UHB SHMI Data Application

The primary aim of this application is to support the production/analysis of statistics using Summary Hospital Mortality Indicator (SHMI) data solely to help the NHS perform its duties. The SHMI data requested is pseudonymised.

SHMI data will be used to look at outcomes analysis and form analytical overviews relating to post discharge mortality. Such overviews relate to standardised post discharge mortality monitoring within distinct clinical cohorts monitoring. This work will increase the understanding of complete pathways of care since SHMI data shows which patients died following discharge from hospital.

NHS organisations are required to provide clinical quality and patient safety assurance within their organisation. The SHMI is a nationally recognised model to detect areas where mortality appears higher than expected. This variation could be due to a number of reasons, which is why further investigation is warranted, to ensure clinical care is being delivered safely and effectively.

Healthcare Evaluation Data (HED) is a web-based system delivering information which enables healthcare organisations to drive clinical performance in order to improve patient care and deliver financial savings. The output of analytics available to NHS organisations using the HED system enable NHS clinicians and managers to increase understanding of patient outcomes and identify areas for improvement and best practice. The HED analytics suite allows healthcare organisations to examine manipulated SHMI data for the sole purpose of helping the NHS perform its duties. The monthly SHMI data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation. HED provides an analytical tool that assists organisations to understand and interpret the SHMI model – i.e. providing standardised mortality figures broken down by a number of areas i.e. specific time periods, diagnoses, specialties, age groups etc. SHMI covers all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.

While non-NHS Organisations can subscribe to HED tool analysis produced using SHMI, data will not be made available to non-NHS organisations. The objective is to provide quality care benchmarking analysis that will enable NHS organisations to deliver better services for patients.

The purpose of this Agreement falls under Article 6 (1) (e) of the GDPR and the lawful basis for using information collected routinely for administrative purposes for research is the ‘public task’. The application also falls under Article 9 (2) (i), as processing is necessary for reasons of public interest in public health, such as ensuring high standards of quality and safety of health care. The data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation.

University Hospitals Birmingham NHS Foundation Trust (UHB) is the sole data controller who process the data for the purposes described in this Agreement. No other organisations have access to NHS Digital data.

The SHMI data is to be reported within the HED (Healthcare Evaluation Data) System. The HED system is designed to deliver intelligence to enable healthcare organisations to drive clinical performance improvement and financial savings. The scope of the data requested is for use within the SHMI mortality reporting section of HED. The data requested in this Data Sharing Agreement (DSA) is that which underpins NHS Digital’s national mortality figures. National SHMI reporting covers a rolling three years each month and includes the data subjects as defined in NHS Digital’s SHMI methodology which is publicly available. UHB request monthly disseminations of patient level data across the fields used to calculate and report national SHMI statistics. There is no alternative, less intrusive ways of analysing the SHMI at a granular level. To replicate accessible transparent nationally published figures requires using an identical source from NHS Digital. To address the GDPR Principle of Data Minimisation the SHMI dataset requested via this method has been minimised so no patient identifiable fields are received.

The sole outputs are analytics designed to assist the NHS in interrogating and deriving understanding from the SHMI. Where appropriate this will include the ability to support the identification of areas of care appropriate for clinical case note review.

Such outputs are solely provided either via:

• a Module made available within the HED system, or

• aggregate small number censored reports

Within the HED system:

The module can contain aggregate-level information and low-level information. The level of data that can be viewed within a module depends on the access level of the named individual user and which organisation they are working for. As such, access to low-level information, including small numbers, is strictly controlled in line with the access controls outlined in the above section on ‘Processing activities’. This means that Hospitals will only have access to low-level information for their own data, and aggregated data with small numbers supressed for other organisations.

Outputs are to be used solely for the purpose of assisting the NHS.

Outputs will be used by NHS Clinicians and Managers to:

• Assure and manage clinical quality and patient safety within NHS Organisations

• Identify trends requiring a clinical review of patient pathways

• Increase the understanding of patient outcomes

• Identify potential areas for improvement in clinical quality or operational efficiency either within a Hospital or a local healthcare economy

• Identify areas of best practice either within hospital Trusts or local healthcare economies

• Examine long term trends in treatment outcomes via Variable Life Adjusted Display charts.

All of the above will serve to increase the understanding of patient outcomes in regard to quality, safety, productivity and efficiency benchmarking within the NHS.

HED users may produce reports, presentations etc. to communicate the findings within the SHMI to internal colleagues, however University Hospitals Birmingham NHS Foundation Trust do not actively track such outputs.

It is not appropriate to set a target date for this work as the work streams are ongoing and the outputs already form part of various NHS organisations’ routine reporting and governance assurance processes.

The yielded benefit of HED is the continual feedback process to trusts that, through benchmarking, enables best practice, clinical excellence, efficiency and financial savings. Most outcomes are intertwined with other ongoing hospital monitoring programmes and initiatives.

In a recent HED User Group Conference, all users agreed that access to a range of mortality measures within HED, including the SHMI, is useful for internal trust-wide and board reporting. As a further example of reliance by NHS Organisations, HED users ask for an extremely quick turnaround of the SHMI data following NHS Digital publishing the official figures

An Acute Trust in the North West region highlighted the yielded benefits of the NHS Digital SHMI data within HED: “ For instance you will be able to view SHMI values per Trust and Diagnostic groups but in HED you can delve deeper into treatment specialties for these diagnostic groups, filter by specific patient demographics, admission details and then even further for OPCS4 codes (procedures) and Charlson co-morbidity scores. By using these filters HED produces interactive charts to use for reporting too so although the base data is the same, the level of detailed analysis is much greater.”

The most recent yielded benefits are similar each time as they relate to supporting on-going processes. There are no additional benefits that have been yielded that are not already stated.

The primary aim of this application is to support the production/analysis of statistics using Summary Hospital Mortality Indicator (SHMI) data solely to help the NHS perform its duties.

SHMI data will be used to look at outcomes analysis and form analytical overviews relating to post discharge mortality. Such overviews relate to standardised post discharge mortality monitoring within distinct clinical cohorts monitoring. This work will increase the understanding of complete pathways of care since SHMI data shows which patients died following discharge from hospital.

NHS organisations are required to provide clinical quality and patient safety assurance within their organisation. The SHMI is a nationally recognised model to detect areas where mortality appears higher than expected. This variation could be due to a number of reasons, which is why further investigation is warranted, to ensure clinical care is being delivered safely and effectively.

Healthcare Evaluation Data (HED) is a web-based system delivering information which enables healthcare organisations to drive clinical performance in order to improve patient care and deliver financial savings. The output of analytics available to NHS organisations using the HED system enable NHS clinicians and managers to increase understanding of patient outcomes and identify areas for improvement and best practice. The HED analytics suite allows healthcare organisations to examine manipulated SHMI data for the sole purpose of helping the NHS perform its duties. The monthly SHMI data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation. HED provides an analytical tool that assists organisations to understand and interpret the SHMI model – i.e. providing standardised mortality figures broken down by a number of areas i.e. specific time periods, diagnoses, specialties, age groups etc. SHMI covers all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.

While non-NHS Organisations can subscribe to HED tool analysis produced using SHMI data will not be made available to non-NHS organisations. The objective is to provide quality care benchmarking analysis that will enable NHS organisations to deliver better services for patients.

The purpose of this application falls under Article 6 (1) (e) of the GDPR and the lawful basis for using information collected routinely for administrative purposes for research is the ‘public task’. The application also falls under Article 9 (2) (i), as processing is necessary for reasons of public interest in public health, such as ensuring high standards of quality and safety of health care. The data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation.

University Hospitals Birmingham NHS Foundation Trust is the sole data controller who process the data for the purposes described in this Agreement. No other organisations have access to NHS Digital data.

The SHMI data is to be reported within the HED (Healthcare Evaluation Data) System. The HED system is designed to deliver intelligence to enable healthcare organisations to drive clinical performance improvement and financial savings. The scope of the data requested is for use within the SHMI mortality reporting section of HED. The data requested in this DSA is that which underpins NHS Digital’s national mortality figures. National SHMI reporting covers a rolling three years each month and includes the data subjects as defined in NHS Digital’s SHMI methodology which is publicly available. UHB request monthly disseminations of patient level data across the fields used to calculate and report national SHMI statistics. There is no alternative, less intrusive ways of analysing the SHMI at a granular level. To replicate accessible transparent nationally published figures requires using an identical source from NHS Digital. To address the GDPR Principle of Data Minimisation the SHMI dataset requested via this method has been minimised so no patient identifiable fields are received.

The sole outputs are analytics designed to assist the NHS in interrogating and deriving understanding from the SHMI. Where appropriate this will include the ability to support the identification of areas of care appropriate for clinical case note review.

Such outputs are solely provided either via:

• a Module made available within the HED system, or

• aggregate small number censored reports

Within the HED system:

The module can contain aggregate-level information and low-level information. The level of data that can be viewed within a module depends on the access level of the named individual user and which organisation they are working for. As such, access to low-level information, including small numbers, is strictly controlled in line with the access controls outlined in the above section on ‘Processing activities’. This means that Hospitals will only have access to low-level information for their own data, and aggregated data with small numbers supressed for other organisations.

Outputs are to be used solely for the purpose of assisting the NHS.

Outputs will be used by NHS Clinicians and Managers to:

• Assure and manage clinical quality and patient safety within NHS Organisations

• Identify trends requiring a clinical review of patient pathways

• Increase the understanding of patient outcomes

• Identify potential areas for improvement in clinical quality or operational efficiency either within a Hospital or a local healthcare economy

• Identify areas of best practice either within hospital Trusts or local healthcare economies

• Examine long term trends in treatment outcomes via Variable Life Adjusted Display charts.

All of the above will serve to increase the understanding of patient outcomes in regard to quality, safety, productivity and efficiency benchmarking within the NHS.

HED users may produce reports, presentations etc. to communicate the findings within the SHMI to internal colleagues, however University Hospitals Birmingham NHS Foundation Trust do not actively track such outputs.

It is not appropriate to set a target date for this work as the work streams are ongoing and the outputs already form part of various NHS organisations’ routine reporting and governance assurance processes.

The yielded benefit of HED is the continual feedback process to trusts that, through benchmarking, enables best practice, clinical excellence, efficiency and financial savings. Most outcomes are intertwined with other ongoing hospital monitoring programmes and initiatives.

In a recent HED User Group Conference, all users agreed that access to a range of mortality measures within HED, including the SHMI, is useful for internal trust-wide and board reporting. As a further example of reliance by NHS Organisations, HED users ask for an extremely quick turnaround of the SHMI data following NHS Digital publishing the official figures

An Acute Trust in the North West region highlighted the yielded benefits of the NHS Digital SHMI data within HED: “ For instance you will be able to view SHMI values per Trust and Diagnostic groups but in HED you can delve deeper into treatment specialties for these diagnostic groups, filter by specific patient demographics, admission details and then even further for OPCS4 codes (procedures) and Charlson co-morbidity scores. By using these filters HED produces interactive charts to use for reporting too so although the base data is the same, the level of detailed analysis is much greater.”

To produce/analyse statistics using births/deaths data solely to help the NHS perform its duties.

Summary Hospital Mortality Indicator (SHMI) data will be used to look at outcomes analysis and form analytical overviews relating to post discharge mortality. Such overviews relate to standardised post discharge mortality monitoring within distinct clinical cohorts and bespoke long term survival monitoring. This work will increase the understanding of complete pathways of care since SHMI data shows which patients died following discharge from hospital. Any analysis produced using SHMI data will not be made available to non-NHS organisations. The objective is to provide quality care benchmarking analysis that will enable NHS organisations to deliver better services for patients.

NHS organisations are required to provide clinical quality and patient safety assurance within their organisation. The SHMI is a nationally recognised model to detect areas where mortality appears higher than expected. This variation could be due to a number of reasons, which is why further investigation is warranted, to ensure clinical care is being delivered safely and effectively.

Healthcare Evaluation Data (HED) is a web-based system delivering information which enables healthcare organisations to drive clinical performance in order to improve patient care and deliver financial savings. The output of analytics available to NHS organisations using the HED system enable NHS clinicians and managers to increase understanding of patient outcomes and identify areas for improvement and best practice. The HED analytics suite allows healthcare organisations to examine SHMI data for the sole purpose of helping the NHS perform its duties. The monthly SHMI data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation. HED provides an analytical tool that assists organisations to understand and interpret the SHMI model – i.e. providing standardised mortality figures broken down by a number of areas i.e. specific time periods, diagnoses, specialties, age groups etc. SHMI covers all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.

University Hospitals Birmingham NHS Foundation Trust are requesting to change the current data receipt frequency from quarterly to monthly as in recent months the national modelling and reporting timeframes have changed similarly from quarterly to monthly for the SHMI. Additionally, the request for further fields reflects the methodological changes made to the indicator by NHS Digital.

The purpose of this application falls under Article 6 (1) (e) of the GDPR and the lawful basis for using information collected routinely for administrative purposes for research is the ‘public task’. The application also falls under Article 9 (2) (i), as processing is necessary for reasons of public interest in the area of public health, such as ensuring high standards of quality and safety of health care. The data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation.

The sole outputs are analytics designed to assist the NHS in interrogating and deriving understanding from the SHMI indicator. Where appropriate this will include the ability to support the identification of areas of care appropriate for clinical case note review.

Such outputs are solely provided either via:

• a Module made available within the HED system, or

• aggregate small number censored reports

Within the HED system:

The module can contain aggregate-level information and low-level information. The level of data that can be viewed within a module depends on the access level of the named individual user and which organisation they are working for. As such, access to low-level information, including small numbers, is strictly controlled in line with the access controls outlined in the above section on ‘Processing activities’. This means that Hospitals will only have access to low-level information for their own data.

Outputs are to be used solely for the purpose of assisting the NHS.

Outputs will be used by NHS Clinicians and Managers to:

• Assure and manage clinical quality and patient safety within NHS Organisations

• Identify trends requiring a clinical review of patient pathways. (Hospital-based users with Caldicott approval are able to investigate metrics and ‘drill-down’ to patient-level information, including local patient identifiers, in order to conduct clinical case note review and route cause analysis)

• Increase the understanding of patient outcomes

• Identify potential areas for improvement in clinical quality or operational efficiency either within a Hospital or a local healthcare economy

• Identify areas of best practice either within hospital Trusts or local healthcare economies

All of the above will serve to increase the understanding of patient outcomes in regard to quality, safety, productivity and efficiency benchmarking within the NHS.

It is not appropriate to set a target date for this work as the work streams are ongoing and the outputs already form part of various NHS organisations’ routine reporting and governance assurance processes.

Within the module NHS hospitals are able to quickly identify areas of potential concern relating to mortality within their organisation. Such areas are then investigated further. When appropriate & authorised, the ability to identify a cohort of patients within the organisations and undertake appropriate clinical case note review is invaluable as a part of ensuring good hospital governance.

This process is used by hospitals up and down the country. Without using the data sets being requested it would be impossible to deliver this benefit to the NHS. This would have a significant impact on a sizeable number of NHS Hospitals across the country.

To produce/analyse statistics using births/deaths data solely to help the NHS perform its duties.

Summary Hospital Mortality Indicator (SHMI) data will be used to look at outcomes analysis and form analytical overviews relating to post discharge mortality. Such overviews relate to standardised post discharge mortality monitoring within distinct clinical cohorts and bespoke long term survival monitoring. This work will increase the understanding of complete pathways of care since SHMI data shows which patients died following discharge from hospital. Any analysis produced using SHMI data will not be made available to non-NHS organisations. The objective is to provide quality care benchmarking analysis that will enable NHS organisations to deliver better services for patients.

NHS organisations are required to provide clinical quality and patient safety assurance within their organisation. The SHMI is a nationally recognised model to detect areas where mortality appears higher than expected. This variation could be due to a number of reasons, which is why further investigation is warranted, to ensure clinical care is being delivered safely and effectively.

Healthcare Evaluation Data (HED) is a web-based system delivering information which enables healthcare organisations to drive clinical performance in order to improve patient care and deliver financial savings. The output of analytics available to NHS organisations using the HED system enable NHS clinicians and managers to increase understanding of patient outcomes and identify areas for improvement and best practice. The HED analytics suite allows healthcare organisations to examine SHMI data for the sole purpose of helping the NHS perform its duties. The monthly SHMI data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation. HED provides an analytical tool that assists organisations to understand and interpret the SHMI model – i.e. providing standardised mortality figures broken down by a number of areas i.e. specific time periods, diagnoses, specialties, age groups etc. SHMI covers all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.

University Hospitals Birmingham NHS Foundation Trust are requesting to change the current data receipt frequency from quarterly to monthly as in recent months the national modelling and reporting timeframes have changed similarly from quarterly to monthly for the SHMI. Additionally, the request for further fields reflects the methodological changes made to the indicator by NHS Digital.

The purpose of this application falls under Article 6 (1) (e) of the GDPR and the lawful basis for using information collected routinely for administrative purposes for research is the ‘public task’. The application also falls under Article 9 (2) (i), as processing is necessary for reasons of public interest in the area of public health, such as ensuring high standards of quality and safety of health care. The data is required to enable NHS organisations to quickly identify and act on areas of potential concern relating to mortality within their organisation.

The sole outputs are analytics designed to assist the NHS in interrogating and deriving understanding from the SHMI indicator. Where appropriate this will include the ability to support the identification of areas of care appropriate for clinical case note review.

Such outputs are solely provided either via:

• a Module made available within the HED system, or

• aggregate small number censored reports

Within the HED system:

The module can contain aggregate-level information and low-level information. The level of data that can be viewed within a module depends on the access level of the named individual user and which organisation they are working for. As such, access to low-level information, including small numbers, is strictly controlled in line with the access controls outlined in the above section on ‘Processing activities’. This means that Hospitals will only have access to low-level information for their own data.

Outputs are to be used solely for the purpose of assisting the NHS.

Outputs will be used by NHS Clinicians and Managers to:

• Assure and manage clinical quality and patient safety within NHS Organisations

• Identify trends requiring a clinical review of patient pathways. (Hospital-based users with Caldicott approval are able to investigate metrics and ‘drill-down’ to patient-level information, including local patient identifiers, in order to conduct clinical case note review and route cause analysis)

• Increase the understanding of patient outcomes

• Identify potential areas for improvement in clinical quality or operational efficiency either within a Hospital or a local healthcare economy

• Identify areas of best practice either within hospital Trusts or local healthcare economies

All of the above will serve to increase the understanding of patient outcomes in regard to quality, safety, productivity and efficiency benchmarking within the NHS.

It is not appropriate to set a target date for this work as the work streams are ongoing and the outputs already form part of various NHS organisations’ routine reporting and governance assurance processes.

Within the module NHS hospitals are able to quickly identify areas of potential concern relating to mortality within their organisation. Such areas are then investigated further. When appropriate & authorised, the ability to identify a cohort of patients within the organisations and undertake appropriate clinical case note review is invaluable as a part of ensuring good hospital governance.

This process is used by hospitals up and down the country. Without using the data sets being requested it would be impossible to deliver this benefit to the NHS. This would have a significant impact on a sizeable number of NHS Hospitals across the country.