DSfC - NHS Herts Valleys CCG - IV & Comm (ICS Sub-License)
NHS Hertfordshire and West Essex ICB · Sub ICB Location
Listed under NHS Central East Integrated Care Board.
Expired The latest version ended on 4 November 2024. The September 2026 register still lists the agreement, but its term has passed.
- Reference
- DARS-NIC-55752-D6X5Y
- Latest version
- v11.2
- Term of latest version
- 4 April 2022 to 4 November 2024
- Start date
- Before 14 May 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- Yes
- Files released to date
- 0
Why the data was released
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
- e-Referral Service (eRS)
- Personal Demographics Service (PDS)
- Summary Hospital-level Mortality Indicator (SHMI)
- Medicines Dispensed in Primary Care (NHSBSA Data)
- Adult Social Care Data
Processing of the Medicines Dispensed in Primary Care (NHSBSA Data) dataset is only permitted to provide intelligence about the safety and effectiveness of medicines, as specified by the NHS Business Services Authority (NHSBSA) Medicines Data Directions 2019.
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight 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.
Support measuring the health, mortality or care needs of the total local population
Provide intelligence about the safety and effectiveness of medicines.
Allow analysis of patient pathways across healthcare and social care.
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
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 Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Social Prescribing Data -
Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. The CCG having access to this data will allow further analysis of the full patient pathway.
The free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
SUB-LICENSING
In order to assure a smooth transition to the new commissioning landscape, the CCG’s need to be able to share data with members of their Integrated Care System (ICS) in the interim period before the ICS comes into existence. Currently the CCGs are prevented from giving access to other organisations due to the anonymised small number suppression rule for onward sharing.
The ICS Sub-License approach will allow the CCG to share data they receive from NHS Digital via this agreement with members of their ICS. This will be limited to pseudonymised commissioning data with the provider unique local patient id excluded. All data sharing will be restricted to ICS members within the area the CCG is part of and only for the sole purpose of Commissioning.
DATA MINIMISATION
The CCG requires data for their entire Integrated Care System (ICS) region in order to start planning commissioning decisions at a wider level when the Integrated Care Board (ICB) is made a legal entity in April 2022. This includes data for patients registered in NHS East and North Hertfordshire CCG and West Essex CCG.
Having access to ICS level data is critical to support the sub-licensing model as it will ensure the CCG is able to provide the sufficient level of data to the sub-licensees as required. Otherwise, the local Trust would only get a subset of patients in the ICS that they interact with and would limit their ability to contribute to commissioning decisions.
Processing activities
Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital.
Data Processors must only act upon specific instructions from the Data Controller.
Data can only be stored at the addresses listed under storage addresses.
All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role.
Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from NHS Digital will not be national data.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data).
ONWARD SHARING:
There is no requirement for the analytical teams to re-identify patients, but in the development of cohorts of patients considered to be at risk, the data controllers may need the facility to provide identifiable results back to direct healthcare professionals or local authority direct care staff only for the purpose of direct care. All re-id requests will be processed and authorised by the DSCRO on a case by case basis. National data opt outs are not applied in these cases as they are for the purposes of direct care which follows the legal basis of implied consent.
An example of a request for the re-id of patients for direct care may be;
A&E High Attendance usage
The CCG can filter data to show for example the number of A&E attendances in a given period for each patient. The CCG can then flag to the relevant GP of the patient any patients that require intervention. An outcome of this is earlier intervention in the patient(s) care thus potentially reducing future costs and minimising future risk.
Polypharmacy re-IDs
CCG's can request re-ID of a list of patients to be sent to the relevant GP with a high number of medications (ingredient count) and review the medication for these patients. This can help address the risk of polypharmacy which is recognised as an adverse risk factor for patient safety. A by-product of such reviews may be to reduce costs of medication.
The Re-identification process for direct care is as follows:
1. The CCG identifies a patient cohort (typically small numbers) to be re-identified for the purpose of direct care.
2. The CCG sends a re-id request to the DSCRO. This may be done through the CCG or CSU’s Business Intelligence (BI) Tool, or through a manual form.
3. The DSCRO (either through an automated system or manual checking in line with the request) assesses as to whether the request passes the specified re-identification process checks. Checks include if the requester is authorised to access identifiable data, if the number of patients in the cohort is appropriate, and that the request does not seem inappropriate or outside of expected parameters, including for example around timings and the requestor’s relationship with patients in the data
4. If successful/approved, the DSCRO re-identifies the relevant data item(s) for the appropriate patients and returns the identifiable fields to Health or care professional(s) with a legitimate relationship to the patient. The CCG does not see the identifiable record.
5. DSCROs retain an audit trail of all re-id requests
6. National Data opt outs are not applied for the purpose of direct care
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.
Where the Data Processor and/or the Data Controller hold identifiable data with opt outs applied and identifiable data with opt outs not applied, the data will be held separately so data cannot be linked.
All access to data is auditable by NHS Digital.
Data for the purpose of Invoice Validation is kept within the CEfF, and only used by staff properly trained and authorised for the activity. Only CEfF staff are able to access data in the CEfF and only CEfF staff operate the invoice validation process within the CEfF. Data flows directly in to the CEfF from the DSCRO and from the providers – it does not flow through any other processors.
Data Minimisation
Data Minimisation in relation to the data sets listed within the application are listed below. This also includes the purpose on which they would be applied -
For the purpose of Commissioning:
• Patients who are normally registered and/or resident within the NHS Herts Valleys CCG, NHS East and North Hertfordshire CCG and West Essex CCG (including historical activity where the patient was previously registered or resident in another commissioner).
and/or
• Patients treated by a provider where NHS Herts Valleys CCG, NHS East and North Hertfordshire CCG and West Essex 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 NHS Herts Valleys CCG, NHS East and North Hertfordshire CCG and West Essex CCG - this is only for commissioning and relates to both national and local flows.
For the purpose of Invoice Validation:
• Patients who are resident and/or registered within the CCG region.
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 provide Cloud Services for NHS Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Microsoft Limited and Amazon Web Services provide cloud services for Optum Health Solutions (UK) Limited and are therefore listed as 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.
NHS Midlands and Lancashire Commissioning Support Unit and Greater Manchester Shared Services (Hosted by Salford Royal 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.
Ilkeston Community Hospital (Part of Derbyshire Community Health Services NHS Foundation Trust), The Bunker 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.
Invoice Validation
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 Data (CRD) (Births)
13. Civil Registries Data (CRD) (Deaths)
14. National Diabetes Audit (NDA)
15. Patient Reported Outcome Measures (PROMs)
16. e-Referral Service (eRS)
17. Personal Demographics Service (PDS)
18. Summary Hospital-level Mortality Indicator (SHMI)
19. Medicines Dispensed in Primary Care (NHSBSA Data)
20. Adult Social Care Data
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
Data Processor 1 - Arden and Greater East Midlands Commissioning Support Unit.
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT), Civil Registries Data (CRD) (Births and Deaths), National Diabetes Audit (NDA), Patient Reported Outcome Measures (PROMs), e-Referral Service (eRS), Personal Demographics Service (PDS), Summary Hospital-level Mortality Indicator (SHMI), Medicines Dispensed in Primary Care (NHSBSA Data) and Adult Social Care data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit.
2. NHS Arden and Greater East Midlands Commissioning Support Unit also receive GP data and Social Prescribing Data (as points i-x)
3. Arden and Greater East Midlands Commissioning Support Unit add derived fields by using existing 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
4. Allowed linkage is between datasets listed in points 1 and 2
5. Arden and Greater East Midlands Commissioning Support Unit then pass the processed, pseudonymised and linked data to the CCG.
6. Aggregation of required data for CCG management use will be completed by Arden and Greater East Midlands Commissioning Support Unit. or the CCG as instructed by the CCG.
7. Patient level data will not be shared outside of the CCGs, other than with their member GP Practices for each Practices own patients only and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
8. GP Practices may only re-identify data when they need to do so for direct care purposes.
Data Processor 2 - Optum Health Solutions (UK) Ltd
1) Pseudonymised SUS, Local Provider Data, GP Primary Care Data, Mental Health data, Community Services and Adult Social Care data is securely transferred from Arden and Gem to Optum Health Solutions (UK) Ltd.
2) Optum Health Solutions (UK) Ltd provide analysis to:
- Whole population segmentation to assess population health needs
- prospective risk scoring for individuals to indicate the likelihood of future adverse events
- predictive modelling to determine individuals at risk and an understand of the drivers of risk
- longitudinal analysis of intersegmental drift - identifying individuals who move between complexity classifications and the drivers of these transitions
- the production of individual -level theographs to identify gaps in care
3) Allowed linkage is between the datasets contained within point 1 above. GP datasets are needed for the processing carried out by Optum to enhance the population health analytics beyond SUS and LPF's which contain only secondary care activity
4) Optum Health Solutions (UK) Ltd then pass the processed, pseudonymised and linked data to the CCG
5) Aggregation of required data for CCG management use will be completed by Optum Health Solutions (UK) Ltd 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
7) Optum Health Solutions (UK) Ltd will only be in receipt of data and only be permitted to act as a Data Processor for the period specified in the contract with NHS Herts Valleys CCG
GP Data:
i. Identifiable GP data is submitted to NHS Arden and Greater East Midlands Commissioning Support Unit.
ii. The data lands in a ring-fenced area for GP data only.
iii. A specific named individual within NHS Arden and Greater East Midlands Commissioning Support Unit acts on behalf of the GP practice. This person has access to a closed black box type system (which includes a pseudonymisation process).
iv. The individual requests a pseudonymisation key from the DSCRO to use with the black box system. There will be a separate key specific to the pseudonymisation request and the key will only be used for that specific project. The key is specific to the pseudonymisation request. The access controls around the individual’s role does not give them access to the data once it has been passed on to the NHS Arden and Greater East Midlands Commissioning Support Unit.
v. The GP data is then pseudonymised using the black box and DSCRO issued key. The identifiable GP data is then deleted from the ring-fenced area.
vi. The data moves is transferred into a separate part of NHS Arden and Greater East Midlands Commissioning Support Unit.
vii. NHS Arden and Greater East Midlands Commissioning Support Unit make a request to NHS Digital (DSCRO).
viii. The DSCRO send a mapping table to NHS Arden and Greater East Midlands Commissioning Support Unit.
ix. NHS Arden and Greater East Midlands Commissioning Support Unit overwrite the organisations specific pseudonymisation keys with the DSCRO provided keys.
x. The mapping table is then deleted.
Social Prescribing Data
Arden and GEM Commissioning Support Unit also receives identifiable Social Prescribing Data from providers. This then follows the same pseudonymisation and linkage method as the GP data mentioned above.
Most free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
SUB-LICENSING
Data shared with ICS partners will be pseudonymised patient level data or aggregated data. The provider unique local patient ID will not be included. Role Based Access Controls will be in place to limit access to the data. The purpose will be restricted to commissioning as per section 5 of this DSA. The sub-licensees must keep the pseudonymised data separate from other identifiable data they hold.
The following conditions are applicable to the Data Controller and its sub-licensees:
1) All sub-licensee’s will be required to sign a Data Sharing Agreement with the CCG before accessing the data.
2) Data owner requirements are inherited by the sub-licensee through the Data Sharing Agreement and Data Sharing Framework Contract.
3) Onward sharing of data (including with Data Processors) is strictly prohibited.
4) Re-identification of data is strictly prohibited unless it is for the purpose of direct care.
5) The CCG Caldicott Guardian will be responsible for managing which individuals are able to make reidentification requests. These must be health or social care professionals with a legitimate relationship with the patient. NHS Digital will facilitate the re-identification in these cases.
6) Sub-licensees must have a valid Data Security and Protection Toolkit and ICO registration.
7) Data must not be stored or processed outside of England and Wales.
8) The CCG and the sub-licensee must update their transparency notices to inform the public on this level of data sharing
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
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 High cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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. Allow Commissioners to better protect or improve the public health of the total local patient population
23. Allow Commissioners to plan, evaluate and monitor health and social care policies, services, or interventions for the total local patient population
24. Allow Commissioners to compare their providers (trusts) mortality outcomes to the national baseline.
25. Investigate mortality outcomes for trusts
26. Identify medication prescribing trends and their effectiveness.
27. Linking prescribing habits to entry points into the health and social care system
28. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy)
29. 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
30. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care
Expected measurable benefits
Invoice Validation
The invoice validation process supports the ongoing delivery of patient care across the NHS and the CCG region by:
1. Ensuring that activity is fully financially validated.
2. Ensuring that service providers are accurately paid for the patients treatment.
3. Enabling services to be planned, commissioned, managed, and subjected to financial control.
4. Enabling commissioners to confirm that they are paying appropriately for treatment of patients for whom they are responsible.
5. Fulfilling commissioners duties to fiscal probity and scrutiny.
6. Ensuring full financial accountability for relevant organisations.
7. Ensuring robust commissioning and performance management.
8. Ensuring commissioning objectives do not compromise patient confidentiality.
9. Ensuring the avoidance of misappropriation of public funds.
Commissioning
1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
a. Analysis to support full business cases.
b. Develop business models.
c. Monitor In year projects.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
3. Health economic modelling using:
a. Analysis on provider performance against 18 weeks wait targets.
b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients.
c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway.
d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC).
4. Commissioning cycle support for grouping and re-costing previous activity.
5. Enables monitoring of:
a. CCG outcome indicators.
b. Financial and Non-financial validation of activity.
c. Successful delivery of integrated care within the CCG.
d. Checking frequent or multiple attendances to improve early intervention and avoid admissions.
e. Case management.
f. Care service planning.
g. Commissioning and performance management.
h. List size verification by GP practices.
i. Understanding the care of patients in nursing homes.
6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.
7. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.
8. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care.
9. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required.
10. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework.
11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
12. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts
13. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
14. Providing greater understanding of the underlying courses and look to commission improved supportive networks, this would be ongoing work which would be continually assessed.
15. Insight to understand the numerous factors that play a role in the outcome for both datasets. The linkage will allow the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice.
16. Provision of indicators of health problems, and patterns of risk within the commissioning region.
17. Support of benchmarking for evaluating progress in future years.
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. 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).
25. Monitoring of entire population, as opposed to only those that engage with services
26. Enable Commissioners to be able to see early indications of potential practice resilience issues in that an early warning marker can often be a trend of patients re-registering themselves at a neighbouring practice.
27. Monitor the quality and safety of the delivery of healthcare services.
28. Allow focused commissioning support based on factual data rather than assumed and projected sources
29. Understand admissions linked to overprescribing.
30. Add value to the population health management workstream by adding prescribing data into linked dataset for segmentation and stratification to help further understand the effectiveness and safety of medications
31. Developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care
32. Designing and implementing new payment models across health and adult social care
33. 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.
Linkage with Primary Care Data allows further analysis of patient pathways and population health management
Benefits reported so far
The CCG are able to track patients who have been onward referred to an acute provider from a community provider. They have been able see the treatment received at the Acute provider as a result of the onward referral and assess the efficacy of these referrals. For clarity, this is coded data but due to the high number of ICD-10 codes, these are still very specific. The CCG can also see the patients previous activity from the pseudonymised number to assess that this pathway reflects with previous conditions and thus be able to assess the efficacy.
As the CCG has been able to link Risk stratification data to other reports – like the A&E High intensity users – they have been able to assist GPs to focus their efforts of those high attenders of A&E with a high risk of being admitted. This has resulted in a reduction of A&E admission rate. A number of patients saw a decrease from over 60 attendances in A&E in 12 months prior to intervention to under 10 A&E attendances in the last 6 months.
A cohort of BAME individuals with Diabetes who have low rates of contact with Primary Care have been identified which has enabled the CCG, as part of their Wave 2 programme, to focus more resource to this group.
The ability to evidence the strong connections between Diabetes, Hypertension and Obesity in local populations has been instrumental in redesigning the Integrated Diabetes Service.
The CCG have been sharing this work with their two neighbouring CCGs – East and North Herts CCG and West Essex CCG – however this has not been put into practice as those CCGs do not have access to the same data feeds in order to re-create this for their CCGs. The CCG have also helped in work with BLMK CCG.
Further evidence of the benefits achieved by the CCG can be found in the annual report published on the CCG's website - https://hertsvalleysccg.nhs.uk/about-us/documents/annual-reports-and-financial-statements?q=%2Fabout-us%2Fdocuments%2Fannual-reports-and-financial-statements
Datasets on the latest version
Legal basis for provision: Health and Social Care Act 2012 - s261 - 'Other dissemination of information'; Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'.
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Acute-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Adult Social Care | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Ambulance-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Children and Young People Health | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Civil Registration - Births | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Civil Registrations of Death | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Community Services Data Set (CSDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Community-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Demand for Service-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Diagnostic Imaging Data Set (DID) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Diagnostic Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| e-Referral Service for Commissioning | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Emergency Care-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Experience, Quality and Outcomes-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Improving Access to Psychological Therapies (IAPT) v1.5 | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Maternity Services Data Set | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Medicines dispensed in Primary Care (NHSBSA data) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health and Learning Disabilities Data Set (MHLDDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health Minimum Data Set (MHMDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health Services Data Set (MHSDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| National Diabetes Audit | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Patient Reported Outcome Measures (PROMs) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Personal Demographic Service | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Population Data-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Primary Care Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Public Health and Screening Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Summary Hospital-level Mortality Indicator (SHMI) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| SUS for Commissioners | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| SUS for Commissioners | Identifiable | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
Files released
Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.
This agreement permits sublicensing: the applicant may pass data on to others. Anything passed on is not recorded in this register.
No files recorded as released under this agreement.
Version history
The register lists each renewal of this agreement as a separate row. This site has 9 versions — earlier versions existed before this site's records begin.
DARS-NIC-55752-D6X5Y-v11.2 4 April 2022 to 4 November 2024
- Title
- DSfC - NHS Herts Valleys CCG - IV & Comm (ICS Sub-License)
- Commercial
- No
- Sublicensing
- Yes
- Datasets
- 32
- Files released
- 0
Datasets: Acute-Local Provider Flows; Adult Social Care; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; e-Referral Service for Commissioning; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Medicines dispensed in Primary Care (NHSBSA data); Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Personal Demographic Service; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; Summary Hospital-level Mortality Indicator (SHMI); SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v10.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2022-04-04 |
Objective for processing
[66 paragraphs unchanged]
In order to assure a smooth transition to the new commissioning landscape,
[10 words unchanged]
members of their Integrated Care System (ICS) in the interim period before
April 2022.
the ICS comes into existence.
Currently the CCGs are prevented from giving access to other organisations due to the anonymised small number suppression rule for onward sharing.
[4 paragraphs unchanged]
Unchanged: Processing activities, Expected output, Expected measurable benefits, Benefits reported.
DARS-NIC-55752-D6X5Y-v10.2 5 November 2021 to 4 November 2024
- Title
- DSfC - NHS Herts Valleys CCG - IV & Comm (ICS Sub-License)
- Commercial
- No
- Sublicensing
- Yes
- Datasets
- 32
- Files released
- 0
Datasets: Acute-Local Provider Flows; Adult Social Care; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; e-Referral Service for Commissioning; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Medicines dispensed in Primary Care (NHSBSA data); Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Personal Demographic Service; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; Summary Hospital-level Mortality Indicator (SHMI); SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v9.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Title | DSfC - NHS Herts Valleys CCG - IV & Comm (ICS Sub-License) | |
| Start date | 2021-11-05 | |
| End date | 2024-11-04 | |
| Sublicensing | Yes |
Objective for processing
[65 paragraphs unchanged] SUB-LICENSING In order to assure a smooth transition to the new commissioning landscape, the CCG’s need to be able to share data with members of their Integrated Care System (ICS) in the interim period before April 2022. Currently the CCGs are prevented from giving access to other organisations due to the anonymised small number suppression rule for onward sharing. The ICS Sub-License approach will allow the CCG to share data they receive from NHS Digital via this agreement with members of their ICS. This will be limited to pseudonymised commissioning data with the provider unique local patient id excluded. All data sharing will be restricted to ICS members within the area the CCG is part of and only for the sole purpose of Commissioning. DATA MINIMISATION The CCG requires data for their entire Integrated Care System (ICS) region in order to start planning commissioning decisions at a wider level when the Integrated Care Board (ICB) is made a legal entity in April 2022. This includes data for patients registered in NHS East and North Hertfordshire CCG and West Essex CCG. Having access to ICS level data is critical to support the sub-licensing model as it will ensure the CCG is able to provide the sufficient level of data to the sub-licensees as required. Otherwise, the local Trust would only get a subset of patients in the ICS that they interact with and would limit their ability to contribute to commissioning decisions.
Processing activities
[6 paragraphs unchanged]
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
[23 paragraphs unchanged]
• Patients who are normally registered and/or resident within the NHS Herts Valleys
CCG, NHS East and North Hertfordshire CCG and West Essex
CCG (including historical activity where the patient was previously registered or resident in another commissioner).
[1 paragraph unchanged]
• Patients treated by a provider where NHS Herts Valleys
CCG, NHS East and North Hertfordshire CCG and West Essex
CCG is the host/co-ordinating commissioner and/or has the primary responsibility for the
[9 words unchanged]
is only for commissioning and relates to both national and local flows.
[1 paragraph unchanged]
• Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of NHS Herts Valleys
CCG, NHS East and North Hertfordshire CCG and West Essex
CCG - this is only for commissioning and relates to both national and local flows.
[2 paragraphs unchanged]
Microsoft Limited provide Cloud Services for NHS Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data
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 provide Cloud Services for NHS Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
[51 paragraphs unchanged]
2. NHS Arden and Greater East Midlands Commissioning Support Unit
also
receive GP data and Social Prescribing Data (as points i-x)
3. Arden and Greater East Midlands Commissioning Support
Unit.
Unit
add derived fields by using existing
data. Allowed linkage is between the data sets listed within point 1 is then linked to the pseudonymised GP and Social Prescribing
data and
provide
analysis
is provided
to:
[7 paragraphs unchanged]
4. Arden and Greater East Midlands Commissioning Support Unit. then pass the processed, pseudonymised and linked data to the CCG.
4. Allowed linkage is between datasets listed in points 1 and 2
5.
Aggregation of required data for CCG management use will be completed by
Arden and Greater East Midlands Commissioning Support
Unit. or
Unit then pass
the
CCG as instructed by
processed, pseudonymised and linked data to
the CCG.
6. Patient level data will not be shared outside of the CCGs, other than with their member GP Practices for each Practices own patients only and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
6. Aggregation of required data for CCG management use will be completed by Arden and Greater East Midlands Commissioning Support Unit. or the CCG as instructed by the CCG.
7. GP Practices may only re-identify data when they need to do so for direct care purposes.
7. Patient level data will not be shared outside of the CCGs, other than with their member GP Practices for each Practices own patients only and will only be shared within the CCGs on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
8. Arden and Gem pass Pseudonymised SUS, Local Provider Data, GP Primary Care data, Mental Health data and Community Services data to Optum Health Solutions (UK) Ltd
8. GP Practices may only re-identify data when they need to do so for direct care purposes.
9. Optum Health Solutions (UK) Ltd analyse the data and pass the data to the CCG
[8 paragraphs unchanged]
3) Allowed linkage is between the datasets contained within point
(1)
1
above. GP datasets are needed for the processing carried out by Optum to enhance the population health analytics beyond SUS and LPF's which contain only secondary care activity
[18 paragraphs unchanged]
SUB-LICENSING
Data shared with ICS partners will be pseudonymised patient level data or aggregated data. The provider unique local patient ID will not be included. Role Based Access Controls will be in place to limit access to the data. The purpose will be restricted to commissioning as per section 5 of this DSA. The sub-licensees must keep the pseudonymised data separate from other identifiable data they hold.
The following conditions are applicable to the Data Controller and its sub-licensees:
1) All sub-licensee’s will be required to sign a Data Sharing Agreement with the CCG before accessing the data.
2) Data owner requirements are inherited by the sub-licensee through the Data Sharing Agreement and Data Sharing Framework Contract.
3) Onward sharing of data (including with Data Processors) is strictly prohibited.
4) Re-identification of data is strictly prohibited unless it is for the purpose of direct care.
5) The CCG Caldicott Guardian will be responsible for managing which individuals are able to make reidentification requests. These must be health or social care professionals with a legitimate relationship with the patient. NHS Digital will facilitate the re-identification in these cases.
6) Sub-licensees must have a valid Data Security and Protection Toolkit and ICO registration.
7) Data must not be stored or processed outside of England and Wales.
8) The CCG and the sub-licensee must update their transparency notices to inform the public on this level of data sharing
Expected measurable benefits
[52 paragraphs unchanged]
25. Monitoring of entire population, as
a pose
opposed
to only those that engage with services
[9 paragraphs unchanged]
Benefits reported
The CCG has realised the measurable benefits for the data collection and the provided data has enabled services to be delivered to match the population requirements whilst planning for future needs.
Listed below is a number of further yielded benefits for commissioning;
1. Monitoring In year projects
2. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients
3. Successful delivery of integrated care within the CCG.
4. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
5. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
The CCG will look to build on the yielded benefits of commissioning services that meet the needs of their local population, and that are effective in their delivery. The CCG will use intelligence to add insight to strategic commissioning and service integration across the CCG Area. This work will continue year on year to match the delivery/funding of targets services for the population within the CCG Area.
The continued access to this data will enable the CCG to further understand and improve service performance and delivery, including patient pathway design, re-design and patient experience.
[1 paragraph unchanged]
As the CCG has been able to link Risk stratification data to
[32 words unchanged]
being admitted. This has resulted in a reduction of A&E admission rate.
A number of patients saw a decrease from over 60 attendances in A&E in 12 months prior to intervention to under 10 A&E attendances in the last 6 months.
[2 paragraphs unchanged]
The CCG have been sharing this work with their two neighbouring CCGs – East and North Herts CCG and West Essex CCG – however this has not been put into practice as those CCGs do not have access to the same data feeds in order to re-create this for their CCGs. The CCG have also helped in work with BLMK CCG.
Further evidence of the benefits achieved by the CCG can be found in the annual report published on the CCG's website - https://hertsvalleysccg.nhs.uk/about-us/documents/annual-reports-and-financial-statements?q=%2Fabout-us%2Fdocuments%2Fannual-reports-and-financial-statements
Unchanged: Expected output.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
- e-Referral Service (eRS)
- Personal Demographics Service (PDS)
- Summary Hospital-level Mortality Indicator (SHMI)
- Medicines Dispensed in Primary Care (NHSBSA Data)
- Adult Social Care Data
Processing of the Medicines Dispensed in Primary Care (NHSBSA Data) dataset is only permitted to provide intelligence about the safety and effectiveness of medicines, as specified by the NHS Business Services Authority (NHSBSA) Medicines Data Directions 2019.
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight 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.
Support measuring the health, mortality or care needs of the total local population
Provide intelligence about the safety and effectiveness of medicines.
Allow analysis of patient pathways across healthcare and social care.
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
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 Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Social Prescribing Data -
Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. The CCG having access to this data will allow further analysis of the full patient pathway.
The free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
SUB-LICENSING
In order to assure a smooth transition to the new commissioning landscape, the CCG’s need to be able to share data with members of their Integrated Care System (ICS) in the interim period before April 2022. Currently the CCGs are prevented from giving access to other organisations due to the anonymised small number suppression rule for onward sharing.
The ICS Sub-License approach will allow the CCG to share data they receive from NHS Digital via this agreement with members of their ICS. This will be limited to pseudonymised commissioning data with the provider unique local patient id excluded. All data sharing will be restricted to ICS members within the area the CCG is part of and only for the sole purpose of Commissioning.
DATA MINIMISATION
The CCG requires data for their entire Integrated Care System (ICS) region in order to start planning commissioning decisions at a wider level when the Integrated Care Board (ICB) is made a legal entity in April 2022. This includes data for patients registered in NHS East and North Hertfordshire CCG and West Essex CCG.
Having access to ICS level data is critical to support the sub-licensing model as it will ensure the CCG is able to provide the sufficient level of data to the sub-licensees as required. Otherwise, the local Trust would only get a subset of patients in the ICS that they interact with and would limit their ability to contribute to commissioning decisions.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
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 High cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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. Allow Commissioners to better protect or improve the public health of the total local patient population
23. Allow Commissioners to plan, evaluate and monitor health and social care policies, services, or interventions for the total local patient population
24. Allow Commissioners to compare their providers (trusts) mortality outcomes to the national baseline.
25. Investigate mortality outcomes for trusts
26. Identify medication prescribing trends and their effectiveness.
27. Linking prescribing habits to entry points into the health and social care system
28. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy)
29. 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
30. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care
Benefits reported
The CCG are able to track patients who have been onward referred to an acute provider from a community provider. They have been able see the treatment received at the Acute provider as a result of the onward referral and assess the efficacy of these referrals. For clarity, this is coded data but due to the high number of ICD-10 codes, these are still very specific. The CCG can also see the patients previous activity from the pseudonymised number to assess that this pathway reflects with previous conditions and thus be able to assess the efficacy.
As the CCG has been able to link Risk stratification data to other reports – like the A&E High intensity users – they have been able to assist GPs to focus their efforts of those high attenders of A&E with a high risk of being admitted. This has resulted in a reduction of A&E admission rate. A number of patients saw a decrease from over 60 attendances in A&E in 12 months prior to intervention to under 10 A&E attendances in the last 6 months.
A cohort of BAME individuals with Diabetes who have low rates of contact with Primary Care have been identified which has enabled the CCG, as part of their Wave 2 programme, to focus more resource to this group.
The ability to evidence the strong connections between Diabetes, Hypertension and Obesity in local populations has been instrumental in redesigning the Integrated Diabetes Service.
The CCG have been sharing this work with their two neighbouring CCGs – East and North Herts CCG and West Essex CCG – however this has not been put into practice as those CCGs do not have access to the same data feeds in order to re-create this for their CCGs. The CCG have also helped in work with BLMK CCG.
Further evidence of the benefits achieved by the CCG can be found in the annual report published on the CCG's website - https://hertsvalleysccg.nhs.uk/about-us/documents/annual-reports-and-financial-statements?q=%2Fabout-us%2Fdocuments%2Fannual-reports-and-financial-statements
DARS-NIC-55752-D6X5Y-v9.2 25 May 2021 to 24 May 2024
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 32
- Files released
- 0
Datasets: Acute-Local Provider Flows; Adult Social Care; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; e-Referral Service for Commissioning; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Medicines dispensed in Primary Care (NHSBSA data); Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Personal Demographic Service; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; Summary Hospital-level Mortality Indicator (SHMI); SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v8.1
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2021-05-25 | |
| End date | 2024-05-24 |
Datasets: + Adult Social Care; + Medicines dispensed in Primary Care (NHSBSA data)
Objective for processing
[2 paragraphs unchanged]
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is
are
able to ensure that the activity claimed for each patient is their
[45 words unchanged]
of backing-data sets (data from providers) and will not be used further.
[35 paragraphs unchanged]
-Summary
- Summary
Hospital-level Mortality Indicator (SHMI)
- Medicines Dispensed in Primary Care (NHSBSA Data)
- Adult Social Care Data
Processing of the Medicines Dispensed in Primary Care (NHSBSA Data) dataset is only permitted to provide intelligence about the safety and effectiveness of medicines, as specified by the NHS Business Services Authority (NHSBSA) Medicines Data Directions 2019.
[5 paragraphs unchanged]
• Using value as the redesign principle
[10 paragraphs unchanged]
Provide intelligence about the safety and effectiveness of medicines.
Allow analysis of patient pathways across healthcare and social care.
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
[2 paragraphs unchanged]
Social Prescribing Data -
Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. The CCG having access to this data will allow further analysis of the full patient pathway.
The free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
Processing activities
[6 paragraphs unchanged]
Onward Sharing
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
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.
ONWARD SHARING:
There is no requirement for the analytical teams to re-identify patients, but in the development of cohorts of patients considered to be at risk, the data controllers may need the facility to provide identifiable results back to direct healthcare professionals or local authority direct care staff only for the purpose of direct care. All re-id requests will be processed and authorised by the DSCRO on a case by case basis. National data opt outs are not applied in these cases as they are for the purposes of direct care which follows the legal basis of implied consent.
An example of a request for the re-id of patients for direct care may be;
A&E High Attendance usage
The CCG can filter data to show for example the number of A&E attendances in a given period for each patient. The CCG can then flag to the relevant GP of the patient any patients that require intervention. An outcome of this is earlier intervention in the patient(s) care thus potentially reducing future costs and minimising future risk.
Polypharmacy re-IDs
CCG's can request re-ID of a list of patients to be sent to the relevant GP with a high number of medications (ingredient count) and review the medication for these patients. This can help address the risk of polypharmacy which is recognised as an adverse risk factor for patient safety. A by-product of such reviews may be to reduce costs of medication.
The Re-identification process for direct care is as follows:
1. The CCG identifies a patient cohort (typically small numbers) to be re-identified for the purpose of direct care.
2. The CCG sends a re-id request to the DSCRO. This may be done through the CCG or CSU’s Business Intelligence (BI) Tool, or through a manual form.
3. The DSCRO (either through an automated system or manual checking in line with the request) assesses as to whether the request passes the specified re-identification process checks. Checks include if the requester is authorised to access identifiable data, if the number of patients in the cohort is appropriate, and that the request does not seem inappropriate or outside of expected parameters, including for example around timings and the requestor’s relationship with patients in the data
4. If successful/approved, the DSCRO re-identifies the relevant data item(s) for the appropriate patients and returns the identifiable fields to Health or care professional(s) with a legitimate relationship to the patient. The CCG does not see the identifiable record.
5. DSCROs retain an audit trail of all re-id requests
6. National Data opt outs are not applied for the purpose of direct care
[63 paragraphs unchanged]
19. Medicines Dispensed in Primary Care (NHSBSA Data)
20. Adult Social Care Data
[2 paragraphs unchanged]
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS),
[44 words unchanged]
(NDA), Patient Reported Outcome Measures (PROMs), e-Referral Service (eRS), Personal Demographics Service
(PDS) and
(PDS),
Summary Hospital-level Mortality Indicator
(SHMI)
(SHMI), Medicines Dispensed in Primary Care (NHSBSA Data) and Adult Social Care
data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit.
2. NHS Arden and Greater East Midlands Commissioning Support Unit receive GP data
and Social Prescribing Data
(as points i-x)
3. Arden and Greater East Midlands Commissioning Support Unit. add derived fields
[10 words unchanged]
sets listed within point 1 is then linked to the pseudonymised GP
and Social Prescribing
data and analysis is provided to:
[13 paragraphs unchanged]
Commissioning -
Data Processor
2
- Optum Health Solutions (UK) Ltd
1) Pseudonymised SUS, Local Provider Data, GP Primary Care Data, Mental Health
data and
data,
Community Services
and Adult Social Care
data is securely transferred from Arden and Gem to Optum Health Solutions (UK) Ltd.
[22 paragraphs unchanged]
Social Prescribing Data
Arden and GEM Commissioning Support Unit also receives identifiable Social Prescribing Data from providers. This then follows the same pseudonymisation and linkage method as the GP data mentioned above.
Most free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
Expected output
[54 paragraphs unchanged] 26. Identify medication prescribing trends and their effectiveness. 27. Linking prescribing habits to entry points into the health and social care system 28. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy) 29. 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 30. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care
Expected measurable benefits
[51 paragraphs unchanged]
24. Understanding the interdependency of care services
24. 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).
25. Targeting care more effectively
25. Monitoring of entire population, as a pose to only those that engage with services
26. Using value as the redesign principle
26. Enable Commissioners to be able to see early indications of potential practice resilience issues in that an early warning marker can often be a trend of patients re-registering themselves at a neighbouring practice.
27. Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
27. Monitor the quality and safety of the delivery of healthcare services.
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
28. Allow focused commissioning support based on factual data rather than assumed and projected sources
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
29. Understand admissions linked to overprescribing.
30. Service redesign
30. Add value to the population health management workstream by adding prescribing data into linked dataset for segmentation and stratification to help further understand the effectiveness and safety of medications
31. Health Needs Assessment – identification of underlying disease prevalence within the local population
31. Developing, through evaluation of person-level data, more effective prevention strategies and interventions across a pathway or care setting involving adult social care
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).
32. Designing and implementing new payment models across health and adult social care
33. Monitoring of entire population, as a pose to only those that engage with services
33. 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.
34. Enable Commissioners to be able to see early indications of potential practice resilience issues in that an early warning marker can often be a trend of patients re-registering themselves at a neighbouring practice.
35. Monitor the quality and safety of the delivery of healthcare services.
36. Allow focused commissioning support based on factual data rather than assumed and projected sources
[1 paragraph unchanged]
Benefits reported
Not stated in the previous version; added here.
The CCG has realised the measurable benefits for the data collection and the provided data has enabled services to be delivered to match the population requirements whilst planning for future needs.
Listed below is a number of further yielded benefits for commissioning;
1. Monitoring In year projects
2. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients
3. Successful delivery of integrated care within the CCG.
4. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
5. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
The CCG will look to build on the yielded benefits of commissioning services that meet the needs of their local population, and that are effective in their delivery. The CCG will use intelligence to add insight to strategic commissioning and service integration across the CCG Area. This work will continue year on year to match the delivery/funding of targets services for the population within the CCG Area.
The continued access to this data will enable the CCG to further understand and improve service performance and delivery, including patient pathway design, re-design and patient experience.
The CCG are able to track patients who have been onward referred to an acute provider from a community provider. They have been able see the treatment received at the Acute provider as a result of the onward referral and assess the efficacy of these referrals. For clarity, this is coded data but due to the high number of ICD-10 codes, these are still very specific. The CCG can also see the patients previous activity from the pseudonymised number to assess that this pathway reflects with previous conditions and thus be able to assess the efficacy.
As the CCG has been able to link Risk stratification data to other reports – like the A&E High intensity users – they have been able to assist GPs to focus their efforts of those high attenders of A&E with a high risk of being admitted. This has resulted in a reduction of A&E admission rate.
A cohort of BAME individuals with Diabetes who have low rates of contact with Primary Care have been identified which has enabled the CCG, as part of their Wave 2 programme, to focus more resource to this group.
The ability to evidence the strong connections between Diabetes, Hypertension and Obesity in local populations has been instrumental in redesigning the Integrated Diabetes Service.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
- e-Referral Service (eRS)
- Personal Demographics Service (PDS)
- Summary Hospital-level Mortality Indicator (SHMI)
- Medicines Dispensed in Primary Care (NHSBSA Data)
- Adult Social Care Data
Processing of the Medicines Dispensed in Primary Care (NHSBSA Data) dataset is only permitted to provide intelligence about the safety and effectiveness of medicines, as specified by the NHS Business Services Authority (NHSBSA) Medicines Data Directions 2019.
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight 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.
Support measuring the health, mortality or care needs of the total local population
Provide intelligence about the safety and effectiveness of medicines.
Allow analysis of patient pathways across healthcare and social care.
Risk Stratification using pseudo data – using a tool for identifying pseudonymised patients at risk. The pseudonymised patient level data is then shared with health and care professionals with a legitimate relationship to the patient who are able to request re-identification when required for direct care purposes.
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 Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Social Prescribing Data -
Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. The CCG having access to this data will allow further analysis of the full patient pathway.
The free text fields will be formatted into a potential list of options. Any free text fields that cannot follow this process will be looked at individually as to their requirement and if required will be subject to Arden and GEM CSU’s quality assurance process to ensure identifiable information regarding the patient is not included.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
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 High cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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. Allow Commissioners to better protect or improve the public health of the total local patient population
23. Allow Commissioners to plan, evaluate and monitor health and social care policies, services, or interventions for the total local patient population
24. Allow Commissioners to compare their providers (trusts) mortality outcomes to the national baseline.
25. Investigate mortality outcomes for trusts
26. Identify medication prescribing trends and their effectiveness.
27. Linking prescribing habits to entry points into the health and social care system
28. Identify, quantify and understand cohorts of patient’s high numbers of different medications (polypharmacy)
29. 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
30. Monitoring service and integrated care outcomes across a pathway or care setting involving adult social care
Benefits reported
The CCG has realised the measurable benefits for the data collection and the provided data has enabled services to be delivered to match the population requirements whilst planning for future needs.
Listed below is a number of further yielded benefits for commissioning;
1. Monitoring In year projects
2. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients
3. Successful delivery of integrated care within the CCG.
4. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
5. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
The CCG will look to build on the yielded benefits of commissioning services that meet the needs of their local population, and that are effective in their delivery. The CCG will use intelligence to add insight to strategic commissioning and service integration across the CCG Area. This work will continue year on year to match the delivery/funding of targets services for the population within the CCG Area.
The continued access to this data will enable the CCG to further understand and improve service performance and delivery, including patient pathway design, re-design and patient experience.
The CCG are able to track patients who have been onward referred to an acute provider from a community provider. They have been able see the treatment received at the Acute provider as a result of the onward referral and assess the efficacy of these referrals. For clarity, this is coded data but due to the high number of ICD-10 codes, these are still very specific. The CCG can also see the patients previous activity from the pseudonymised number to assess that this pathway reflects with previous conditions and thus be able to assess the efficacy.
As the CCG has been able to link Risk stratification data to other reports – like the A&E High intensity users – they have been able to assist GPs to focus their efforts of those high attenders of A&E with a high risk of being admitted. This has resulted in a reduction of A&E admission rate.
A cohort of BAME individuals with Diabetes who have low rates of contact with Primary Care have been identified which has enabled the CCG, as part of their Wave 2 programme, to focus more resource to this group.
The ability to evidence the strong connections between Diabetes, Hypertension and Obesity in local populations has been instrumental in redesigning the Integrated Diabetes Service.
DARS-NIC-55752-D6X5Y-v8.1 11 November 2020 to 10 November 2023
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 30
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; e-Referral Service for Commissioning; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Personal Demographic Service; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; Summary Hospital-level Mortality Indicator (SHMI); SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v7.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-11-11 | |
| End date | 2023-11-10 | |
| Acute-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Ambulance-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Children and Young People Health: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Civil Registration - Births: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Civil Registrations of Death: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Community Services Data Set (CSDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Community-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Demand for Service-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Diagnostic Imaging Data Set (DID): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Diagnostic Services-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Emergency Care-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Experience, Quality and Outcomes-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Improving Access to Psychological Therapies Data Set_v1.5: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Maternity Services Data Set v1.5: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health Minimum Data Set (MHMDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health Services Data Set (MHSDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| National Diabetes Audit: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Patient Reported Outcome Measures (PROMs): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Population Data-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Primary Care Services-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Public Health and Screening Services-Local Provider Flows: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| SUS for Commissioners: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information'; Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'. | |
| e-Referral Service for Commissioning: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' |
Datasets: + Personal Demographic Service; + Summary Hospital-level Mortality Indicator (SHMI)
Objective for processing
[37 paragraphs unchanged] - Personal Demographics Service (PDS) -Summary Hospital-level Mortality Indicator (SHMI) [13 paragraphs unchanged] Patient stratification and predictive modelling - to highlight cohorts of patients at risk of requiring hospital admission and other avoidable factors such [7 words unchanged] executed against linked de-identified data, and identification of future service delivery models [1 paragraph unchanged] Support measuring the health, mortality or care needs of the total local population [2 paragraphs unchanged]
Processing activities
[24 paragraphs unchanged]
Microsoft Limited
supply
provide Cloud Services for
NHS
Arden and GEM Commissioning Support Unit and are therefore listed as a
[30 words unchanged]
agreement. This includes granting of access to the database[s] containing the data
NHS Midlands
Microsoft Limited
and
Lancashire Commissioning Support Unit and Greater Manchester Shared
Amazon Web
Services
(hosted by NHS Oldham CCG) supply IT infrastructure
provide cloud services
for
Arden and GEM Commissioning Support Unit
Optum Health Solutions (UK) Limited
and are therefore listed as
data
processors. They supply support to the system, but do not access data.
[17 words unchanged]
agreement. This includes granting of access to the database[s] containing the data.
NHS Midlands and Lancashire Commissioning Support Unit and Greater Manchester Shared Services (Hosted by Salford Royal 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.
[42 paragraphs unchanged]
17. Personal Demographics Service (PDS)
18. Summary Hospital-level Mortality Indicator (SHMI)
[2 paragraphs unchanged]
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS),
[37 words unchanged]
(CRD) (Births and Deaths), National Diabetes Audit (NDA), Patient Reported Outcome Measures
(PROMs) and
(PROMs),
e-Referral Service
(eRS)
(eRS), Personal Demographics Service (PDS) and Summary Hospital-level Mortality Indicator (SHMI)
data only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit.
[39 paragraphs unchanged]
Expected output
[50 paragraphs unchanged] 22. Allow Commissioners to better protect or improve the public health of the total local patient population 23. Allow Commissioners to plan, evaluate and monitor health and social care policies, services, or interventions for the total local patient population 24. Allow Commissioners to compare their providers (trusts) mortality outcomes to the national baseline. 25. Investigate mortality outcomes for trusts
Expected measurable benefits
[60 paragraphs unchanged] 33. Monitoring of entire population, as a pose to only those that engage with services 34. Enable Commissioners to be able to see early indications of potential practice resilience issues in that an early warning marker can often be a trend of patients re-registering themselves at a neighbouring practice. 35. Monitor the quality and safety of the delivery of healthcare services. 36. Allow focused commissioning support based on factual data rather than assumed and projected sources [1 paragraph unchanged]
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
- e-Referral Service (eRS)
- Personal Demographics Service (PDS)
-Summary Hospital-level Mortality Indicator (SHMI)
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight 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.
Support measuring the health, mortality or care needs of the total local population
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
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 High cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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. Allow Commissioners to better protect or improve the public health of the total local patient population
23. Allow Commissioners to plan, evaluate and monitor health and social care policies, services, or interventions for the total local patient population
24. Allow Commissioners to compare their providers (trusts) mortality outcomes to the national baseline.
25. Investigate mortality outcomes for trusts
DARS-NIC-55752-D6X5Y-v7.2 8 September 2020 to 7 September 2023
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 28
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; e-Referral Service for Commissioning; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v6.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-09-08 | |
| End date | 2023-09-07 |
Datasets: + e-Referral Service for Commissioning
Objective for processing
[36 paragraphs unchanged]
- e-Referral Service (eRS)
[14 paragraphs unchanged]
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.
[1 paragraph unchanged]
The CCG is changing DSCRO and Commissioning Support Unit to North West DSCRO and Arden and Greater East Midlands Commissioning Support Unit. In order to ensure a smooth transition, there will be a maximum of 3 months of dual processing, after which, processing for North East London Commissioning Support Unit will cease.
Processing for commissioning will be conducted by Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Processing activities
[24 paragraphs unchanged]
Interxion
Microsoft Limited supply provide Cloud Services for Arden and GEM Commissioning Support Unit and are therefore listed as a data processor. They supply support to the system, but
do not access
data held under this agreement as they only supply the building.
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.
data
[1 paragraph unchanged]
Ilkeston Community Hospital (Part of Derbyshire Community Health Services NHS Foundation
Trust)
Trust), The Bunker
and Wrightington, Wigan and Leigh NHS Foundation Trust do not access data
[27 words unchanged]
agreement. This includes granting of access to the database[s] containing the data.
[40 paragraphs unchanged]
16. e-Referral Service (eRS)
[1 paragraph unchanged]
Data Processor 1
– NHS North
- Arden
and
Greater
East
London
Midlands
Commissioning Support Unit.
This will cease 31/01/2020.
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS),
[32 words unchanged]
Set (CWT), Civil Registries Data (CRD) (Births and Deaths), National Diabetes Audit
(NDA) and
(NDA),
Patient Reported Outcome Measures (PROMs)
and e-Referral Service (eRS) data
only is securely transferred from the DSCRO to
NHS North
Arden
and
Greater
East
London
Midlands
Commissioning Support
Unit
Unit.
2. NHS North and East London 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. NHS North and East London 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 NHS North and East London 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.
Data Processor 2 - Arden and Greater East Midlands Commissioning Support Unit.
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT), Civil Registries Data (CRD) (Births and Deaths), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit.
[13 paragraphs unchanged]
8. Arden and Gem pass Pseudonymised SUS, Local Provider
Data and
Data,
GP Primary Care
data, Mental Health data and Community Services
data to Optum Health Solutions (UK) Ltd
[2 paragraphs unchanged]
1) Pseudonymised SUS, Local Provider
Data and
Data,
GP Primary Care
Data
Data, Mental Health data and Community Services data
is securely transferred from Arden and Gem to Optum Health Solutions (UK) Ltd.
[22 paragraphs unchanged]
Dual running for Arden and Greater East Midlands Commissioning Support Unit and North East London Commissioning Support Unit is limited to three months from the start of the Data Sharing Agreement. After this date, North East London Commissioning Support Unit will cease to receive and process data for the CCG under this agreement. North East London will complete a Destruction Certificate and submit this to NHS Digital by 28/02/2020
Expected output
[26 paragraphs unchanged]
8. GP Practice level dashboard
reports include high flyers.
reports.
[5 paragraphs unchanged]
o
Most expensive patients
High cost activity uses
(top 15%)
[14 paragraphs unchanged]
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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.
Expected measurable benefits
[45 paragraphs unchanged] 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). [1 paragraph unchanged]
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
- e-Referral Service (eRS)
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
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 Arden and GEM Commissioning Support Unit and Optum Heath Solutions (UK) Ltd.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
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 High cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
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. Monitor the timing of key actions relating to referral letters. CCG’s are unable to see the contents of the referral letters.
21. 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.
DARS-NIC-55752-D6X5Y-v6.2 9 December 2019 to 31 October 2020
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v5.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
Objective for processing
[52 paragraphs unchanged]
Optum Health Solutions (IK) Ltd - NHS England Wave 2 PHM Project
NHS Herts Valley CCG is working with NHS England as a Wave 2 Population Health Management CCG. NHS England has contracted Optum Health Solutions (UK) Ltd to work with selected CCGs to undertake population health and actuarial analysis to build up a methodology for dissemination across the NHS in England. The Optum Health Solutions (UK) Ltd involvement is for 20 weeks, anticipated to start in March 2020 for approximately 20 weeks. Data held by Optum Health Solutions (UK) Ltd for this project will be destroyed within 6 months of completion of the project and permissions as a data processor the this project will be removed from this agreement by amendment.
Processing activities
[97 paragraphs unchanged]
8. Arden and Gem pass Pseudonymised SUS, Local Provider Data and GP Primary Care data to Optum Health Solutions (UK) Ltd
9. Optum Health Solutions (UK) Ltd analyse the data and pass the data to the CCG
Commissioning - Data Processor - Optum Health Solutions (UK) Ltd
1) Pseudonymised SUS, Local Provider Data and GP Primary Care Data is securely transferred from Arden and Gem to Optum Health Solutions (UK) Ltd.
2) Optum Health Solutions (UK) Ltd provide analysis to:
- Whole population segmentation to assess population health needs
- prospective risk scoring for individuals to indicate the likelihood of future adverse events
- predictive modelling to determine individuals at risk and an understand of the drivers of risk
- longitudinal analysis of intersegmental drift - identifying individuals who move between complexity classifications and the drivers of these transitions
- the production of individual -level theographs to identify gaps in care
3) Allowed linkage is between the datasets contained within point (1) above. GP datasets are needed for the processing carried out by Optum to enhance the population health analytics beyond SUS and LPF's which contain only secondary care activity
4) Optum Health Solutions (UK) Ltd then pass the processed, pseudonymised and linked data to the CCG
5) Aggregation of required data for CCG management use will be completed by Optum Health Solutions (UK) Ltd 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
7) Optum Health Solutions (UK) Ltd will only be in receipt of data and only be permitted to act as a Data Processor for the period specified in the contract with NHS Herts Valleys CCG
[11 paragraphs unchanged]
Dual running for Arden and Greater East Midlands Commissioning Support Unit and North East London Commissioning Support Unit is limited
until 08/03/2020.
to three months from the start of the Data Sharing Agreement.
After this date, North East London Commissioning Support Unit will cease to
[11 words unchanged]
East London will complete a Destruction Certificate and submit this to NHS
Digital.
Digital by 28/02/2020
Data held by Optum Health Solutions (UK) Ltd for this project will be destroyed within 6 months of completion of the project and permissions as a data processor the this project will be removed from this agreement by amendment.
Expected output
[47 paragraphs unchanged]
Optum Health Solutions (UK) Ltd - NHS England Wave 2 PHM Project
The outputs, as part of the NHS England Wave 2 PHM national programme will identify patient cohorts and inequalities in outcome, spend and opportunity for further investigation, with a view to improving service delivery and patient health outcomes.
Wave 2 PHM will also begin to develop the CCG capability to undertake actuarial analysis of linked datasets from multiple care settings to develop further the understanding of the wider determinants of health across the population. All outputs will be delivered within the timescales of the contract between Optum Health Solutions (UK) Ltd and the CCG.
Unchanged: Expected measurable benefits.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
The CCG is changing DSCRO and Commissioning Support Unit to North West DSCRO and Arden and Greater East Midlands Commissioning Support Unit. In order to ensure a smooth transition, there will be a maximum of 3 months of dual processing, after which, processing for North East London Commissioning Support Unit will cease.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where 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.
DARS-NIC-55752-D6X5Y-v5.2 9 December 2019 to 31 October 2020
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v4.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2019-12-09 |
Objective for processing
[3 paragraphs unchanged] The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not. [32 paragraphs unchanged] In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners. [15 paragraphs unchanged] Optum Health Solutions (IK) Ltd - NHS England Wave 2 PHM Project NHS Herts Valley CCG is working with NHS England as a Wave 2 Population Health Management CCG. NHS England has contracted Optum Health Solutions (UK) Ltd to work with selected CCGs to undertake population health and actuarial analysis to build up a methodology for dissemination across the NHS in England. The Optum Health Solutions (UK) Ltd involvement is for 20 weeks, anticipated to start in March 2020 for approximately 20 weeks. Data held by Optum Health Solutions (UK) Ltd for this project will be destroyed within 6 months of completion of the project and permissions as a data processor the this project will be removed from this agreement by amendment.
Processing activities
[84 paragraphs unchanged]
2.
NHS
Arden and Greater East Midlands Commissioning Support
Unit. add derived fields by using existing data, link
Unit receive GP
data
and provide analysis to:
(as points i-x)
3. Arden and Greater East Midlands Commissioning Support Unit. add derived fields by using existing data. Allowed linkage is between the data sets listed within point 1 is then linked to the pseudonymised GP data and analysis is provided to:
[7 paragraphs unchanged]
3. Allowed linkage is between the data sets contained within point 1.
[2 paragraphs unchanged]
6. Patient level data will not be shared outside of the
CCG
CCGs, other than with their member GP Practices for each Practices own patients only
and will only be shared within the
CCG
CCGs
on a need to know basis, as per the purposes stipulated within
[15 words unchanged]
as set out within NHS Digital guidance applicable to each data set.
Dual running for Arden and Greater East Midlands Commissioning Support Unit and North East London Commissioning Support Unit is limited to three months from the start of the Data Sharing Agreement. After this date, North East London Commissioning Support Unit will cease to receive and process data for the CCG under this agreement North East London will complete a Destruction Certificates and submit this to NHS Digital.
7. GP Practices may only re-identify data when they need to do so for direct care purposes.
GP Data:
i. Identifiable GP data is submitted to NHS Arden and Greater East Midlands Commissioning Support Unit.
ii. The data lands in a ring-fenced area for GP data only.
iii. A specific named individual within NHS Arden and Greater East Midlands Commissioning Support Unit acts on behalf of the GP practice. This person has access to a closed black box type system (which includes a pseudonymisation process).
iv. The individual requests a pseudonymisation key from the DSCRO to use with the black box system. There will be a separate key specific to the pseudonymisation request and the key will only be used for that specific project. The key is specific to the pseudonymisation request. The access controls around the individual’s role does not give them access to the data once it has been passed on to the NHS Arden and Greater East Midlands Commissioning Support Unit.
v. The GP data is then pseudonymised using the black box and DSCRO issued key. The identifiable GP data is then deleted from the ring-fenced area.
vi. The data moves is transferred into a separate part of NHS Arden and Greater East Midlands Commissioning Support Unit.
vii. NHS Arden and Greater East Midlands Commissioning Support Unit make a request to NHS Digital (DSCRO).
viii. The DSCRO send a mapping table to NHS Arden and Greater East Midlands Commissioning Support Unit.
ix. NHS Arden and Greater East Midlands Commissioning Support Unit overwrite the organisations specific pseudonymisation keys with the DSCRO provided keys.
x. The mapping table is then deleted.
Dual running for Arden and Greater East Midlands Commissioning Support Unit and North East London Commissioning Support Unit is limited until 08/03/2020. After this date, North East London Commissioning Support Unit will cease to receive and process data for the CCG under this agreement. North East London will complete a Destruction Certificate and submit this to NHS Digital.
Data held by Optum Health Solutions (UK) Ltd for this project will be destroyed within 6 months of completion of the project and permissions as a data processor the this project will be removed from this agreement by amendment.
Expected output
[44 paragraphs unchanged]
16. Understanding where
patients
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.
[2 paragraphs unchanged]
Optum Health Solutions (UK) Ltd - NHS England Wave 2 PHM Project
The outputs, as part of the NHS England Wave 2 PHM national programme will identify patient cohorts and inequalities in outcome, spend and opportunity for further investigation, with a view to improving service delivery and patient health outcomes.
Wave 2 PHM will also begin to develop the CCG capability to undertake actuarial analysis of linked datasets from multiple care settings to develop further the understanding of the wider determinants of health across the population. All outputs will be delivered within the timescales of the contract between Optum Health Solutions (UK) Ltd and the CCG.
Expected measurable benefits
[45 paragraphs unchanged] Linkage with Primary Care Data allows further analysis of patient pathways and population health management
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF approver whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
In addition, GP data will be linked to the datasets to give further enriched outputs at a GP level to support commissioners.
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
The CCG is changing DSCRO and Commissioning Support Unit to North West DSCRO and Arden and Greater East Midlands Commissioning Support Unit. In order to ensure a smooth transition, there will be a maximum of 3 months of dual processing, after which, processing for North East London Commissioning Support Unit will cease.
Optum Health Solutions (IK) Ltd - NHS England Wave 2 PHM Project
NHS Herts Valley CCG is working with NHS England as a Wave 2 Population Health Management CCG. NHS England has contracted Optum Health Solutions (UK) Ltd to work with selected CCGs to undertake population health and actuarial analysis to build up a methodology for dissemination across the NHS in England. The Optum Health Solutions (UK) Ltd involvement is for 20 weeks, anticipated to start in March 2020 for approximately 20 weeks. Data held by Optum Health Solutions (UK) Ltd for this project will be destroyed within 6 months of completion of the project and permissions as a data processor the this project will be removed from this agreement by amendment.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where 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.
Optum Health Solutions (UK) Ltd - NHS England Wave 2 PHM Project
The outputs, as part of the NHS England Wave 2 PHM national programme will identify patient cohorts and inequalities in outcome, spend and opportunity for further investigation, with a view to improving service delivery and patient health outcomes.
Wave 2 PHM will also begin to develop the CCG capability to undertake actuarial analysis of linked datasets from multiple care settings to develop further the understanding of the wider determinants of health across the population. All outputs will be delivered within the timescales of the contract between Optum Health Solutions (UK) Ltd and the CCG.
DARS-NIC-55752-D6X5Y-v4.2 1 November 2019 to 31 October 2020
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-55752-D6X5Y-v3.3
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2019-11-01 | |
| End date | 2020-10-31 | |
| Acute-Local Provider Flows: sensitivity | Sensitive | |
| Acute-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Ambulance-Local Provider Flows: sensitivity | Sensitive | |
| Ambulance-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Children and Young People Health: sensitivity | Sensitive | |
| Children and Young People Health: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Civil Registration - Births: sensitivity | Sensitive | |
| Civil Registration - Births: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Civil Registrations of Death: sensitivity | Sensitive | |
| Civil Registrations of Death: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Community Services Data Set (CSDS): sensitivity | Sensitive | |
| Community Services Data Set (CSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Community-Local Provider Flows: sensitivity | Sensitive | |
| Community-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Demand for Service-Local Provider Flows: sensitivity | Sensitive | |
| Demand for Service-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Diagnostic Imaging Data Set (DID): sensitivity | Sensitive | |
| Diagnostic Imaging Data Set (DID): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Diagnostic Services-Local Provider Flows: sensitivity | Sensitive | |
| Diagnostic Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Emergency Care-Local Provider Flows: sensitivity | Sensitive | |
| Emergency Care-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Experience, Quality and Outcomes-Local Provider Flows: sensitivity | Sensitive | |
| Experience, Quality and Outcomes-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Improving Access to Psychological Therapies Data Set_v1.5: sensitivity | Sensitive | |
| Improving Access to Psychological Therapies Data Set_v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Maternity Services Data Set v1.5: sensitivity | Sensitive | |
| Maternity Services Data Set v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health Minimum Data Set (MHMDS): sensitivity | Sensitive | |
| Mental Health Minimum Data Set (MHMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health Services Data Set (MHSDS): sensitivity | Sensitive | |
| Mental Health Services Data Set (MHSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): sensitivity | Sensitive | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health-Local Provider Flows: sensitivity | Sensitive | |
| Mental Health-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): sensitivity | Sensitive | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows: sensitivity | Sensitive | |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Population Data-Local Provider Flows: sensitivity | Sensitive | |
| Population Data-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Primary Care Services-Local Provider Flows: sensitivity | Sensitive | |
| Primary Care Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Public Health and Screening Services-Local Provider Flows: sensitivity | Sensitive | |
| Public Health and Screening Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| SUS for Commissioners: sensitivity | Sensitive | |
| SUS for Commissioners: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
Datasets: + National Diabetes Audit; + Patient Reported Outcome Measures (PROMs)
Objective for processing
[32 paragraphs unchanged]
- Civil Registries Data (CRD)
(Births and Deaths)
(Births)
- Civil Registries Data (CRD) (Deaths)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
[1 paragraph unchanged]
§
Population health management:
·
•
Understanding the interdependency of care services
·
•
Targeting care more effectively
·
•
Using value as the redesign principle
§
Data Quality and Validation – allowing data quality checks on the submitted data
§
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
§
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
§
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
§
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
§
Service redesign
§
Health Needs Assessment – identification of underlying disease prevalence within the local population
§
Patient stratification and predictive modelling - to highlight patients at risk of
[15 words unchanged]
executed against linked de-identified data, and identification of future service delivery models
[1 paragraph unchanged]
Processing for commissioning will be conducted by North East London CSU
The CCG is changing DSCRO and Commissioning Support Unit to North West DSCRO and Arden and Greater East Midlands Commissioning Support Unit. In order to ensure a smooth transition, there will be a maximum of 3 months of dual processing, after which, processing for North East London Commissioning Support Unit will cease.
Processing activities
[11 paragraphs unchanged]
Where the Data Processor and/or the Data Controller hold identifiable data with opt outs applied and identifiable data with opt outs not applied, the data will be held separately so data cannot be linked.
[11 paragraphs unchanged]
• CCG of residence and/or registration.
• Patients who are resident and/or registered within the CCG region.
[1 paragraph unchanged]
NHS Midlands and Lancashire Commissioning Support Unit and Greater Manchester Shared Services (hosted by NHS Oldham CCG) 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.
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.
[3 paragraphs unchanged]
3. The CEfF conduct the following processing activities for invoice validation purposes:
3. The CEfF also receive backing data from the provider.
4. The CEfF conduct the following processing activities for invoice validation purposes:
[5 paragraphs unchanged]
4.
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.
[25 paragraphs unchanged]
12. Civil Registries Data (CRD)
(Births)
13. Civil Registries Data (CRD) (Deaths)
14. National Diabetes Audit (NDA)
15. Patient Reported Outcome Measures (PROMs)
[1 paragraph unchanged]
Data Processor 1 – NHS North and East London Commissioning Support
Unit
Unit. This will cease 31/01/2020.
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS),
[21 words unchanged]
(CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set
(CWT) and
(CWT),
Civil Registries Data (CRD)
(Births and Deaths), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs)
only is securely transferred from the DSCRO to NHS North and East London Commissioning Support
Unit.
Unit
2. NHS North and East London Commissioning Support Unit add derived
fields,
fields by using existing data,
link data and provide analysis to:
[9 paragraphs unchanged]
5. Aggregation of required data for CCG management use will be completed by NHS North and East London Commissioning Support Unit
or the CCG
as instructed by the CCG.
[1 paragraph unchanged]
Data Processor 2 - Arden and Greater East Midlands Commissioning Support Unit.
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT), Civil Registries Data (CRD) (Births and Deaths), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to Arden and Greater East Midlands Commissioning Support Unit.
2. Arden and Greater East Midlands Commissioning Support Unit. add derived fields 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. Arden and Greater East Midlands 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 Arden and Greater East Midlands 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.
Dual running for Arden and Greater East Midlands Commissioning Support Unit and North East London Commissioning Support Unit is limited to three months from the start of the Data Sharing Agreement. After this date, North East London Commissioning Support Unit will cease to receive and process data for the CCG under this agreement North East London will complete a Destruction Certificates and submit this to NHS Digital.
Changed only in punctuation, spacing or capitalisation: Expected output.
Unchanged: Expected measurable benefits.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
The CCG is changing DSCRO and Commissioning Support Unit to North West DSCRO and Arden and Greater East Midlands Commissioning Support Unit. In order to ensure a smooth transition, there will be a maximum of 3 months of dual processing, after which, processing for North East London Commissioning Support Unit will cease.
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patients are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
DARS-NIC-55752-D6X5Y-v3.3 14 May 2019 to 13 May 2022
- Title
- DSfC - NHS Herts Valleys CCG IV & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 25
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); Other Not Elsewhere Classified (NEC)-Local Provider Flows; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so the CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
The CCG are advised by the appointed CEfF whether payment for invoices can be made or not.
Invoice Validation with be conducted by NHS Herts Valleys 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 and Deaths)
The pseudonymised data is required to for the following purposes:
§ Population health management:
· Understanding the interdependency of care services
· Targeting care more effectively
· Using value as the redesign principle
§ Data Quality and Validation – allowing data quality checks on the submitted data
§ Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
§ Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
§ Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
§ Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
§ Service redesign
§ Health Needs Assessment – identification of underlying disease prevalence within the local population
§ Patient stratification and predictive modelling - to highlight patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
Processing for commissioning will be conducted by North East London CSU
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patients are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
Register history
When this agreement appeared in, or was edited in, each monthly edition of the register. Built by comparing every edition this site holds, the earliest of which is July 2021.
-
July 2021 —
already listed in the earliest edition this site holds, so it may be older. 6 versions: DARS-NIC-55752-D6X5Y-v3.3, DARS-NIC-55752-D6X5Y-v4.2, DARS-NIC-55752-D6X5Y-v5.2, DARS-NIC-55752-D6X5Y-v6.2, DARS-NIC-55752-D6X5Y-v7.2, DARS-NIC-55752-D6X5Y-v8.1
-
November 2021
1 version added: DARS-NIC-55752-D6X5Y-v9.2
-
February 2022
1 version added: DARS-NIC-55752-D6X5Y-v10.2
-
July 2022
1 version added: DARS-NIC-55752-D6X5Y-v11.2
-
October 2022
Succeeded Applicant organisation: NHS Herts Valleys CCG succeeded by NHS Hertfordshire and West Essex ICB from 1 July 2022, according to NHS ODS. Not counted as a change.Succeeded Data controllers: NHS Herts Valleys CCG succeeded by NHS Hertfordshire and West Essex ICB from 1 July 2022, according to NHS ODS. Not counted as a change.
-
December 2022
Register-wide edit DARS-NIC-55752-D6X5Y-v3.3, DARS-NIC-55752-D6X5Y-v4.2, DARS-NIC-55752-D6X5Y-v5.2, DARS-NIC-55752-D6X5Y-v6.2, DARS-NIC-55752-D6X5Y-v7.2 — Datasets: legal basis: “
s261(1) and” taken out. Made to 639 agreements in this edition, so it is reported once, on the changes page, and not counted as an amendment of this agreement.
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-55752-D6X5Y, “DSfC - NHS Herts Valleys CCG - IV & Comm (ICS Sub-License)”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-55752-d6x5y/ (accessed [date]).
This address stays the same, but the page is rebuilt with each monthly edition, so the citation names the edition it shows. Every edition's data is kept in the facts store.
Source: datausesregister_september2026.xlsx, September 2026 edition of the NHS England Data Uses Register. Search that workbook for DARS-NIC-55752-D6X5Y to see the original rows.