Department of Health and Social Care - Adult Social Care Client Level Data

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Datasets: + Adult Social Care Client Level Data Set (ASCCLDS); + Commissioning Datasets · − Adult Social Care

Objective for processing

This agreement is for Department of Health and Social Care (DHSC) require access to access Adult Social Care (ASC) NHS England commissioning datasets to enable DHSC to manage and quality assurance the Client Level Data (CLD) collection, and Secondary Use Services data (SUS) disseminated via NHS England’s Data Services Commissioners Regional Office (DSCRO). DHSC are the Controller its use for this Data Sharing Agreement national oversight and Arden assurance and GEM Commissioning Support Unit will act as a Data Processor. to support local improvement. The Department of Health & Social Care (DHSC) DHSC will use the ASC CLD and SUS NHS England commissioning datasets in support of the Secretary of State for Health in delivery of [15 words unchanged] the Health and Social Care Act 2012 and the Care Act 2014. These duties are set out in the 2006, 2012 and 2014 Acts, [12 words unchanged] of State for Health and Social Care and the role of the Department of Health and Social Care DHSC as the relevant Department of State, exercising these executive functions on behalf [36 words unchanged] of those in a way that makes best use of available resources. The Department does this by formulating Government policy and overseeing the role and functions of a range of other national bodies, mostly those established by the Health and Social Care Act 2012. To make government policy in this area effective, to meet the needs of a population of c.50m people and service interactions that run into the hundreds of millions, it is important that policy is responsive, nuanced and takes account of differences in the needs of different population demographics and needs and both local rural and urban geographies across England. The primary objective is to link various health and care datasets to create a more complete and holistic picture of an individual's journey through the health and social care systems. This integrated view will enable more accurate and frequent tracking of care usage and outcomes. Ultimately, this will lead to better national and local oversight, driving improvements in adult social care services and delivering better outcomes for individuals. It is important that policy formulation is evidence based. The DHSC analysts and officials will use data accessed via this agreement to explore and analyse these data to identify and provide actionable insights that will inform policy decisions. They will also use the data and evidence to respond rapidly to emergent challenges and issues, for example analysing in detail the impact on services from any pandemic contagious illnesses; providing actionable evidence and briefing to decision makers. The use and linkage of pseudonymised NHS commissioning data are essential for creating a comprehensive evidence base that provides a wider, system-level perspective. This will support several key functions: These duties and primary activities in general include, but are not limited to the following: • Enhancing Data Quality and Completeness: By integrating health data with existing adult social care information, DHSC can identify and address significant data gaps. For example, it can help complete records for individuals receiving short-term care or those with complex needs whose care is funded by different parts of the health and care system. This process is vital for improving the accuracy of national statistics and reports, reducing the reliance on imputation for missing data. a. Monitoring, at a population level, particular cohorts of service users and designing analytical models which support more effective interventions in health and adult social care; • Strengthening National Oversight and Policy Development: A comprehensive dataset allows for more robust national oversight and assurance of the social care sector. It informs national policy, particularly around prevention, by enabling the identification of high-risk cohorts based on their historical use of health services. This evidence base is critical for the development and monitoring of national improvement programmes, such as the Better Care Fund (BCF). b. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care; • Improving Outcome Measurement: Linking health data with social care and civil registration records allows for the development of more sophisticated and meaningful national outcome measures, such as those within the Adult Social Care Outcomes Framework (ASCOF). This enables DHSC to track the long-term outcomes for individuals receiving different types of care, including those receiving short-term reablement support after a hospital stay or those who receive services funded by both the NHS and local authorities. c. Developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care; • Supporting Local Commissioning and Improvement: The insights gained from this linked data will be used to support local authorities. By developing predictive tools and providing richer data dashboards summarising trends and outcomes, DHSC can help local commissioners target prevention activities more effectively and better understand the needs of their populations, including those who draw on both mental health and adult social care support. d. Designing and implementing new payment models across health and adult social care; In summary, creating a linked, pseudonymised dataset is fundamental to understanding the complex interactions between the health and social care systems. This will enable a shift towards a more data-driven approach to policy, commissioning, and service improvement, for the direct benefit of individuals who rely on adult social care. e. Understanding current and future population needs and resource utilisation for local strategic planning and commissioning purposes including for health, social care and public health needs; The following NHS England Data will be accessed: f. Monitoring and understanding variations in service provision and outcomes across England to inform policy making to improve the quality of service commissioning and reducing inequalities. - Pseudonymised commissioning datasets disseminated via NHS England’s Data Services Commissioners Regional Office (DSCRO). For a full list of products, see https://digital.nhs.uk/services/data-services-for-commissioners/commissioning-datasets These duties include the following in relation to social care and integrated care, but are not limited to the following elements within the National Health Service Act 2006. The lawful basis for processing personal data under the UK GDPR is Article 6(1)(e) - processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller’. 1 Secretary of State's duty to promote a comprehensive health service designed to secure improvement- The lawful basis for processing special category data under the UK GDPR is Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject. The Data are required for the public interest and judged subject to the appropriate safeguards. This means that DHSC can use the personal data they hold about individuals for the purposes described in this agreement with appropriate safeguards in place and that the controller has demonstrated in this purpose that their objective serves the interests of society. (a) in the physical and mental health of the people of England, and DHSC has published a privacy notice describing how it uses the data: (b) in the prevention, diagnosis and treatment of physical and mental illness. https://www.gov.uk/government/publications/adult-social-care-client-level-data-privacy-notice/adult-social-care-client-level-data-privacy-notice, and 1A Duty as to improvement in quality of services https://www.ardengemcsu.nhs.uk/media/3589/dhsc-cld-transparency-statement.pdf (1) )The Secretary of State must exercise the functions of the Secretary of State in relation to the health service with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with- DHSC will update the documents will be updated to reflect any new uses agreed under this request. (a)the prevention, diagnosis or treatment of illness, or (b)the protection or improvement of public health. PURPOSES (2) In discharging the duty under subsection (1) the Secretary of State must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services. DHSC require access to NHS commissioning datasets to support operational use of the data by DHSC, including the management and quality assurance of the Client Level Data (CLD) collection itself, and its use for national oversight and assurance and to support local improvement. (3) The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show- (a)the effectiveness of the services, In line with the Client Level Data Directions No 3, data will be analysed and used to support the Secretary of State's delivery of duties under the Care Act 2014 including, but not limited to: (b)the safety of the services, and a. Monitoring, at a population level, particular cohorts of service users and designing analytical models which support more effective interventions in adult social care. (c)the quality of the experience undergone by patients. b. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care (4) In discharging the duty under subsection (1), the Secretary of State must have regard to the quality standards prepared by The National Institute for Health and Care Excellence (NICE) under section 234 of the Health and Social Care Act 2012. c. Developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care. 1B Duty as to reducing inequalities d. Designing and implementing new payment models in adult social care. In exercising functions in relation to the health and social care service, the Secretary of State must have regard to the need to reduce inequalities between the people of England with respect to the benefits that they can obtain from the locally funded social care service and health service. e. Understanding current and future population needs and resource utilisation for local strategic planning and commissioning purposes including for health, social care and public health needs. 1C Duty as to research f. Monitoring and understanding variations in service provision and outcomes across England to inform policy making to improve service commissioning and reduce inequalities. In exercising functions in relation to the health and social care services, the Secretary of State must promote- DHSC will use the data shared under this agreement to undertake the following activities: (a) research on matters relevant to the social care service, and - Analytical quality assurance of the CLD collection. DHSC is responsible for managing the data collection from local authorities, alongside delivery partners in NHSE. Under the current DSA, DHSC receives data in close to real time, as it is submitted by local authorities each quarter. This enables DHSC analysts to assess the data quality and contact local authorities where errors are identified, in turn enabling local analysts to correct errors and resubmit the data within the submission window. This is part of the ongoing quality assurance of the collection, in line with the Office for Statistics Regulation’s standards for quality assurance of administrative data. (b) the use in the social care service of evidence obtained from research. - Production of timely analytical insights and outputs from CLD and linked health data back with local authorities to support their delivery of duties under the Care Act 2014. To produce these analytical outputs, DHSC analysts process and aggregate the record level data. These outputs are shared back with local authorities via the national CLD dashboard to support local assurance of the data and its use in planning and service commissioning. In addition, local authority analysts who submit CLD can download the centrally processed CLD records containing a local record ID that enables them to match these back to their local systems. This supports additional quality assurance of submitted CLD and national metric derivations by DHSC (see details on sub-licensing below). 1D Duty as to education and training - Internal and external reporting on adult social care, including ministerial briefings on priority areas such as waiting times for adult social care services and in departmental responses to parliamentary questions. (1) The Secretary of State must exercise the functions of the Secretary of State under any relevant enactment so as to secure that there is an effective system for the planning and delivery of education and training to persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health and social care service in England. For the purposes of social care services this includes carers. In subsection (1), "relevant enactment" means- - Development of published official statistics, including the Adult Social Care Outcomes Framework (ASCOF), the Adult Social Care Activity and Finance Report and DHSC’s monthly statistics for adult social care. (a) section 63 of the Health Services and Public Health Act 1968, (b)this Act, - Provide insights into how people use health and care services. CLD records will be linked to health records for the same individual in NHS datasets (using the pseudonymised NHS number) to provide insights into use of services and outcomes. For example, linked CLD, SUS and mortality data has been used to develop a measure describing outcomes of short-term social care support after hospital discharge. The community and mental health datasets requested will be used to provide a fuller picture of community support people receive after hospital discharge. Linked data will be used to provide in-depth analysis and evaluation of patterns of health and care use e.g. at end of life, and evaluation of different types of services. (c)the Health and Social Care Act 2008, (d)the Health Act 2009, and - Provide information, evidence and insights to support effective local delivery and national oversight, monitoring and assurance of the adult social care system and joint surveillance with health e.g. dementia. The data will be used to identify and respond rapidly to emerging challenges and issues, for example analysing pressures on local authority adult social care services from any future pandemics, providing actionable evidence and briefing ministers. (e)the Health and Social Care Act 2012.] Published datasets will also be used alongside data in this request at care provider, local authority and area level, including: The Secretary of State has a statutory duty to protect and improve the health of the population under sections 2A and 2B of the NHS Act 2006 (as inserted by the Health and Social Care Act 2012): • ONS population estimates for local authority areas by sex, age and ethnicity. This data will be used to provide denominators for a range of statistics describing rates of demand and use of care by local authority e.g., number of requests for support per 100,000 adults in the local population. It will be used to reproduce statistics reported through the Adult Social Care Activity and Finance Report, e.g. Table 24 describing number of episodes of short-term support per 100,000 adults by local authority, and for the updated Adult Social Care Outcomes Framework, e.g. The number of adults aged 65 and over whose long-term support needs are met by admission to residential and nursing care homes per 100,000 population. Section 2B: (2) The Secretary of State may take such steps as the Secretary of State considers appropriate for improving the health of the people of England. The steps that may be taken under subsection (1) or (2) include: (a)providing information and advice; (b)providing services or facilities designed to promote healthy living (whether by helping individuals to address behaviour that is detrimental to health or in any other way); (c)providing services or facilities for the prevention, diagnosis or treatment of illness; (d)providing financial incentives to encourage individuals to adopt healthier lifestyles; (e)providing assistance (including financial assistance) to help individuals to minimise any risks to health arising from their accommodation or environment; (f)providing or participating in the provision of training for persons working or seeking to work in the field of health improvement; (g)making available the services of any person or any facilities. Health and Social Care Act 2012 The Introduction to the Act states its purpose as: “to make provision about regulating health and adult social care services; to make provision about public involvement in health and social care matters, scrutiny of health matters by local authorities and co-operation between local authorities and commissioners of health care services; to make provision about regulating health and social care workers;” The Act provides amendments to the 2006 Act and a number of organisation restructures have taken place since 2006 including the establishment of NHS Improvement to replace Monitor and subsequent merger of NHS Improvement with NHS England and additional legislation has been published relevant to the data analysis and reporting duties of DHSC such as Health and Social Care Act 2008 that sets out the regulatory role of the Care Quality Commission. The Social Care Data (CLD) will provide DHSC analytics function to support the Secretary of State’s duties in respect of: PART 3 Regulation of health and adult social care services PART 5 Public Involvement and local government Chapter 2 Local Government 190. Scrutiny Functions of Local Authorities 191.Amendments consequential on section 190 192. Joint Strategic needs assessments 193. Joint health and wellbeing strategies The Care Act 2014 “An Act to make provision to reform the law relating to care and support for adults and the law relating to support for carers; to make provision about safeguarding adults from abuse or neglect; to make provision about care standards; to establish and make provision about Health Education England; to establish and make provision about the Health Research Authority; to make provision about integrating care and support with health services; and for connected purposes.” PART 1 Care and Support General responsibilities of Local Authorities 3. Promoting integration of care and support with health services etc. 5. Promoting diversity and quality in provision of services 8. How to meet needs 9. Assessment of an adult’s needs for care and support 10. Assessment of a carer’s needs for support 12. Assessments under sections 9 and 10: further provision 25. Care and support plan, support plan 27. Review of care and support plan or of support plan 38. Case where assessments not complete on day of move In supporting the Secretary of State (SofS) in the delivery of the above duties, DHSC will use the data shared under this agreement to undertake: - Advanced analytics to support evaluation of service transformation - Analysis and processing of varying needs of social care service users, health service patients and the wider population - Following patient pathways - Benchmarking - Provision of support services; - Production of publications including contributing to national and regional publications such as A&E reports; - Support of the Government in the development and monitoring of policy; - Early analysis for projects and programmes to support commissioning and policy decisions; - Responding to and answering of parliamentary questions in a timely fashion as part of statutory duties. - Applying advanced analytical methods to the data to allow policy formulation to take due account of variation in needs arising from characteristics of service users (demographics, combinations of needs analysis, pattern of interaction with services) and characteristics of health and care interactions in order to fulfil SofS's responsibilities to deliver health and care services effectively, to deliver the greatest possible benefit to the health of the wider population and do both of these in a way that makes the best possible use of available resources. DHSC have multiple analytical teams that conduct policy facing analysis to inform Ministerial decisions. Department of Health & Social Care analysts are often required to carry out detailed analysis of data. This serves two broad purposes: (i) In effect, to operate a focused research, analysis and discovery function: to use the data to understand the nuance and subtlety of policy formulation and its potential impacts on particular groups of patients or public. This work includes the need to consider associations or correlations between different aspects of healthcare provision, to understand how services and policies relate to each other. (ii) To respond urgently to requests for briefing; analysing detailed data to provide summary aggregate information that will allow policy decision makers (including Government Ministers) to address emergent challenges or issues and to make informed policy and service management decisions. The lawful basis for processing data under GDPR has been reviewed against the guidance and been assessed as acceptable. The Department of Health and Social Care process data under the legal basis of Article 6(1)(e) ‘processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller’ as the Department of Health and Social Care is a public authority and government department. The Department of Health and Social Care process special category data under Article 9(2)(j) ‘processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes …’ as the data are required for the public interest and judged subject to the appropriate safeguards. This means that DHSC can use the personal data they hold about individuals for the purposes described in this Agreement with appropriate safeguards in place. The Controller has demonstrated in this purpose section that their objective serves the interests of society as a whole. Uses of the Data This data will be used to improve understanding of the movement of people out of hospital who receive care and support from their local authority. Improving hospital discharge processes and ensuring adequate capacity in social care to meet needs of people leaving hospital is a priority area across government. Improving data and analysis about discharge is one part of this work e.g. p38 of the UEC delivery plan. Along with the discharge-ready date that will start to be recorded in SUS, linked CLD will be used to describe processes, including waiting times, for groups of people receiving different types of social care after leaving hospital (e.g. reablement, residential and nursing care, specialised placements) and what happened next. This will be used to support collaborative action across the NHS, local government and the social care sector to improve discharge and social care capacity planning. Sub-licensing DHSC will provide access to a Power BI dashboard for local authorities, providing Client Level Data in an accessible and useful form. The purpose will be limited to service planning and commissioning, as described within the terms of the end user agreement. Any Local Authority wishing to access the Dashboard will be required to agree with the terms of this agreement with the Department of Health and Social Care. The information accessed via the dashboard is intended to support local authority commissioners and performance leads of adult social care services to: • gain a better understanding of local demand in their areas and resulting pressures on services • monitor activity and operational performance • carry out strategic thinking to plan services • improve strategic commissioning of services. By giving local authorities timely access to consistent data (now that CLD is a mandated collection) and access to reports, it will add value to both the usefulness of the data, and also provide insight to ultimately improve outcomes for individuals drawing on care and support. DHSC have the specific knowledge and skills to create the dashboards and delivering through sub-licensing can ensure reports are accurate, consistent, comparable and standardised across the country. Through the dashboard, local authorities will be able to access a pseudonymised (de-identified) form of the data that they submit in their Client Level Data return, and metrics derived from it. Since these data will be used for secondary purposes (planning and commissioning) rather than direct care, data will be pseudonymised beforehand using appropriate techniques to remove and prevent disclosure of identifying personal information. In line with sub-licensing guidance, any local identifiers will be removed from the data before sharing with the councils to ensure they have no means within the data of re-identifying it. It is important that the council have access to client-level data via the dashboards to enable them to ‘cut’ and filter the data by different criteria to gain better insight, and to drill down to the client level to understand specific areas or cohorts where further action may be needed. Through the dashboard, local authorities will also be able to access Client Level Data and linked health data that is aggregated at national, regional and local authority level, with appropriate aggregation and small-number suppression. DHSC has asked NHS Arden & Greater East Midlands Commissioning Support Unit (AGEM CSU) to act as a data processor and host the dashboards for them, including managing user access in line with the sub-licensing agreements. Published datasets to be used alongside CLD Published national datasets containing information at higher levels of aggregation will be used at care provider, local authority and area level, including: • ONS population estimates for local authority areas by sex and age. This data will be used to provide denominators for a range of statistics describing rates of demand and use of care by local authority e.g., number of requests for support per 100,000 adults in the local population. It will be used to reproduce statistics reported through the Adult Social Care Activity and Finance Report (e.g. Table 24 describing number of episodes of short-term support per 100,000 adults by local authority) and for the updated Adult Social Care Outcomes Framework (e.g. The number of adults aged 65 and over whose long-term support needs are met by admission to residential and nursing care homes per 100,000 population). [1 paragraph unchanged] A Transparency Statement for these uses can be found at https://www.ardengemcsu.nhs.uk/media/3589/dhsc-cld-transparency-statement.pdf DHSC is the Data Controller and will also be processing the data included within the request. NHS Arden and GEM Commissioning Support Unit (AGEM CSU in their capacity as a DSCRO) will act as a processor under the instruction of DHSC. The repository hosted by AGEM CSU (DSCRO) provides DHSC analysts with access to pseudonymised individual level data, tools and code in a secure environment. This provides assurance to service users and the public that any personal data is being processed in a safe and secure way. Only anonymised and aggregated data are exported from this secure environment with the exception of record-level sharing with local authorities via a secure dashboard hosted by AGEM on their Athena platform, and fed directly by the secure repository. SUB LICENSING TO LOCAL AUTHORITIES DHSC will provide access to Power BI dashboards and downloadable datasets for local authorities. These will include outputs derived from CLD and linked data in accessible and useful forms to support local authorities to deliver their duties under the Care Act. The purposes will be limited to those described in the end user (sub licensing) agreement attached with this request. Any local authority wishing to access the outputs will be required to sign up to the terms of this agreement with DHSC. The data will be provided via two separate routes: 1) the main CLD dashboard, a Power BI dashboard, to support local service planning and commissioning; and 2) a separate DQ dashboard providing access to downloadable processed datasets of individual processed records, available to specific roles (using role-based access controls) to specifically support CLD quality assurance. The information accessed via the main CLD dashboard is designed to support local authority analysts, commissioners and performance leads of adult social care services to: - Gain a better understanding of local demand in their areas and resulting pressures on services. - Monitor activity and operational performance. - Carry out strategic thinking to plan services. - Improve strategic commissioning of services by evaluating outcomes using CLD and linked health datasets The dashboard gives local authorities timely access to a consistent dataset and analytical outputs that use consistent national methodologies. This will add value to the usefulness of the data and provide insights to support local commissioning and planning, in turn improving outcomes for individuals who need care and support. Through the main CLD dashboard, local authorities will be able to access a pseudonymised (de-identified) form of the CLD and linked health data, with appropriate techniques to remove and prevent disclosure of identifying personal information: - Local authorities will be able to access the individual-level data for their own area, so that they can ‘cut’ and filter the data by different characteristics to understand patterns of service use and trends for specific areas or cohorts in detail. - No personal identifiable data will be included on the dashboard and no means of re-identifying individuals. Local identifiers will be removed from the client-level data on the main CLD dashboard before it is shared back with councils (in contrast to the DQ dashboard described below). - Local authorities will also be able to access aggregated data from outside their own area for purposes of benchmarking e.g. aggregated to national, regional and local authority level, with appropriate statistical disclosure control. A separate, second DQ dashboard will provide access to the dataset to support analytical quality assurance of CLD submissions and outputs. This dashboard dataset will contain CLD only i.e. it will not include any linked health data. The dataset will include the local authority unique person ID and event reference numbers, along with derived fields from CLD, to enable local authorities to identify cohorts of individuals included in different measures and statistics derived centrally from their submitted CLD. The local identifiers do not include any person identifiable information but are unique identifiers on local systems. Retaining these fields in the CLD dashboard dataset shared back with authorities will enable analytical staff in appropriate roles (i.e. staff who already have access to individual records on local systems) to cross-reference the dataset to data on local systems. The purpose is to enable local authorities to assess and correct data quality issues in their submitted CLD and to support effective local scrutiny and use of nationally produced CLD statistics. Appropriate role-based access controls (RBAC) will ensure that access is limited to individuals in specific roles, and the sub-licensing agreement will set out the purposes of this sharing (attached with this request). DHSC analysts have the specific knowledge and skills to create the dashboards and delivering these through sub-licensing ensures reports are accurate, consistent, comparable and standardised across the country. NHS Arden & Greater East Midlands Commissioning Support Unit will host the dashboards for DHSC, including managing role-based user access in line with the sub-licensing agreement.

Processing activities

Data must will only be used for the purposes stipulated within this Data Sharing Agreement. Agreement (DSA). Any additional disclosure / publication will require further approval from NHS England. Processors must will only act upon specific instructions from the Controller. Controller (DHSC). [1 paragraph unchanged] Patient Individual level data will not be linked other than as specifically detailed within this Data Sharing Agreement. DSA. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. DSA. NHS England reminds all All organisations party to this agreement of the need to will comply with the Data Sharing Framework Contract requirements, including those regarding the [20 words unchanged] contractors of the Data Recipient who may have access to that data) DHSC must will publish and maintain a publicly accessible UK GDPR compliant transparency privacy notice that includes sharing data with local authorities under sub-licensing. The current privacy notice will be updated to reflect any new uses agreed as part of this DSA. [1 paragraph unchanged] Aggregated reports only with small number suppression can be shared externally as set out within NHS England guidance applicable to each data set. Aggregated reports will be shared externally, with appropriate statistical disclosure control applied in line with DHSC and NHS England guidance applicable to each data set to ensure that no individual person is identifiable from a data output. This includes statistics published by DHSC in the monthly adult social care statistics publication, where cells referring to fewer than five people are suppressed. Similar rules will be applied to annual official ASC statistics publication. Patient level data can only be shared outside of the Data Controller & Data Processors under the terms of a sub-licensing agreement as detailed in this Data Sharing Agreement. Outside of the Data Controller & Data Processors listed in this agreement, individual-level data will only be shared with local authorities under the terms of a sub-licensing agreement. To facilitate the sharing of individual-level and event-level data, DHSC will publish a release register detailing any sub-licences and onward sharing throughout the life of this DSA in the public domain. This will be updated at a minimum on a quarterly basis up to 3 months in arrears e.g. if a sub-licencing agreement is granted in May 2025, it is expected that this will be shown on a release register by September 2025. For data sharing under sub-licensing, DHSC must publish a release register detailing any sub-licences and onward sharing throughout the life of this agreement in the public domain, at a minimum, updated on a quarterly basis up to 3 months in arrears e.g. If a sub-licencing agreement is granted in October 2023, it is expected that this will be shown on a release register by April 2024. [1 paragraph unchanged] All access to data is auditable by NHS England. [2 paragraphs unchanged] 1. Pseudonymised Adult Social Care data and SUS data is NHS commissioning datasets are transferred from the DSCRO to Arden and GEM Commissioning Support Unit 2. Arden and GEM process and transfer the data to the Department of Health and Social Care DHSC 3. Patient Individual level data will only be shared outside of the Controller/Processor under the terms of a Sub-Licensing sub-licensing agreement and will only be shared within 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 England guidance applicable to each data set. Access and use of data within DHSC will be controlled by the teams and individuals within the analysis function. External aggregated reports only with small number suppression can be shared as set out within NHS England guidance applicable to each data set. Access to and use of data within DHSC will be controlled by the teams and individuals within the social care group analysis function. [1 paragraph unchanged] Microsoft Limited provide Cloud Services for Arden and GEM Commissioning Support Unit [35 words unchanged] the agreement. This includes granting of access to the database[s] containing the data data. Ilkeston Community Hospital (Part of Derbyshire Community Health Services NHS Foundation Trust) and Wrightington, Wigan and Leigh NHS Foundation Trust do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.

Expected output

Due to the context and nature of the Department and its work, outputs are often unknown in advance, and these will be driven by changing policy and ministerial priorities. This is because the organisation is responsible for the formulation of policy in relation to around £120bn of publicly funded health and care provision each year, across millions of different types of service provision, to patients and public of all ages, ethnicities and health status. Longer term analysis and evidence formulation is directed towards the policy priorities of the Department. Data accessed via this request will be used to produce the following planned outputs: • As part of the New Models of Care and Transformation agendas. • DHSC’s Adult Social Care monthly statistics that includes statistics from CLD describing the number of adults receiving long term support arranged or provided by local authorities each month, and the number of adults who have a care needs assessment each month. Figures are broken down by age, gender and ethnicity and are reported at national, regional and local level. These are badged as ‘official statistics in development’ to reflect the fact that CLD is a relatively new data collection. • Research into areas of current policy interest, eg Winter admissions, Delayed Transfers of Care, Sector resilience (Providers). • Annual official statistics describing local authority adult social care, including the types of services people use, the characteristics of people requesting and receiving care, and the outcomes of that care. CLD has replaced the previous annual adult social care data collection, SALT, as the primary source of data on local authority activity. Data covered by this request will be the version used in the annual Adult Social Care Activity and Finance Report, since the analytical and publication function has shifted from NHSE to DHSC analysts. In October 2025, figures for 2024/25 activity will be published from CLD as ‘official statistics in development’. • Cross sectional and time series analysis to understand efficiency and productivity of providers - This analysis is to be used for work relating to the Lord Carter report on efficiency, reporting on measures of efficiency and productivity for Secretary of State and HMT. • The published Adult Social Care Outcomes Framework (ASCOF) describing how well adult social care helps people to maintain their independence and, where appropriate, regain it. CLD will be used for five ASCOF measures and linked CLD, SUS and mortality data covered by this request will be used to create a sixth measure describing outcomes of reablement support following hospital discharge. In December 2025, ASCOF data will be published, including measures from CLD and SUS, as ‘official statistics in development’. • Ministerial briefings - On-going work to understanding the link between activity/workload, staffing levels, work to understand impact upon safety and quality of care. • The CLD PowerBI dashboard and linked analytical outputs for local authorities to use the data, including linked health data, to evaluate and improve services and service commissioning locally. • The CLD DQ dashboard/dataset to help local authorities investigate DQ issues affecting their published statistics. This will be separate from the main CLD dashboard and available to different RBAC roles, shared for data quality assurance purposes, and based on only the CLD data submitted by the council, since it will include local IDs i.e. no linked health data will be included. • The BCF PowerBI dashboard. ASCOF measures derived from CLD will also be used as part of the Better Care Fund (BCF) – a grant administered by local health and wellbeing boards that include local authorities and ICBs – to help set and evaluate progress against improvement goals. Due to the context and nature of the Department and its work, other outputs are often unknown in advance, and these will be driven by changing policy and ministerial priorities. This is because the organisation is responsible for the formulation of policy in relation to around £20bn of publicly funded adult social care provision each year, across different types of service provision, to people of all ages, ethnicities and health status. Examples of outputs include: • Research into areas of current ministerial and policy interest, eg waiting times for care. • Ministerial briefings - ongoing work to understand the link between social care and outcomes. [1 paragraph unchanged] Linked CLD and SUS data will also be used to develop metrics for the Adult Social Care Outcomes Framework (ASCOF) to assess how well adult social care helps people to maintain their independence and, where appropriate, regain it. The ASCOF metric covering effective discharge describes whether an individual receiving care remains living at home 91 days following discharge, and as such acts as a proxy for the appropriateness and effectiveness of the care received following a hospital episode. This metric will initially be experimental and will be improved over time once linked CLD and SUS data can be used, rather than CLD alone (where hospital discharge is identified just from social care side using the route of access field in CLD). The linked data will be used to develop a range of metrics and exploratory analyses to improve understanding of people's use of services across different health and social care settings. For example, a key area of policy focus is on prevention, and the data in this request will be used to look at the role of social care in helping people to stay out of hospital e.g. by comparing rates of hospital admission across groups of people receiving different short term reablement and intermediate care and understanding care use of people with different patterns of previous hospital use and diagnoses. It will also be used to look at patterns of care use across groups with different patterns of previous hospital use and diagnoses. Data on community and mental health services in this request will be used to provide a fuller picture of social and community care people receive coming out of hospital, since CLD only covers people who receive support organised or provided by the local authority. The linked data will be used to develop a range of metrics to improve the understanding of people's journeys across the settings and services. For example, it will be possible to look at the role of social care in helping people to stay out of hospital by comparing rates of hospital admission across groups of people receiving different care. One additional, specific exploratory use will be examine the relationship between local authority social care use and hospital readmission for hip fracture using machine learning. This work will be carried out by a DHSC analyst as part of the Open Innovation Policy Fellowship. The intended output is a policy report for DHSC and potential publication of results in a peer-reviewed paper.

Expected measurable benefits

The Department (and wider health and care system) historically receives annual aggregate social care activity data and analysis reports from NHS England in the form of the Local Authority annual SALT returns (Short and Long Term Services). ASC Client Level Data was established to enable person and record-level data to flow for linking with health data and to provide more frequent and granular data for the Department's and system-wide secondary data analysis use cases. Data accessed via this request will be used to produce the following planned outputs: The ability to link care and health records will improve understanding of interactions supporting joint planning and commissioning. It will help shed light on questions such as which groups face delays to hospital discharge and which ways of providing social care are effective in reducing unplanned A&E attendances & hospital admissions. • DHSC’s Adult Social Care monthly statistics that includes statistics from CLD describing the number of adults receiving long term support arranged or provided by local authorities each month, and the number of adults who have a care needs assessment each month. Figures are broken down by age, gender and ethnicity and are reported at national, regional and local level. These are badged as ‘official statistics in development’ to reflect the fact that CLD is a relatively new data collection. Access to person-level ASC data and linked health data at a more granular level and with greater frequency and recency provides enhanced analytical opportunity and flexibility to access and use data when policy priorities and Secretary of State requests require the department to do so. It is a key requirement for improving the analytical capability within the department and to deliver higher quality and timely reporting and insight to support policy professionals (within the Civil Service profession) in their use of evidence and analysis for decision making as effectively if access was not granted. • Annual official statistics describing local authority adult social care, including the types of services people use, the characteristics of people requesting and receiving care, and the outcomes of that care. CLD has replaced the previous annual adult social care data collection, SALT, as the primary source of data on local authority activity. Data covered by this request will be the version used in the annual Adult Social Care Activity and Finance Report, since the analytical and publication function has shifted from NHSE to DHSC analysts. In October 2025, figures for 2024/25 activity will be published from CLD as ‘official statistics in development’. The provision of this data enables rapid analysis to be performed on the most recent version of the data. The availability of this function is crucial to DHSC in circumstances where speedy analysis is required to react to either local public health, commissioning, or service planning requirements. • The published Adult Social Care Outcomes Framework (ASCOF) describing how well adult social care helps people to maintain their independence and, where appropriate, regain it. CLD will be used for five ASCOF measures and linked CLD, SUS and mortality data covered by this request will be used to create a sixth measure describing outcomes of reablement support following hospital discharge. In December 2025, ASCOF data will be published, including measures from CLD and SUS, as ‘official statistics in development’. Access to the data will help to inform national policy development aimed at the improvement of patient and service user outcomes more generally. DHSC analysts and users use data to inform broader development of Government policy on health and social care. The evidence is used to advise and brief ministers. • The CLD PowerBI dashboard and linked analytical outputs for local authorities to use the data, including linked health data, to evaluate and improve services and service commissioning locally. This provision of this data to the local authorities in a readily usable format (Power BI dashboard), will enable local government to fulfil their statutory functions, in connection with the provision of health services and of adult social care in England for example, functions of local authorities by virtue of Part 1 of the Care Act 2014, such as • The CLD DQ dashboard/dataset to help local authorities investigate DQ issues affecting their published statistics. This will be separate from the main CLD dashboard and available to different RBAC roles, shared for data quality assurance purposes, and based on only the CLD data submitted by the council, since it will include local IDs i.e. no linked health data will be included. • monitoring, at a population level, particular cohorts of service users and designing analytical models which support more effective interventions in health and adult social care • The BCF PowerBI dashboard. ASCOF measures derived from CLD will also be used as part of the Better Care Fund (BCF) – a grant administered by local health and wellbeing boards that include local authorities and ICBs – to help set and evaluate progress against improvement goals. • monitoring service and integrated care outcomes across a pathway or care setting involving adult social care Due to the context and nature of the Department and its work, other outputs are often unknown in advance, and these will be driven by changing policy and ministerial priorities. This is because the organisation is responsible for the formulation of policy in relation to around £20bn of publicly funded adult social care provision each year, across different types of service provision, to people of all ages, ethnicities and health status. Examples of outputs include: • developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care • Research into areas of current ministerial and policy interest, eg waiting times for care. • designing and implementing new payment models across health and adult social care • Ministerial briefings - ongoing work to understand the link between social care and outcomes. • understanding current and future population needs and resource utilisation for local strategic planning and commissioning purposes including for health, social care and public health needs • Internal analysis to provide management information required for spending reviews. The linked data will be used to develop a range of metrics and exploratory analyses to improve understanding of people's use of services across different health and social care settings. For example, a key area of policy focus is on prevention, and the data in this request will be used to look at the role of social care in helping people to stay out of hospital e.g. by comparing rates of hospital admission across groups of people receiving different short term reablement and intermediate care and understanding care use of people with different patterns of previous hospital use and diagnoses. It will also be used to look at patterns of care use across groups with different patterns of previous hospital use and diagnoses. Data on community and mental health services in this request will be used to provide a fuller picture of social and community care people receive coming out of hospital, since CLD only covers people who receive support organised or provided by the local authority. One additional, specific exploratory use will be examine the relationship between local authority social care use and hospital readmission for hip fracture using machine learning. This work will be carried out by a DHSC analyst as part of the Open Innovation Policy Fellowship. The intended output is a policy report for DHSC and potential publication of results in a peer-reviewed paper.

Benefits reported

Following one year of the mandatory data collection, some of the wide-ranging anticipated benefits are starting to be realised. DHSC and wider health and care system historically received annual aggregate social care activity data and analysis reports from NHS England derived from the local authority SALT (Short and Long Term Support) data collection. ASC CLD was established to enable person and record-level data to flow for linking with health records and to provide more frequent and detailed data for the department's and system-wide secondary data analysis use cases. Data covered by this request is essential to realising these benefits. - DHSC have developed a measure of waiting times for care using CLD that can be used to assess improvement within local authorities. CLD is an essential data source for statistics and metrics used to monitor progress against the Minister’s objectives for adult social care: - In consultation with local authorities, DHSC have developed a dashboard for local authorities that shares back the data in a readily usable format to help them improve data quality and fulfil their statutory functions. 1) To help people to stay independent in their homes, and where all adults including disabled individuals, have choice and control over their support. o This shows data for the whole of 2023/24 with pages on requests, assessments, services, reviews, costs and waiting times for care. CLD is an essential data source for measures in the Adult Social Care Outcomes Framework (ASCOF), which describes how well care and support services achieve the outcomes that matter to people. The ASCOF is used locally and nationally to set priorities for care and support, measure progress and strengthen transparency and accountability. This includes several CLD-based measures of independence e.g. the % of people are living at home or with family and the % who receive direct payments. o It provides the data in accessible and useful formats, also giving users the ability to easily filter what is shown at any one time so they can view the areas they are most interested in and look at care for particular user groups by age, ethnicity, gender and primary support reason. 2) To join up services at neighbourhood level so people receive wrap-around support o At time of writing over 90% of local authorities (143 out of 153) have accessed the dashboard, 112 used it at least once last month, and there are 448 unique users registered. CLD contains individual records of adult social care events that can be linked to hospital and other health records to assess how well services are working together for individuals. A flagship integration measure has already been developed for the ASCOF using linked data to describe outcomes of reablement support following hospital discharge. It will be possible in future to link to a range of data sources including mental health and community health datasets to support join up of services. o DHSC have received positive comments from local authorities about how they are using the dashboard and CLD more generally to improve data quality and improve care locally. For example, waiting times calculated from CLD are being used by one council as the basis for discussion and improvement of processes with area practice managers and front-line teams. These discussions have helped identify areas for improvement and resulted in reduced waits for non-placement referrals and reviews. DHSC have also had positive comments about the value of the dashboard for identifying and rectifying data quality issues. 3) To radically improve the quality of care through higher standards and a professionalised workforce. - DHSC have started to publish statistics from CLD describing the number of people receiving long-term support by local authority, support setting and demographic breakdown, to provide useful new information to the public, and local and national government that can be used in a range of ways. By collecting and sharing more timely analytical outputs CLD will help improve local commissioning and national assurance through better monitoring, benchmarking and evaluation of improvement initiatives. DHSC have also carried out extensive work to develop the data collection, processing, and analytical methods to be able to realise benefits over the coming year, including: To support local use of the data to improve services: - setting up necessary technical infrastructure and data processing routines, to enable use of the data • Insights from their own CLD are shared securely back with councils via a dashboard hosted by AGEM on their Athena platform. - performing data quality assessments to feed into development of data uses and to inform actions to drive data quality improvement (such as 1:1 engagement with local authorities and updating of the guidance), with basic data quality indicators showing improvement each quarter • Quarterly statistics are published by DHSC and used by local authorities in LGA’s benchmarking tool LG Inform. - reproducing existing adult social care activity statistics, in partnership with NHSE colleagues, for use in analytical models and routine reporting for policy development and delivery in adult social care • CLD has been included in the local authority operating model toolkit to support them to use the data when improving assessments - beginning work developing appropriate benchmarking for local authorities, towards supporting care market oversight and improved service planning and commissioning • DHSC and AGEM are working with NW ADASS to explore better sharing and use of data to support regional quality improvement. - developing proof of concept analyses linking CLD with health records, towards understanding patterns of health and care use and evaluation of how effective and integrated services, and individuals getting the most effective care and best outcomes. Access to person-level ASC data and linked health data at a more granular level and with greater frequency and recency provides enhanced analytical opportunity and flexibility to access and use data when policy priorities and Secretary of State requests require the department to do so. It is a key requirement for improving the analytical capability within the department and to deliver higher quality and timely reporting and insight to support policy professionals (within the Civil Service profession) in their use of evidence and analysis for decision making as effectively if access was not granted. The voluntary data returns have enabled DHSC to develop proof of concept analyses and carry out early feasibility studies to determine potential metrics for use in policy making. Additionally, they have enabled us to set up necessary technical infrastructure and data processing routines, and to perform data quality assessments to aid updating of the guidance, ahead of mandatory submission. The provision of this data enables rapid analysis to be performed on the most recent version of the data. The availability of this function is crucial to DHSC in circumstances where speedy analysis is required to react to either local public health, commissioning, or service planning requirements. Access to the data will help to inform national policy development aimed at the improvement of patient and service user outcomes more generally. DHSC analysts and users use data to inform broader development of Government policy on health and social care. The evidence is used to advise and brief ministers. This provision of this data to the local authorities in a readily usable format (Power BI dashboard), enables local government to fulfil their statutory functions, in connection with the provision of health services and of adult social care in England for example, functions of local authorities by virtue of Part 1 of the Care Act 2014.

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

Processing activities

[20 paragraphs unchanged] NHS Midlands and Lancashire Commissioning Support Unit and Greater Manchester Shared Services (hosted by Northern Care Alliance NHS Foundation Trust) supply IT infrastructure for Arden and GEM Commissioning Support Unit and are therefore listed as data processors. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data. [1 paragraph unchanged]

Benefits reported

No yielded benefits can be evidenced yet as the mandatory data has not been processed (the first quarter of mandatory data returns are due July 2023). The voluntary data returns however have enabled DHSC to develop proof of concept analyses and carry out early feasibility studies to determine potential metrics for use in policy making. Additionally, they have enabled us to set up necessary technical infrastructure and data processing routines, and to perform data quality assessments to aid updating of the guidance, ahead of mandatory submission. Following one year of the mandatory data collection, some of the wide-ranging anticipated benefits are starting to be realised. - DHSC have developed a measure of waiting times for care using CLD that can be used to assess improvement within local authorities. - In consultation with local authorities, DHSC have developed a dashboard for local authorities that shares back the data in a readily usable format to help them improve data quality and fulfil their statutory functions. o This shows data for the whole of 2023/24 with pages on requests, assessments, services, reviews, costs and waiting times for care. o It provides the data in accessible and useful formats, also giving users the ability to easily filter what is shown at any one time so they can view the areas they are most interested in and look at care for particular user groups by age, ethnicity, gender and primary support reason. o At time of writing over 90% of local authorities (143 out of 153) have accessed the dashboard, 112 used it at least once last month, and there are 448 unique users registered. o DHSC have received positive comments from local authorities about how they are using the dashboard and CLD more generally to improve data quality and improve care locally. For example, waiting times calculated from CLD are being used by one council as the basis for discussion and improvement of processes with area practice managers and front-line teams. These discussions have helped identify areas for improvement and resulted in reduced waits for non-placement referrals and reviews. DHSC have also had positive comments about the value of the dashboard for identifying and rectifying data quality issues. - DHSC have started to publish statistics from CLD describing the number of people receiving long-term support by local authority, support setting and demographic breakdown, to provide useful new information to the public, and local and national government that can be used in a range of ways. DHSC have also carried out extensive work to develop the data collection, processing, and analytical methods to be able to realise benefits over the coming year, including: - setting up necessary technical infrastructure and data processing routines, to enable use of the data - performing data quality assessments to feed into development of data uses and to inform actions to drive data quality improvement (such as 1:1 engagement with local authorities and updating of the guidance), with basic data quality indicators showing improvement each quarter - reproducing existing adult social care activity statistics, in partnership with NHSE colleagues, for use in analytical models and routine reporting for policy development and delivery in adult social care - beginning work developing appropriate benchmarking for local authorities, towards supporting care market oversight and improved service planning and commissioning - developing proof of concept analyses linking CLD with health records, towards understanding patterns of health and care use and evaluation of how effective and integrated services, and individuals getting the most effective care and best outcomes. The voluntary data returns have enabled DHSC to develop proof of concept analyses and carry out early feasibility studies to determine potential metrics for use in policy making. Additionally, they have enabled us to set up necessary technical infrastructure and data processing routines, and to perform data quality assessments to aid updating of the guidance, ahead of mandatory submission.

Unchanged: Objective for processing, Expected output, Expected measurable benefits.

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

Datasets: + SUS for Commissioners

Objective for processing

This agreement is for Department of Health and Social Care (DHSC) to access Adult Social Care (ASC) Client Level Data (CLD) and Secondary Use Services data (SUS) disseminated via NHS Digital’s England’s Data Services Commissioners Regional Office (DSCRO). DHSC are the Data Controller for this Data Sharing Agreement and Arden and GEM Commissioning Support Unit will act as a Data Processor. The Department of Health & Social Care (DHSC) will use the ASC CLD and SUS in support of the Secretary of State for Health in delivery of [15 words unchanged] the Health and Social Care Act 2012 and the Care Act 2014. [82 paragraphs unchanged] The Department of Health and Social Care process special category data under [51 words unchanged] the purposes described in this Agreement with appropriate safeguards in place. The Data Controller have has demonstrated in this purpose section that their objective serves the interests of society as a whole. Uses of the Data This data will be used to improve understanding of the movement of people out of hospital who receive care and support from their local authority. Improving hospital discharge processes and ensuring adequate capacity in social care to meet needs of people leaving hospital is a priority area across government. Improving data and analysis about discharge is one part of this work e.g. p38 of the UEC delivery plan. Along with the discharge-ready date that will start to be recorded in SUS, linked CLD will be used to describe processes, including waiting times, for groups of people receiving different types of social care after leaving hospital (e.g. reablement, residential and nursing care, specialised placements) and what happened next. This will be used to support collaborative action across the NHS, local government and the social care sector to improve discharge and social care capacity planning. Sub-licensing DHSC will provide access to a Power BI dashboard for local authorities, providing Client Level Data in an accessible and useful form. The purpose will be limited to service planning and commissioning, as described within the terms of the end user agreement. Any Local Authority wishing to access the Dashboard will be required to agree with the terms of this agreement with the Department of Health and Social Care. The information accessed via the dashboard is intended to support local authority commissioners and performance leads of adult social care services to: • gain a better understanding of local demand in their areas and resulting pressures on services • monitor activity and operational performance • carry out strategic thinking to plan services • improve strategic commissioning of services. By giving local authorities timely access to consistent data (now that CLD is a mandated collection) and access to reports, it will add value to both the usefulness of the data, and also provide insight to ultimately improve outcomes for individuals drawing on care and support. DHSC have the specific knowledge and skills to create the dashboards and delivering through sub-licensing can ensure reports are accurate, consistent, comparable and standardised across the country. Through the dashboard, local authorities will be able to access a pseudonymised (de-identified) form of the data that they submit in their Client Level Data return, and metrics derived from it. Since these data will be used for secondary purposes (planning and commissioning) rather than direct care, data will be pseudonymised beforehand using appropriate techniques to remove and prevent disclosure of identifying personal information. In line with sub-licensing guidance, any local identifiers will be removed from the data before sharing with the councils to ensure they have no means within the data of re-identifying it. It is important that the council have access to client-level data via the dashboards to enable them to ‘cut’ and filter the data by different criteria to gain better insight, and to drill down to the client level to understand specific areas or cohorts where further action may be needed. Through the dashboard, local authorities will also be able to access Client Level Data and linked health data that is aggregated at national, regional and local authority level, with appropriate aggregation and small-number suppression. DHSC has asked NHS Arden & Greater East Midlands Commissioning Support Unit (AGEM CSU) to act as a data processor and host the dashboards for them, including managing user access in line with the sub-licensing agreements. Published datasets to be used alongside CLD Published national datasets containing information at higher levels of aggregation will be used at care provider, local authority and area level, including: • ONS population estimates for local authority areas by sex and age. This data will be used to provide denominators for a range of statistics describing rates of demand and use of care by local authority e.g., number of requests for support per 100,000 adults in the local population. It will be used to reproduce statistics reported through the Adult Social Care Activity and Finance Report (e.g. Table 24 describing number of episodes of short-term support per 100,000 adults by local authority) and for the updated Adult Social Care Outcomes Framework (e.g. The number of adults aged 65 and over whose long-term support needs are met by admission to residential and nursing care homes per 100,000 population). • ONS English Indices of Deprivation that compare 32,844 small areas (Lower-layer Super Output Areas or LSOAS) in England, each with an average population of 1,500 people. This data will be linked using the LSOA field (based on the individual’s address) in the CLD dataset to help understand characteristics of care users, and potential inequalities in use of local authority funded social care, as well as differences in health and care outcomes linked to deprivation. A Transparency Statement for these uses can be found at https://www.ardengemcsu.nhs.uk/media/3589/dhsc-cld-transparency-statement.pdf

Processing activities

PROCESSING CONDITIONS: Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS England. 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. Processors must only act upon specific instructions from the Controller. Data Processors must only act upon specific instructions from the Data Controller. Data can only be stored at the addresses listed under storage addresses. [2 paragraphs unchanged] NHS Digital England reminds all organisations party to this agreement of the need to comply [31 words unchanged] contractors of the Data Recipient who may have access to that data) DHSC must publish and maintain a publicly accessible UK GDPR compliant transparency notice that includes sharing data under sub-licensing. [1 paragraph unchanged] Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital England guidance applicable to each data set. Patient level data can only be shared outside of the Data Controller & Data Processors under the terms of a sub-licensing agreement as detailed in this Data Sharing Agreement. For data sharing under sub-licensing, DHSC must publish a release register detailing any sub-licences and onward sharing throughout the life of this agreement in the public domain, at a minimum, updated on a quarterly basis up to 3 months in arrears e.g. If a sub-licencing agreement is granted in October 2023, it is expected that this will be shown on a release register by April 2024. [1 paragraph unchanged] All access to data is auditable by NHS Digital. England. [2 paragraphs unchanged] 1. Pseudonymised Adult Social Care data and SUS data is transferred from the DSCRO to Arden and GEM Commissioning Support Unit [1 paragraph unchanged] 3. Patient level data will not only be shared outside of the Data Controller / Processor Controller/Processor under the terms of a Sub-Licensing agreement and will only be shared within on a need to know basis, [14 words unchanged] with small number suppression can be shared as set out within NHS Digital England guidance applicable to each data set. [5 paragraphs unchanged]

Expected output

[6 paragraphs unchanged] Linked CLD and SUS data will also be used to develop metrics for the Adult Social Care Outcomes Framework (ASCOF) to assess how well adult social care helps people to maintain their independence and, where appropriate, regain it. The ASCOF metric covering effective discharge describes whether an individual receiving care remains living at home 91 days following discharge, and as such acts as a proxy for the appropriateness and effectiveness of the care received following a hospital episode. This metric will initially be experimental and will be improved over time once linked CLD and SUS data can be used, rather than CLD alone (where hospital discharge is identified just from social care side using the route of access field in CLD). The linked data will be used to develop a range of metrics to improve the understanding of people's journeys across the settings and services. For example, it will be possible to look at the role of social care in helping people to stay out of hospital by comparing rates of hospital admission across groups of people receiving different care.

Expected measurable benefits

The Department (and wider health and care system) historically receives annual aggregate social care activity data and analysis reports from NHS Digital England in the form of the Local Authority annual SALT returns (Short and Long Term Services). The purpose of the 2017 ASC Client Level Data pilot and the 2021 national (voluntary) CLD data flow was established to enable person and record-level data to flow for linking with health data for local commissioning purposes and to provide more frequent and granular data for the Department's and system-wide secondary data analysis use cases. Access to person-level ASC data at a more granular level and with greater frequency and recency provides enhanced analytical opportunity and flexibility to access and use data when policy priorities and Secretary of State requests require the department to do so. It is a key requirement for improving the analytical capability within the department and to deliver higher quality and timely reporting and insight to support policy professionals (within the Civil Service profession) in their use of evidence and analysis for decision making as effectively if access was not granted. The ability to link care and health records will improve understanding of interactions supporting joint planning and commissioning. It will help shed light on questions such as which groups face delays to hospital discharge and which ways of providing social care are effective in reducing unplanned A&E attendances & hospital admissions. The provision of this data enables rapid analysis to be performed on the most recent version of the data. The availability of this function is crucial to DHSC in circumstances where speedy analysis is required to react to either local public health, commissioning, or research requirements. Access to person-level ASC data and linked health data at a more granular level and with greater frequency and recency provides enhanced analytical opportunity and flexibility to access and use data when policy priorities and Secretary of State requests require the department to do so. It is a key requirement for improving the analytical capability within the department and to deliver higher quality and timely reporting and insight to support policy professionals (within the Civil Service profession) in their use of evidence and analysis for decision making as effectively if access was not granted. The provision of this data enables rapid analysis to be performed on the most recent version of the data. The availability of this function is crucial to DHSC in circumstances where speedy analysis is required to react to either local public health, commissioning, or service planning requirements. [1 paragraph unchanged] This provision of this data to the local authorities in a readily usable format (Power BI dashboard), will enable local government to fulfil their statutory functions, in connection with the provision of health services and of adult social care in England for example, functions of local authorities by virtue of Part 1 of the Care Act 2014, such as • monitoring, at a population level, particular cohorts of service users and designing analytical models which support more effective interventions in health and adult social care • monitoring service and integrated care outcomes across a pathway or care setting involving adult social care • developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care • designing and implementing new payment models across health and adult social care • understanding current and future population needs and resource utilisation for local strategic planning and commissioning purposes including for health, social care and public health needs

Benefits reported

No yielded benefits can be evidenced as of yet as the data has not been processed No yielded benefits can be evidenced yet as the mandatory data has not been processed (the first quarter of mandatory data returns are due July 2023). The voluntary data returns however have enabled DHSC to develop proof of concept analyses and carry out early feasibility studies to determine potential metrics for use in policy making. Additionally, they have enabled us to set up necessary technical infrastructure and data processing routines, and to perform data quality assessments to aid updating of the guidance, ahead of mandatory submission.