DSfC - NHS Bedfordshire CCG - IV & Comm

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 they 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 and will not be used further.

The CCG are advised by the CEfF whether payment for invoices can be made or not.

Invoice Validation with be conducted by NHS Bedfordshire CCG.

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)

- Civil Registries Data (CRD) (Deaths)

- National Diabetes Audit (NDA)

- Patient Reported Outcome Measures (PROMs)

- NHS e-Referral Service (e-RS)

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 identify specific cohorts of patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models

 Demand Management - to improve the care service for patients by predicting the impact on certain care pathways and support the secondary care system in ensuring enough capacity to manage the demand.

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 the following:

South Central and West Commissioning Support Unit - Provide the general commissioning reports for the CCG

Circle Health - this processing allows for the correct charging mechanisms to be applied across the local healthcare system thereby facilitating efficient use of public monies which can support the delivery of frontline healthcare in the local area.

RSR Consultants Ltd - processes the data to help to identify changes that are most likely changes in how activity is coded and counted rather than changes in patient care as well as help understand the likely financial impact. They also provide additional capacity for general commissioning reporting

AH Analysis Ltd currently analyses local data flows including Service Level Agreement Manager data within NHS Bedfordshire CCG and are therefore listed as a data processor. They supply support to the system, and will need to be a data processor going forward with access to SUS data flows. This will ensure they can support the development of Population Health analytics.

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)

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 section 3 are listed below. This also includes the purpose on which they would be applied -

For the purpose of Commissioning:

• Patients who are normally registered and/or resident within Bedfordshire CCG (including historical activity where the patient was previously registered or resident in another commissioner).

and/or

• Patients treated by a provider where Bedfordshire 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 Bedfordshire CCG - this is only for commissioning and relates to both national and local flows.

For the purpose of Invoice Validation:

• CCG of residence and/or registration.

Ark Data Centres supply IT infrastructure for Circle Health Ltd and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.

Microsoft Limited Supply Cloud Services to NHS South, Central and West 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.

The aspirations of Population Health will mean A H Analysis Ltd will require access to SUS to develop the reporting output to encompass some of the detail that SUS includes i.e. demographics, age bands etc so that it can support the CCG to deliver Population Health.

ANS Group Limited will be assisting in the set up and management of the South Central and West Commissioning Support Unit Microsoft Azure Cloud and are therefore listed as a data processor. They will not have any additional processing / storage addresses (as these will be the Microsoft Azure addresses). Using the data for any other purpose would be considered a breach of this agreement.

INVOICE VALIDATION

(CEfF in CCG)

1. Identifiable SUS+ Data is obtained from the SUS+ Repository by 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) located in the CCG.

3. The CEfF also receive backing data from the provider.

4. The CEfF conduct the following processing activities 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, it 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. In relation to a patient registered with the 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 by the CEfF that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved.

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 (Births and Deaths) (CRD)

13. Civil Registries Data (CRD) (Deaths)

14. National Diabetes Audit (NDA)

15. Patient Reported Outcome Measures (PROMs)

16. e-Referral Service (eRS)

Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:

DATA PROCESSOR 1- South Central & West Commissioning Support Unit

1) 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) (Births and Deaths), National Diabetes Audit (NDA), Patient Reported Outcome Measures (PROMs) and NHS e-Referral Service (eRS) only is securely transferred from the DSCRO to South Central & West Commissioning Support Unit.

2. South Central & West Commissioning Support Unit add derived fields by using existing data, 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. South Central & West 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 South Central & West 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.

In addition to the dissemination of Cancer Waiting Times Data via the DSCRO, the CCG is able to access reports held within the CWT system in NHS Digital directly. Access within the CCG is limited to those with a need to process the data for the purposes described in this agreement.”

A CCG user will be able to access the provider extracts from the portal for any provider where at least 1 patient for whom they are the registered CCG for that individuals GP practice appears in that setting

Although a CCG user may have access to pseudonymised patient information not related to that CCG, users should only process and analyse data for which they have a legitimate relationship (as described within Data Minimisation).

Microsoft Limited supply Cloud Services for NHS South Central and West 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.

ANS Group Limited will be assisting in the set up and management of the South Central and West Commissioning Support Unit Microsoft Azure Cloud and are therefore listed as a data processor. They will not have any additional processing / storage addresses (as these will be the Microsoft Azure addresses). Using the data for any other purpose would be considered a breach of this agreement.

The CSU is directly transferring SUS data to CCG data warehouse so middle process of uploading is removed from the process.

Data Processor 2-RSR Consultants Limited

1. Pseudonymised SUS+ only is securely transferred from the DSCRO to Bedfordshire CCG.

2. Bedfordshire CCG conduct calculations and provide a subset of pseudonymised SUS to RSR Consultants Limited. (A subset of pseudo SUS PLD data is passed to RSR Consultants Limited without any calculations)

3. RSR Consultants Limited provide analysis.

4. RSR Consultants Limited then pass the processed, pseudonymised data to the CCG.

5. Aggregation of required data for CCG management use will be completed by RSR Consultants Limited or the CCG as instructed by the CCG. (Aggregation is provided by RSR)

6. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.

Data Processor 3-Circle Health Limited

1. Pseudonymised SUS+ only is securely transferred from the DSCRO to Bedfordshire CCG.

2. Once the pseudonymised data is available to the CCG, data from the assigned database and extract detail relating to Muscoskeletal (MSK) activities will then be shared with Circle Health by sending an excel version of the data through NHS.net along with a calculation of the proposed recharge to Databasebe invoiced

3. Circle Health then validate the calculation of the recharge and on agreement with the CCG, an appropriate invoice can be raised

4. Aggregation of required data for CCG management use will be completed by Circle Health or the CCG as instructed by the CCG. (Aggregate data is provided by CCG in this case)

5. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.

Data Processor 4 -AH Analysis Ltd - Routine/standard SUS queries using Service Level Aagreement Manager (SLAM) and SUS data.

1. Pseudonymised SUS+ only is securely transferred from the DSCRO to Bedfordshire CCG.

2. AH Analysis Ltd use data from the CCG data warehouse which has been supplied by DSCRO (CSU) and only aggregated non PID (personal identifiable data) into CIVICA to perform multiple analytics to explain the position and issues to contracts,

finance and commissioners across the CCG. (AH Analysis Ltd processes non-PID Patient Level Data SLAM data in CIVICA to produce required reports)

3. Results of the processing are then made available to the CCG

4. AH Analysis Ltd will use Pseudonymised Patient Level Data SUS data from Bedfordshire CCG Data Warehouse to produce regular SUS reporting for different teams in CCG which will support the Intergrated Care System workstreams and wider Population Health reporting and analytics requirements

5. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.

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.

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.

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 patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.

17. Removal of patients from Risk Stratification reports.

18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.

19. Manage demand - by understanding the quantity of assessments required, CCGs are able to improve the care service for patients by predicting the impact on certain care pathways and ensure the secondary care system has enough capacity to manage the demand.

20. In improving the quality of referrals under current structures, CCGs are able to monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.

21. CCGs may identify low priority procedures which could be directed to community-based alternatives and as such commission these services and deflect referrals for low priority procedures resulting in a reduction in hospital referrals.

22. Using pseudonymised e-RS data to provide intelligence will support the understanding of the quantity of assessments required and demand management. CCGs will be able to improve the care service for patients by predicting the impact on certain care pathways and support the secondary care system in ensuring enough capacity to manage the demand.

RSR Consultants Ltd

It is important that the limited resources available to the NHS are utilised in the best way possible for patient care. NHS England have set out, via the NHS Standard Contract, that changes in coding and counting are locally notified so that changes in how patient care are reported are:

1. identified as changes in coding and counting rather than changes in actual care

2. locally discussed to ensure they are valid changes and

3. any financial impact from the change is neutralised for the required amount of time so that the financial impact can be properly planned for.

Circle Health -

Line level data is converted into pivot table which summarises commissioned activity by speciality, HRG subchapter and activity type (outpatient/inpatient).

AH Analysis Ltd

1. Provides the monthly challenge process - running Structured Query Language (SQL) on SUS data to establish counting and coding queries. This ensures the CCG can query the level of detail it wishes to check as opposed to generic CSU packages.

2. Run the analytics for the CCG including Deep Dives for acute activity trends year on year actuals whereby using SUS to append age analysis, outcomes and Length Of Stay (LOS) to the SLAM billing data all of which is at an aggregated level to explain the story and why finances maybe affected adversely. The LOS is a length of stay which we can only usually obtain in SUS as local flows have started to exclude this due to the file sizes In addition LOS helps the CCG to look at for example patients admitted from Accident & Emergency with short LOS, this may be down to hospital flows and meeting their constitutional targets 4 hour wait

3. Provide full Primary Care Network (PCN) GP reporting to look at A&E slot attendance use by practice/locality, planned care volumes over time etc to support system management.

4. Also reconcile SUS to SLAM for assurance purposes which is standard reconciliation practice on acute contracts.

Ultimately the CCGs patients will benefit from improved pathways and service integration further to better decision making as a result of the provision of enhanced analytics. AH Analysis Ltd will require access all the data for the CCG where it can develop population health management analytics. This will support the CCG’s preventative care programme across primary care and the CCG's population health management initiatives. The CCG anticipate the need to use data at its lowest level to facilitate this agenda and for AH Analysis Ltd to actively support key workstreams owing to their expertise. This will support the development of the Intergrated Care System (ICS) and enable decision makers to determine the best use of resource for their patient population, make best use of resources and reshape the way contracts are designed. AH Analysis Ltd will act as an enabler to provide the detailed analytics which enable the CCG to improve patient care and outcomes through the analysis and aggregation of such data.

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 patient's 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 commissioner's 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.

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 Accident & Emergency (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.

18. Allow reporting to drive changes and improve the quality of commissioned services and health outcomes for people.

19. Assists commissioners to make better decisions to support patients

20. Help drive changes in healthcare

21. Allows comparisons of providers performance to assist improvement in services – increase the quality

22. Inform commissioners and improve services

23. Allow analysis of health care provision to 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.

24. Understanding the interdependency of care services

25. Targeting care more effectively

26. Using value as the redesign principle

27. Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them

28. 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

29. 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

30. Service redesign

31. Health Needs Assessment – identification of underlying disease prevalence within the local population

32. To evaluate the impact of new services and innovations (e.g. if commissioners implement a new service or type of procedure with a provider, they can evaluate whether it improves outcomes for patients compared to the previous one).

Circle Health

1. Allows correct charging mechanisms to be applied across the local healthcare system

RSR Consultants Ltd

1. Identify changes that are most likely changes in how activity is coded and counted rather than changes in patient care

2. help understand the likely financial impact in coding changes

AH Analysis Ltd

1. Deliver reporting for all aspects of patient level care mainly delivered by large NHS providers (but not limited to) for example urgent care, by tracking the full pathway of services/charge points

2. Moving forward they will track Quality, Innovation, Productivity and Prevention (QIPP) schemes at code level (OPCS or ICD10 depending on scheme) as SLAM aggregated billing if often too summarised for the schemes. SLAM provides the insight to price, monitor and manage activities and costs in line with contract requirements. It unifies activity and price data sets across health settings to deliver efficient, transparent and consistent expenditure control

This supports commissioning transformation programmes, including Heat Interface Unit respiratory reporting on patient volumes and complexity, all reported at aggregated level.

3. They will also use The Secondary Uses Service (SUS) and SLAM to create Population Health reporting to facilitate Primary Care Networks (PCN) development workstreams and support system management with advanced analytics capability.

The CCG has realised the measurable benefits for the data collection and the viable evaluation data has enabled services to be delivered to match the population requirements whilst planning for future needs. This work will continue year on year to match the delivery/funding of targets services for the population.

The QIPP Project Management Office (PMO) is where we used the process to identify the activity within contracts at a detailed level and set phased plans to then monitor against in year. This saved the PMO team the labour resource of aggregating many reports as all QIPPs relating to acute contracts were within the one output from our process. This assisted the CCG to set, monitor and track progress of schemes in a timely way each month to assure itself that it could meet its transformation requirements and change the ways in which care was being delivered. In addition, this monitoring helps identify new areas of QIPP that can be targeted moving forward, thus quickly identifying areas of concern.