Boston Consulting Group UK - NHS England Data Extract

Boston Consulting Group UK LLP (BCG UK), a UK subsidiary of the US based company The Boston Consulting Group, Inc., requires access to NHS England data for the purpose of providing consultancy services to clients in the health sector. BCG UK LLP is one of multiple worldwide subsidiaries that are legal entities under The Boston Consulting Group, Inc.. Boston Consulting Group UK LLP (BCG UK) have confirmed that they determine the purposes and the means of the NHSE data they receive under this agreement and that only BCG UK LLP will process the data under this agreement, no other subsidiaries of The Boston Consulting Group, Inc. will be involved in processing the data.

The data will be used to provide services to the following types of clients only:

• Department for Health and Social Care (DHSC)

• The Care Quality Commission (CQC)

• NHS Trusts

• Mental Health Trusts

• Community Provider Trusts

• Commissioning Support Units (CSUs)

• Integrated Care Systems (ICSs)

• Sustainability and Transformation Partnerships (STPs)

• Health and Wellbeing Boards

The data will be used to provide the following services only:

• Benchmarking

• Financial and operational performance analysis

• Demand and Capacity Modelling

• Service evaluation

• Service analysis

• Care pathway analysis

• Hospital feedback services

• Health economics and outcomes analysis

The following NHS England datasets will be accessed:

• Hospital Episode Statistics - Admitted Patient Care, Critical Care, Outpatients & Accident and Emergency

• Emergency Care Dataset (ECDS)

• Diagnostic Imaging Dataset (DID)

• Mental Health Services Dataset (MHSDS)

• Community Services Dataset (CSDS)

• Patient Reported Outcome Measures (PROMS)

The datasets listed above are necessary to provide information on patient journeys through NHS & supporting care services. The data will enable BCG to understand and benchmark service demands and capacity across its client’s jurisdiction or region, build a clear view of care pathways across clinical specialties and care provision settings and support identification of gaps in services, opportunities for development or efficiency improvements. The data will provide information on historic trends in use of care services for establishing accurate baselines and making robust projections.

The level of the data will be pseudonymised.

The data will be limited to data between 2018/19 financial year to latest available data available during the data sharing agreement period.

The data controller has reviewed the data items requested within this agreement and determined with the assistance of NHSE that they are necessary in order to help them achieve the intended outputs and benefits. The data controller has aligned their data request to similar requests from other commercial organisations in terms of the breadth of data being requested. The applicant will review the data disseminated throughout the term of the agreement and should it be determined that any data is not utilised as expected it would not be further requested and would be destroyed.

Boston Consulting Group UK LLP (BCG UK) is the data controller as the organisation responsible for ensuring that the data will only be processed for the purpose described above. The client types listed above commission to undertake the work. Clients do not specify what data are required to deliver the work nor how the data shall be processed to achieve that purpose. Such decisions are taken by BCG UK.

The lawful basis for processing personal data under the UK GDPR is:

Article 6(1)(f) - processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party.

BCG UK as part of their Legitimate Interests, will use the data to provide commercial services to improve healthcare for patients and provide support services to healthcare providers to enable those providers to deliver better healthcare to citizens. BCG UK has determined the processing is necessary for its legitimate interests in being able to conduct the following analyses to support production of advanced analytical tools and services that will benefit healthcare organisations:

• Demand & capacity modelling

• Financial & operational performance analysis and benchmarking

• Patient journey mapping

Without the processing of patient data, detailed analysis of the above areas to support improvements to patient care cannot take place. Models, forecasts, benchmarks and recommendations based on summary statistics cannot be as accurate as those built on detailed patient records. National data is necessary to enable accurate benchmarking of services against national standards including recognition of gaps or trends in service delivery.

The lawful basis for processing special category data under the UK GDPR is:

Article 9(2)(j) - processing is necessary for scientific research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.

Amazon Web Services provides IT support services to BCG UK through cloud storage and will store the data as contracted by BCG UK.

Any data to which BCG gains access via this agreement will be used for services commissioned by NHS and other public sector clients only which aim to benefit the health and social care system in the UK. The data will not be used for private sector organisations or for organisations outside of the UK. BCG UK LLP do charge clients for the work delivered using the requested data.

BCG UK maintains that there will be a persistent commercial aspect to the data processing included in this data sharing agreement. Through processing of NHS England data, BCG UK will seek to maximise the business effectiveness of services provided to NHS & UK Public Sector organisations. BCG UK provided services for patient pathway analyses for hospital clients in the UK using client & publicly available data, however has experienced limitations in the ability to perform comprehensive patient pathway analysis across multiple providers as well as benchmarking services against national standards.

BCG UK LLP may use insights from outcomes of processing the data on behalf of clients for commercial benefit by means of developing publishing articles and/or creating client engagement materials and analytical tools. All outputs of this form will contain aggregated data with small numbers suppressed only.

Whilst it is not possible to present full details of specific measurable benefits as they will depend on the project that BCG UK LLP is commissioned to deliver by each client, the aim of all BCG UK LLP’s projects with NHS and other public sector clients is to improve the provision of health and social care services for better public health outcomes in the UK. A few selected case studies are provided in the ‘Benefits’ section of the agreement to illustrate the way in which BCG UK LLP will deliver benefits using the data from NHS England. BCG UK LLP has delivered sizeable societal benefits via its work with NHS and UK public sector clients, by means of improved operational efficiency, quality of services and cost reduction to date. It is expected that the access to the requested data will increase the value in BCG UK LLP’s service offerings to these clients and the subsequent societal benefits resulting from the improved health and social care provision and effective health care planning delivered by the clients.

No data will flow to NHS England for the purposes of this Agreement.

NHS England data will provide the relevant records from the following datasets to Boston Consulting UK LLP (BCG UK):

• Hospital Episode Statistics

• Emergency Care Dataset

• Community Services Dataset

• Mental Health Services Dataset

• Patient Reported Outcome Measures

• Diagnostic Imaging Dataset

The data will contain no direct identifying data items. The data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient. There will be no requirement and no attempt to reidentify individuals when using the data.

The data will not be transferred to any other location. The data will be stored on servers at BCG UK. BCG UK stores data on the Cloud provided by Amazon Web Services. The data will not leave England/Wales at any time.

The Data will be accessed by authorised personnel via remote access.

The Controller(s) must confirm and provide evidence upon audit by NHS England that access via any remote device complies with the data security obligations within this DSA and the Data Sharing Framework Contract.

For remote access:

- Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA;

- Access controls granting users the minimum level of access required are in place;

- Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data;

- Multifactor authentication (MFA) is required for remote access;

- Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access;

- All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this DSA) and complies with the organisation’s remote access policy.

The above applies in addition to any condition set out elsewhere within the DSA (e.g. who may carry out processing, and for what purpose).

The data will remain on the servers at BCG UK at all times. Personnel are prohibited from downloading or copying data to local devices.

Access is restricted to employees or agents of BCG UK who have authorisation from the Managing Director. All such individuals are substantive employees of BCG UK. BCG UK LLP is one of multiple worldwide subsidiaries that are legal entities under The Boston Consulting Group, Inc. For the processing outlined in this agreement, only BCG UK LLP will process the data under this agreement, no other subsidiaries of The Boston Consulting Group, Inc will be involved in processing the data.

All personnel accessing the data have been appropriately trained in data protection and confidentiality. Analysts from the BCG UK will analyse the data for the purposes described within the Objectives above.

Data will be deleted after 5 years on a rolling basis. i.e. the oldest year of data will be securely destroyed within 4 weeks when the next full year is received (rolling retention of 5 full years of data, plus current year-to-date). Data will be destroyed in line with NHS England's Data Destruction policy and a Data Destruction Certificate produced.

The expected outputs of the processing will be:

• A report of findings including graphs and tables based on outcomes of analysis submitted to clients.

• Presentations of aggregated data and findings distributed to clients.

• Publication of dashboards on [organisation’s] website

• web-based benchmarking tool with which the clients can use to view analysis outcomes under license with the client.

• Interactive workshops and working sessions with clients and stakeholders of the commissioned work to communicate findings of analysis undertaken.

BCG UK plan to publish the outcomes of analysis done using this data via publications in the forms of case studies and/or articles which may be published on BCG UK website and client engagement materials.

The outputs will not contain NHS England data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.

The outputs will be communicated to relevant recipients through the following dissemination channels:

• Workshops & working sessions involving clients and associated stakeholders.

• Briefing documents provided to clients.

• Reports aimed at clients and associated stakeholders.

• Web-based portal access to benchmarking tools.

As BCG UK’s services and deliverables are tailored to the needs of individual clients, it is difficult to specify full details of expected outputs and their target dates. Each NHS or UK public sector client and the outputs will therefore vary depending on the commissioned work.

Whilst it is difficult to present full details of specific measurable benefits as they will vary dependant on the project that BCG UK is commissioned to deliver by each client, the services provided to clients are expected to identify improvement opportunities which the client may then exploit by making changes to systems, processes, resources or infrastructure in order to improve patient experience and patient care.

The use of the data could:

• help the system to better understand the health and care needs of populations.

• lead to the identification or improvement of treatments or interventions, or health and care system design to improve health and care outcomes or experience.

• advance understanding of regional and national trends in health and social care needs.

• inform planning health services and programmes, for example to improve equity of access, experience and outcomes.

• inform decisions on how to effectively allocate and evaluate funding according to health needs.

• provide a mechanism for checking the quality of care. This could include identifying areas of good practice to learn from, or areas of poorer practice which need to be addressed.

A few select case studies are provided below to illustrate the way in which BCG UK will deliver benefits via each of the three analytical activities described above:

1. Demand & capacity modelling

Anticipated benefits to NHS are hoped include:

• Clear understanding of service baselines

• Identification of underlying causes to shortfalls in meeting patient demand

• Reliable forecast of demand and capacity

• Identification of opportunities to address demand and capacity challenges

• Improved capability to monitor activities and prepare for demand surge

Case Study: Regional and Trust Level – Endoscopy Service Improvement (2021)

Context: Supported Trusts across an ICB who historically struggled to meet elective endoscopy demand, which was exacerbated during COVID-19. Key focus areas were modelling demand-capacity gap now and in the future; identifying opportunities; and supporting improvement delivery

What BCG UK did:

• Developed a system-wide demand and capacity model incorporating patient-level hospital data, workforce, and facilities data

• Identified projected demand-capacity gap under various scenarios and under influence of demand/capacity levers

• Engaged with a Trust as an exemplar, working with clinical and operational leads to identify improvement opportunities and put in place a ‘continuous improvement’ process for the service through:

o Robust analytics and direct observations to identify opportunities

o Engagement with clinical leadership to prioritise, define and implement opportunities

o Establishment of strong governance to provide a rhythm of review and continuous improvement

o Delivery of new dashboards to get future visibility, and analyse past operational performance

• Rolled out approach across other Trusts: undertaking analyses and observations; supporting working sessions to identify opportunities, share cross-learnings and enable cross-Trust support. Key transformational opportunities identified included:

o Improved booking process via refined criteria, education of admin staff, targeted overbooking

o Better patient flow through empowerment of flow coordinators

Impact:

• Model continues to be used by Trusts within the ICB for strategic planning (facilities and staff) to manage capacity/demand

• One of the Trusts was rated as most improved Trust in endoscopy backlog clearance Spring 2021 following the intervention, and continues to use the tools and processes to drive continuous improvement.

2. Financial & operational performance analysis and benchmarking

Case Study: Regional Level – Specialised Services planning (2020)

Context: BCG UK LLP supported an ICB and providers across a region to define how they would work together to transform delivery of specialised services. The work covered commissioned spend of over £1.7bn across over 40 service lines

What BCG UK LLP did:

• Undertook a detailed baseline analysis of spend and activity across the ICB and provider footprint, including exploring activity flows into the region from neighbouring ICB

• Undertook stakeholder beliefs audit to understand pain points and opportunities – in outcomes, cost, risk and decision making

• Defined an option set of potential models of collaboration – across governance, clinical leadership, and operational delivery - benchmarked against international models using BCG UK experts & databases

• Developed proposed future-state model and roadmap, taking account of enablers, risks, and trade-offs. Identified potential risks of the programme to other areas of service delivery including primary and emergency care

• Supported identification of four pilot transformation areas and developed exemplar models & governance

Impact:

• New model in place in pilot year - covering governance, delivery, and accountabilities

• Clinical networks have been enhanced to ensure closer alignment between clinical improvement and operational delivery

3. Patient journey mapping

Case Study: Trust Level – Transformation of care pathways within specialist acute provider (2020)

Context: BCG UK LLP supported a large-scale transformation at a multi-site specialist Trust where outcomes were below target, and the organisation was financially unsustainable. Specific areas of focus included outpatients, diagnostics, day surgery, theatre optimisation.

What BCG UK LLP did:

• Undertook detailed diagnostic of improvement opportunities, including beliefs audits, benchmarking, direct observation and analytics, across the Trust

• Supported leadership to align behind ambition and targets and design clear governance to deliver

• Worked with clinical and operations leads, co-designing with patients to redesign clinical pathways end-to-end, e.g.:

o Outpatients: introduced virtual follow-up consultations to several pathways; increased one-stop-shop clinics; and new model for medical and surgical FUs

o Preop: made day of surgery admission standard (vs 1 day current pre op) – with opening of day of surgery unit

o Shift to day case model as standard for several key medical pathways vs. current of up to 5 days IP (eg Interstitial Lung Disease)

o Increase theatre utilisation to >85% (vs current of 69%) with KTS/turnaround dashboards, ‘smart scheduling’ (median operative time/surgeon, and tailored surgical day length) to avoid down-time when scheduling long cases

o Post op LOS: set expected norms, standardised pathways, and created transparency with dashboards and a rhythm of regular review and continuous improvement

Impact:

Rationalised clinical pathways – with improved patient experience scores

• Outpatients: 50% DNA reduction; moved to PIFU for key pathways

• Day of surgery admission unit saved >3.1k bed days during ramp up year

• Day surgery unit Increased day case rates from 50% to ~70%; and day of procedure unit increases from 25% to 50%

• New theatre scheduling template increased capacity by 15-20%, with an additional 65 major cardiac cases completed within first 6m

• Efficiency marker dashboards improved start times, leading to a yearly saving of 8 weeks of Theatre time

• Project shortlisted for Health Service Journal (HSJ) partnership award

It is hoped that through publication of findings in appropriate media, the findings of this analysis will add to the body of evidence that is considered by the bodies, organisations and individual care practitioners charged with making policy decisions for or within the NHS or treatment decisions in relation to specific patients.

Clients will need to take action based on the information provided to them in order to realise the potential improvement opportunities, such as in the example case studies shown above.

In addition to the previous uses, BCG has used HES data for the following purposes in 2025.

1. Productivity analysis for an ICS

- BCG supported an ICS in early 2025 to identify opportunities and the strategy to improve its clinical productivity

- HES data was used for rapid initial scoping of opportunity for 20% uplift in productivity, which was then further built out with the ICS’s internal data

- The project is currently being implemented with the expected benefits being contingent on the ICS’s delivery of the strategy

2. Development of productivity benchmarking tool

- HES data was used in building a benchmarking tool to compare productivity at a local and national level

- The insights have been used to support identifying potential drivers for productivity improvement in NHS organisations