DSfC - Redditch and Bromsgrove CCG - IV, RS
NHS Herefordshire and Worcestershire ICB · Sub ICB Location
Listed under NHS Herefordshire and Worcestershire Integrated Care Board.
Expired The latest version ended on 31 January 2023. The September 2026 register still lists the agreement, but its term has passed.
- Reference
- DARS-NIC-41522-S6G4K
- Latest version
- v4.4
- Term of latest version
- 31 January 2020 to 31 January 2023
- Start date
- Before 1 June 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 0
Why the data was released
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF).
The CCG are advised by the appointed CEfF whether payment for invoices can be made or not.
Invoice Validation will be conducted by NHS Midlands and Lancashire Commissioning Support Unit and Liaison Financial Services.
Liaison Financial Services conduct an independent ad-hoc review on retrospective payments made. Investing resource, skills and experience into deeper reconciliation, this identifies overcharges already paid and recovers savings for the CCG that would otherwise be lost.
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by Midlands and Lancashire Commissioning Support Unit
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.
Data Processors must only act upon specific instructions from the Data Controller.
Data can only be stored at the addresses listed under storage addresses.
All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role.
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. The data to be released from NHS Digital will not be national data.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)
The DSCRO (part of NHS Digital) will apply National Opt-outs before any identifiable data leaves the DSCRO only for the purpose of Risk Stratification.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
The only identifier available in the data set is the NHS numbers. Any further identification of the patients will only be completed by the patient’s clinician on their own systems for the purpose of direct care with a legitimate relationship.
Onward Sharing
Patient level data will not be shared outside of the CCG unless it is for the purpose of Direct Care, where it may be shared only with those health professionals who have a legitimate relationship with the patient and a legitimate reason to access the data.
Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital guidance applicable to each data set.
Segregation
Where the Data Processor and/or the Data Controller hold both identifiable and pseudonymised data, the data will be held separately so data cannot be linked.
All access to data is auditable by NHS Digital.
Data for the purpose of Invoice Validation is kept within the CEfF, and only used by staff properly trained and authorised for the activity. Only CEfF staff are able to access data in the CEfF and only CEfF staff operate the invoice validation process within the CEfF. Data flows directly in to the CEfF from the DSCRO and from the providers – it does not flow through any other processors.
Data Minimisation
Data Minimisation in relation to the data sets listed within the application are listed below. This also includes the purpose on which they would be applied -
For the purpose of Risk Stratification:
• Patients who are normally registered and/or resident within Redditch and Bromsgrove CCG (including historical activity where the patient was previously registered or resident in another commissioner
For the purpose of Invoice Validation:
• CCG of residence and/or registration.
Microsoft UK supply provide Cloud Services for Liaison Financial Services Ltd and Midlands and Lancashire CSU 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.
Lima Networks Limited 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.
Invoice Validation
1. Identifiable SUS+ Data is obtained from the SUS+ Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and pseudonymisation is completed within the DSCRO and the data is then sent to the Controlled Environment for Finance (CEfF) in Midlands and Lancashire Commissioning Support Unit.
3. NHS Midlands and Lancashire Commissioning Support Unit carry out the following processing activities within the CEfF for invoice validation purposes:
a. Validating that the Clinical Commissioning Group is responsible for payment for the care of the individual by using SUS+ and/or backing flow data.
b. Once the backing information is received, this will be checked against national NHS and local commissioning policies as well as being checked against system access and reports provided by NHS Digital to confirm the payments are:
i. In line with Payment by Results tariffs
ii. are in relation to a patient registered with a CCG GP or resident within the CCG area.
iii. The health care provided should be paid by the CCG in line with CCG guidance.
4. The CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between NHS Midlands and Lancashire Commissioning Support Unit CEfF team and the provider meaning that no identifiable data needs to be sent to the CCG. The CCG only receives notification to pay and management reporting detailing the total quantum of invoices received pending, processed etc.
INVOICE VALIDATION - Liaison Financial Services Ltd
1. Identifiable SUS+ Data is obtained from the SUS+ Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. The DSCRO pushes a one-way data flow of SUS+ data into the Controlled Environment for Finance (CEfF) in the Liaison Financial Services Ltd.
3. The CEfF also receive backing data from the provider.
4. Liaison Financial Services Ltd carry out the following processing activities within the CEfF for invoice validation purposes:
a. Validating that the Clinical Commissioning Group are responsible for payment for the care of the individual by using SUS+ and/or provider backing flow data.
b. Once the provider backing information is received, this will be checked against national NHS and local commissioning policies as well as being checked against system access and reports provided by NHS Digital to confirm the payments are:
i. In line with Payment by Results tariffs
ii. are in relation to a patient registered with a CCG GP or resident within the CCG area.
iii. The health care provided should be paid by the CCG in line with CCG guidance.
5. The CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between Liaison Financial Services Ltd CEfF team and the provider, meaning that no identifiable data needs to be sent to the CCG. The CCG only receives notification to pay and management reporting detailing the total quantum of invoices received pending, processed etc.
Risk Stratification
1. Identifiable SUS+ data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to Midlands and Lancashire Commissioning Support Unit, who securely hold the SUS+ data.
3. Identifiable GP Data is securely sent from the GP system to Midlands and Lancashire Commissioning Support Unit.
4. SUS+ data is linked to GP data in the risk stratification tool by the data processor.
5. As part of the risk stratification processing activity, GPs have access to the risk stratification tool within the data processor, which highlights patients with whom the GP has a legitimate relationship and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
6. Once Midlands and Lancashire Commissioning Support Unit has completed the processing, the CCG can access the online system via a secure connection to access the data pseudonymised at patient level
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
INVOICE VALIDATION - Liaison
1. Validation of Continuing Healthcare related invoices and payments
2. Independent Identification of potential overpayments made by the CCG through invoice validation
3. Liaising with providers with a view to recouping these monies
4. Review is completed for the retrospective period from date of contract with Liaison Financial Services back to 01/04/2013.
5. Reviews take 3-9 months depending on number of claims to investigate and resolve
6. Liaison Financial Services would repeat the exercise 2-3 years later
7. CCGs could request reviews to be done more frequently
8. SUS+ would only be requested each time a review was completed, and could be requested at different times as independent reviews
Risk Stratification
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
Expected measurable benefits
Invoice Validation
The invoice validation process supports the ongoing delivery of patient care across the NHS and the CCG region by:
1. Ensuring that activity is fully financially validated.
2. Ensuring that service providers are accurately paid for the patients treatment.
3. Enabling services to be planned, commissioned, managed, and subjected to financial control.
4. Enabling commissioners to confirm that they are paying appropriately for treatment of patients for whom they are responsible.
5. Fulfilling commissioners duties to fiscal probity and scrutiny.
6. Ensuring full financial accountability for relevant organisations.
7. Ensuring robust commissioning and performance management.
8. Ensuring commissioning objectives do not compromise patient confidentiality.
9. Ensuring the avoidance of misappropriation of public funds.
INVOICE VALIDATION - Liaison
Expected measurable benefits to health and/or social care including target date:
1. Financial validation of activity
2. CCG Budget control
3. Assurances over the robustness of internal control mechanisms relating to the payment of invoices and/or suggested improvements
4. Identification and recovery of monies which would otherwise be lost
5. Meeting commissioning objectives without compromising patient confidentiality
6. The avoidance of misappropriation of public funds to ensure the ongoing delivery of patient care
7. Benefit delivered 3-9 months from receiving data, depending on number of claims to investigate and resolve
Risk Stratification
Risk stratification promotes improved case management in primary care and will lead to the following benefits being realised:
1. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.
2. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services thus allowing early intervention.
3. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required.
4. Supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework by allowing for more targeted intervention in primary care.
5. Better understanding of local population characteristics through analysis of their health and healthcare outcomes
All of the above lead to improved patient experience through more effective commissioning of services.
Benefits reported so far
N/A
Datasets on the latest version
Legal basis for provision: Health and Social Care Act 2012 – s261(2)(b)(ii); Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'.
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| SUS for Commissioners | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 |
| SUS for Commissioners | Identifiable | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 |
Files released
Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.
No files recorded as released under this agreement.
Version history
The register lists each renewal of this agreement as a separate row. This site has 3 versions — earlier versions existed before this site's records begin.
DARS-NIC-41522-S6G4K-v4.4 31 January 2020 to 31 January 2023
- Title
- DSfC - Redditch and Bromsgrove CCG - IV, RS
- Commercial
- No
- Sublicensing
- No
- Datasets
- 2
- Files released
- 0
Datasets: SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-41522-S6G4K-v3.3
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Title | DSfC - Redditch and Bromsgrove CCG - IV, RS | |
| Start date | 2020-01-31 | |
| End date | 2023-01-31 | |
| SUS for Commissioners: legal basis | Health and Social Care Act 2012 – s261(2)(b)(ii); Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'. |
Datasets:
− Acute-Local Provider Flows; − Ambulance-Local Provider Flows; − Children and Young People Health; − Civil Registration - Births; − Civil Registrations of Death; − Community Services Data Set (CSDS); − Community-Local Provider Flows; − Demand for Service-Local Provider Flows; − Diagnostic Imaging Data Set (DID); − Diagnostic Services-Local Provider Flows; − Emergency Care-Local Provider Flows; − Experience, Quality and Outcomes-Local Provider Flows; − Improving Access to Psychological Therapies Data Set_v1.5; − Maternity Services Data Set v1.5; − Mental Health Minimum Data Set (MHMDS); − Mental Health Services Data Set (MHSDS); − Mental Health and Learning Disabilities Data Set (MHLDDS); − Mental Health-Local Provider Flows; − National Cancer Waiting Times Monitoring DataSet (NCWTMDS); − National Diabetes Audit; − Other Not Elsewhere Classified (NEC)-Local Provider Flows; − Patient Reported Outcome Measures (PROMs); − Population Data-Local Provider Flows; − Primary Care Services-Local Provider Flows; − Public Health and Screening Services-Local Provider Flows
Objective for processing
[2 paragraphs unchanged]
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG
[26 words unchanged]
data, which is received into a secure Controlled Environment for Finance (CEfF).
The SUS+ data is pseudonymised.
[1 paragraph unchanged]
Invoice Validation will be conducted by NHS Midlands and Lancashire Commissioning Support
Unit.
Unit and Liaison Financial Services.
Liaison Financial Services conduct an independent ad-hoc review on retrospective payments made. Investing resource, skills and experience into deeper reconciliation, this identifies overcharges already paid and recovers savings for the CCG that would otherwise be lost.
[4 paragraphs unchanged]
Commissioning
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 CCG 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 pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registries Data (CRD) (Births and Deaths)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by Midlands and Lancashire Commissioning Support Unit
Processing activities
[8 paragraphs unchanged]
(RS)
The only identifier available in the data set is the NHS numbers.
[16 words unchanged]
own systems for the purpose of direct care with a legitimate relationship.
[9 paragraphs unchanged]
For the purpose of Commissioning:
• Patients who are normally registered and/or resident within the Redditch and Bromsgrove CCG (including historical activity where the patient was previously registered or resident in another commissioner).
and/or
• Patients treated by a provider where Redditch and Bromsgrove CCG 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 relates to both national and local flows.
and/or
• Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of Redditch and Bromsgrove CCG - this is only for commissioning and relates to both national and local flows.
[4 paragraphs unchanged]
Blackpool Teaching Hospitals NHS Foundation Trust
Microsoft UK supply provide Cloud Services for Liaison Financial Services Ltd
and
Lima Networks Limited supply IT infrastructure
Midlands and Lancashire CSU
and are therefore listed as a data processor. They supply support to
[24 words unchanged]
agreement. This includes granting of access to the database[s] containing the data.
Lima Networks Limited 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.
[10 paragraphs unchanged]
INVOICE VALIDATION - Liaison Financial Services Ltd
1. Identifiable SUS+ Data is obtained from the SUS+ Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. The DSCRO pushes a one-way data flow of SUS+ data into the Controlled Environment for Finance (CEfF) in the Liaison Financial Services Ltd.
3. The CEfF also receive backing data from the provider.
4. Liaison Financial Services Ltd carry out the following processing activities within the CEfF for invoice validation purposes:
a. Validating that the Clinical Commissioning Group are responsible for payment for the care of the individual by using SUS+ and/or provider backing flow data.
b. Once the provider backing information is received, this will be checked against national NHS and local commissioning policies as well as being checked against system access and reports provided by NHS Digital to confirm the payments are:
i. In line with Payment by Results tariffs
ii. are in relation to a patient registered with a CCG GP or resident within the CCG area.
iii. The health care provided should be paid by the CCG in line with CCG guidance.
5. The CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between Liaison Financial Services Ltd CEfF team and the provider, meaning that no identifiable data needs to be sent to the CCG. The CCG only receives notification to pay and management reporting detailing the total quantum of invoices received pending, processed etc.
[7 paragraphs unchanged]
Commissioning
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
b. Ambulance
c. Community
d. Demand for Service
e. Diagnostic Service
f. Emergency Care
g. Experience, Quality and Outcomes
h. Mental Health
i. Other Not Elsewhere Classified
j. Population Data
k. Primary Care Services
l. Public Health Screening
3. Mental Health Minimum Data Set (MHMDS)
4. Mental Health Learning Disability Data Set (MHLDDS)
5. Mental Health Services Data Set (MHSDS)
6. Maternity Services Data Set (MSDS)
7. Improving Access to Psychological Therapy (IAPT)
8. Child and Young People Health Service (CYPHS)
9. Community Services Data Set (CSDS)
10. Diagnostic Imaging Data Set (DIDS)
11. National Cancer Waiting Times Monitoring Data Set (CWT)
12. Civil Registries Data (CRD) (Births and Deaths)
13. National diabetes Audit (NDA)
14. Patient Reported Outcome Measures (PROMs)
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
Data Processor 1 – Midlands and Lancashire Commissioning Support Unit
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT), Civil Registries Data (CRD), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to Midlands and Lancashire Commissioning Support Unit.
2. Midlands and Lancashire Commissioning Support Unit add derived fields, link data and provide analysis 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
3. Allowed linkage is between the data sets contained within point 1.
4. Midlands and Lancashire Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG.
5. Aggregation of required data for CCG management use will be completed by Midlands and Lancashire Commissioning Support Unit or the CCG as instructed by the CCG.
6. Patient level data will not be shared outside of the CCG and will only be shared within the CCG on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
Expected output
[7 paragraphs unchanged]
INVOICE VALIDATION - Liaison
1. Validation of Continuing Healthcare related invoices and payments
2. Independent Identification of potential overpayments made by the CCG through invoice validation
3. Liaising with providers with a view to recouping these monies
4. Review is completed for the retrospective period from date of contract with Liaison Financial Services back to 01/04/2013.
5. Reviews take 3-9 months depending on number of claims to investigate and resolve
6. Liaison Financial Services would repeat the exercise 2-3 years later
7. CCGs could request reviews to be done more frequently
8. SUS+ would only be requested each time a review was completed, and could be requested at different times as independent reviews
[19 paragraphs unchanged]
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
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 Most expensive patients (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 patients 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.
Expected measurable benefits
[11 paragraphs unchanged]
INVOICE VALIDATION - Liaison
Expected measurable benefits to health and/or social care including target date:
1. Financial validation of activity
2. CCG Budget control
3. Assurances over the robustness of internal control mechanisms relating to the payment of invoices and/or suggested improvements
4. Identification and recovery of monies which would otherwise be lost
5. Meeting commissioning objectives without compromising patient confidentiality
6. The avoidance of misappropriation of public funds to ensure the ongoing delivery of patient care
7. Benefit delivered 3-9 months from receiving data, depending on number of claims to investigate and resolve
[8 paragraphs unchanged]
Commissioning
1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
a. Analysis to support full business cases.
b. Develop business models.
c. Monitor In year projects.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
3. Health economic modelling using:
a. Analysis on provider performance against 18 weeks wait targets.
b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients.
c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway.
d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC).
4. Commissioning cycle support for grouping and re-costing previous activity.
5. Enables monitoring of:
a. CCG outcome indicators.
b. Financial and Non-financial validation of activity.
c. Successful delivery of integrated care within the CCG.
d. Checking frequent or multiple attendances to improve early intervention and avoid admissions.
e. Case management.
f. Care service planning.
g. Commissioning and performance management.
h. List size verification by GP practices.
i. Understanding the care of patients in nursing homes.
6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.
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.
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.
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.
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.
11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
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.
Unchanged: Benefits reported.
DARS-NIC-41522-S6G4K-v3.3 1 June 2019 to 31 May 2022
- Title
- DSfC - Redditch and Bromsgrove CCG - IV, RS, Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-41522-S6G4K-v2.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Acute-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Ambulance-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Children and Young People Health: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Civil Registration - Births: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Civil Registrations of Death: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Community Services Data Set (CSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Community-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Demand for Service-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Diagnostic Imaging Data Set (DID): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Diagnostic Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Emergency Care-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Experience, Quality and Outcomes-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Improving Access to Psychological Therapies Data Set_v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Maternity Services Data Set v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Mental Health Minimum Data Set (MHMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Mental Health Services Data Set (MHSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Mental Health-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| National Diabetes Audit: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Patient Reported Outcome Measures (PROMs): common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Population Data-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Primary Care Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| Public Health and Screening Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 | |
| SUS for Commissioners: common law duty of confidentiality | Mixture of confidential data flow(s) with consent and flow(s) with support under section 251 NHS Act 2006 |
Objective for processing
[2 paragraphs unchanged]
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG
[30 words unchanged]
into a secure Controlled Environment for Finance (CEfF). The SUS+ data is
identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
pseudonymised.
[1 paragraph unchanged]
Invoice Validation will be conducted by
NHS
Midlands and Lancashire Commissioning Support
Unit
Unit.
[49 paragraphs unchanged]
Processing activities
[31 paragraphs unchanged]
2.
The
Data quality management and pseudonymisation is completed within the
DSCRO
pushes a one-way
and the
data
flow of SUS+ data into
is then sent to
the Controlled Environment for Finance (CEfF) in
the
Midlands and Lancashire Commissioning Support Unit.
3.
NHS
Midlands and Lancashire Commissioning Support Unit carry out the following processing activities within the CEfF for invoice validation purposes:
a. Validating that the Clinical Commissioning Group
are
is
responsible for payment for the care of the individual by using SUS+ and/or
provider
backing flow data.
b. Once the
provider
backing information is received, this will be checked against national NHS and
[10 words unchanged]
access and reports provided by NHS Digital to confirm the payments are:
[3 paragraphs unchanged]
4. The CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between
NHS
Midlands and Lancashire Commissioning Support Unit CEfF team and the
provider,
provider
meaning that no identifiable data needs to be sent to the CCG.
[8 words unchanged]
management reporting detailing the total quantum of invoices received pending, processed etc.
[50 paragraphs unchanged]
Unchanged: Expected output, Expected measurable benefits, Benefits reported.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is pseudonymised.
The CCG are advised by the appointed CEfF whether payment for invoices can be made or not.
Invoice Validation will be conducted by NHS Midlands and Lancashire Commissioning Support Unit.
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by Midlands and Lancashire Commissioning Support Unit
Commissioning
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 CCG 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 pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registries Data (CRD) (Births and Deaths)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by Midlands and Lancashire Commissioning Support Unit
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Risk Stratification
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
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 Most expensive patients (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 patients 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.
Benefits reported
N/A
DARS-NIC-41522-S6G4K-v2.2 1 June 2019 to 31 May 2022
- Title
- DSfC - Redditch and Bromsgrove CCG - IV, RS, Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF whether payment for invoices can be made or not.
Invoice Validation will be conducted by Midlands and Lancashire Commissioning Support Unit
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by Midlands and Lancashire Commissioning Support Unit
Commissioning
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 CCG 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 pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registries Data (CRD) (Births and Deaths)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by Midlands and Lancashire Commissioning Support Unit
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Risk Stratification
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
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 Most expensive patients (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 patients 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.
Benefits reported
N/A
Register history
When this agreement appeared in, or was edited in, each monthly edition of the register. Built by comparing every edition this site holds, the earliest of which is July 2021.
-
July 2021 —
already listed in the earliest edition this site holds, so it may be older. 3 versions: DARS-NIC-41522-S6G4K-v2.2, DARS-NIC-41522-S6G4K-v3.3, DARS-NIC-41522-S6G4K-v4.4
-
October 2022
Succeeded Applicant organisation: NHS Herefordshire and Worcestershire CCG succeeded by NHS Herefordshire and Worcestershire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.Succeeded Data controllers: NHS Herefordshire and Worcestershire CCG succeeded by NHS Herefordshire and Worcestershire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.
-
December 2022
Register-wide edit DARS-NIC-41522-S6G4K-v2.2, DARS-NIC-41522-S6G4K-v3.3, DARS-NIC-41522-S6G4K-v4.4 — Datasets: legal basis: “
s261(1) and” taken out. Made to 639 agreements in this edition, so it is reported once, on the changes page, and not counted as an amendment of this agreement.
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-41522-S6G4K, “DSfC - Redditch and Bromsgrove CCG - IV, RS”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-41522-s6g4k/ (accessed [date]).
This address stays the same, but the page is rebuilt with each monthly edition, so the citation names the edition it shows. Every edition's data is kept in the facts store.
Source: datausesregister_september2026.xlsx, September 2026 edition of the NHS England Data Uses Register. Search that workbook for DARS-NIC-41522-S6G4K to see the original rows.