackburn & Darwin CCG NHS Blackpool CCG NHS Chorley & South Ribble CCG NHS East Lancashire CCG NHS Fylde & Wyre CCG NHS Greater Preston CCG NHS Morecambe Bay CCG NHS West Lancashire CCG NHS North Cumbria CCG [10 paragraphs unchanged] • Ensuring we do what we should [8 paragraphs unchanged] Processing for commissioning will be conducted by Arden and GEM Commissioning Support Unit The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets. Processing for commissioning will be conducted by NHS Arden and GEM Commissioning Support Unit [1 paragraph unchanged] Advancing Quality Alliance (AQuA) [a team within Salford Royal NHS Foundation Trust] provide support for a range of quality improvement programmes across regions of [64 words unchanged] conditions, orthopaedics (for example Hip and Knee replacement surgery) and respiratory conditions. [5 paragraphs unchanged] o Civil Registration Deaths (CRD)

Processing activities

[20 paragraphs unchanged] This includes data that was previously under a different organisation name but has now merged into a new CCG (NHS Cheshire CCG). [3 paragraphs unchanged] Mersey Care NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.. This storage address is used by the following CCG's - NHS Liverpool CCG - NHS South Sefton CCG - NHS Southport & Formby CCG St Helens & Knowsley Hospital NHS Trust supply IT infrastructure and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.. This storage address is used by the following CCG's - Knowsley CCG - Halton CCG - Warrington CCG [5 paragraphs unchanged] NHS Cheshire CCG [8 paragraphs unchanged] NHS Eastern Cheshire CCG [3 paragraphs unchanged] NHS South Cheshire CCG [3 paragraphs unchanged] NHS Vale Royal CCG [1 paragraph unchanged] NHS West Cheshire CCG [14 paragraphs unchanged] 3. Civil Registration Deaths Data [1 paragraph unchanged] 1. Pseudonymised SUS+ SUS+, Civil Registration Deaths, and Local Provider data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit. [14 paragraphs unchanged] - Advancing Quality Alliance (AQuA) team members have access to SUS+ SUS+, Civil Registration Deaths, and local provider flow data only. [2 paragraphs unchanged]

Expected output

[25 paragraphs unchanged] 8. GP Practice level dashboard reports include high flyers. reports. [5 paragraphs unchanged] o Most expensive patients High cost activity uses (top 15%) [14 paragraphs unchanged]

Benefits reported

The expected benefits have all been yielded. There is robust evidence that the impact of the this work has a very positive impact on reducing mortality.

Unchanged: Expected measurable benefits.