Integrated Care Board Pseudonymised National HES Extract Service

The data provided will be used by the Integrated Care Board (ICB) in fulfilment of it's functions towards health care as illustrated in the National Health Service Act 2006:

Section 1I - General functions of Integrated Care Boards

arranging for the provision of services for the purposes of the health service in England

Section 3A Duties of integrated care boards as to commissioning certain health services

(1)An integrated care board must arrange for the provision of the following to such extent as it considers necessary to meet the reasonable requirements of the people for whom it has responsibility—

(a)hospital accommodation,

(b)other accommodation for the purpose of any service provided under this Act,

(c)medical services other than primary medical services,

(d)dental services other than primary dental services,

(e)ophthalmic services other than primary ophthalmic services,

(f)nursing and ambulance services,

(g)such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as the board considers are appropriate as part of the health service,

(h)such other services or facilities for palliative care as the board considers are appropriate as part of the health service,

(i)such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as the board considers are appropriate as part of the health service, and

(j)such other services or facilities as are required for the diagnosis and treatment of illness.

Section 14Z33 - Duty as to effectiveness, efficiency etc

Each integrated care board must exercise its functions effectively, efficiently and economically.

Section 14Z34 - Duty as to improvement in quality of services

(1)Each integrated care board must exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness.

(2)In discharging its duty under subsection (1), an integrated care board must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services.

(3)The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show—

(a)the effectiveness of the services,

(b)the safety of the services, and

(c)the quality of the experience undergone by patients.

Section 14Z35 - Duties as to reducing inequalities

Each integrated care board must, in the exercise of its functions, have regard to the need to—

(a)reduce inequalities between persons with respect to their ability to access health services, and

(b)reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services (including the outcomes described in section 14Z34(3)).

National HES and ECDS data will be used by the ICB to meet these statutory duties in the following ways:

- Allow the ICB to compare / benchmark services commissioned by other ICBs with their own to show their effectiveness and adjust their future commissioning decisions

- Compare rare patient conditions where local data does not provide a sufficient cohort count so they can understand the most effective patient pathways

- Compare levels of inequality nationally to understand any shortcomings in their local area

- Nationally compare specific demographics of patients to understand areas of low performance

- Understand national trends in health care and public health risks in order to support capacity planning

The historic data will be used by the ICB in fulfilment of its health function, and specifically to:

- Recognise and monitor trends in disease incidence and prevalence and other risks to public health in collaboration with the ICBs local authority;

- Recognise and monitor trends in treatment patterns, particularly hospital readmissions, and outcomes;

- Recognise and monitor trends in access to treatment and care between demographic, geographic, ethnic and socio-economic groups in the population; and

- Recognise and monitor trends in the association between the wider social, economic and environmental determinants of health and health outcomes

- For the purpose of informing the planning, commissioning and provision of effective health and care services at a local level.

Although the ICB also receives data from NHS Digital for it's commissioning activities, this data is only for patients in their local area and does not allow cross comparison with other areas.

An extract is being requested as opposed to system access via DAE / TRE as the ICB has heavily invested in it's own data warehouse hosted in Arden and GEM Commissioning Support Unit which it also uses for it's commissioning data which cannot be hosted in DAE/TRE.

PROCESSING CONDITIONS

Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital. All access to data is auditable by NHS Digital.

The Data Controller must keep a record of locations the data is processed and stored. These addresses must be within the UK. The Data Controller should minimise the number of processing and storage locations to prevent excessive processing. NHS Digital may request a record of processing and storage locations at any time.

All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role and the tasks that they are required to undertake.

The former CCG(s) has submitted their Data Security Protection Toolkit (DSPT) for 21/22. The ICB will submit their DSPT in line with the 22/23 submission timetable, and the ICB commits to abide by the former DSPT assessments submitted under those CCG(s);

The following CCG(s) previously occupied the footprint of the ICB:

• NHS Coventry and Warwickshire CCG

Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be used for the purposes laid out in the application/agreement.

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 i.e.: employees, agents and contractors of the Data Recipient who may have access to that data).

DATA PROCESSORS

The Data Controller should ensure appropriate data processing agreements with all data processors contracted to undertaking work referenced within this agreement.

CONDITIONS OF SUPPLY

In addition to those outlined elsewhere within this application, the ICB will:

1. only use the HES data for the purposes as outlined in this agreement;

2. comply with the requirements of the NHS Digital Code of Practice on Confidential Information, the Caldicott Principles and other relevant statutory requirements and guidance to protect confidentiality;

3. not attempt any record-level linkage of HES data with other data sets held by the ICB, or attempt to identify any individuals from the HES data;

4. not transfer and disseminate record-level HES data to anyone outside this agreement;

5. not publish the results of any analyses of the HES data unless safely de-identified in line with the anonymisation standard; and

6. comply with the guidelines set out in the HES Analysis Guide;

7. ensure role-based control access is in place to manage access to the HES data.

DATA RETENTION

A maximum of ten years data will be retained at any point, such that as each new data year is received, the oldest year will be deleted (i.e. at any point in time only ten historic years of data plus the current year may be held). The ICB will securely destroy the year’s data within six weeks of receiving the latest annual dataset and provide a data destruction certificate to NHS Digital.

The results of the analyses of the data will be used by the ICB to support the discharge of its statutory duties in relation to health. Outputs will include (but not be limited to) the routine and ad hoc production of:

a) Commissioning Strategies

b) Capacity planning

c) Reports on inequalities

d) Reports commissioned by the Health and Wellbeing Board;

e) Advice to other members of the Integrated Care System including Local Authorities and Trusts

f) National insight into Population Health Management that will form local knowledge

g) local health profiles;

h) Service redesign

i) Responses to internal and external requests for information and intelligence on the health and wellbeing of the local population compared to national averages.

j) Benchmarking reports comparing local utilisation and outcomes with peers and other comparator groups

These outputs will be shared among other integrated Care Boards in order to increase understanding nationally and allow greater collaboration.

All outputs will be of aggregated data with small numbers suppressed in line with the HES Analysis Guide.

Access to the data will enable the ICB to undertake analysis on national level data that can be used to inform local commissioning decisions. This has the potential to bring the following benefits:

a) Improved decision making regarding which services to commission based on outcomes from other ICB areas

b) Improved Population Health Management models by including national health trends into the model

c) Better understanding of potential inequalities that exist in the local area compared to other regions

d) Improved capacity planning by understanding trends in other ICB areas

e) Improved outcomes for patients with rare or complex conditions by comparing outcomes nationally against a larger cohort

Yielded Benefits is not a requirement for new applications.