Archus Limited direct HES data feed

Archus Limited works with the NHS and Health & Safety Executive to quantify what the United Kingdom’s healthcare needs are likely to be in future and how those needs will be met. Increasingly this requires whole health economy understanding to enable service redesign and recovery.

Who are Archus Limited:

Archus Limited works nationally to define what people, services and estates the NHS needs and how to get the most from them. Archus Limited are specialists, providing support at every stage of the asset and system lifecycle, working across the UK to deliver wider system thinking and strategy. Archus Limited's end-to-end advice brings clarity to any healthcare project as the team is made up of over 95 health planners, clinicians, project managers, strategic property advisors and technical specialists working together to develop strategies for future service delivery and to implement changes in health systems. Archus Limited have opened offices in Ireland and Canada in the past 12 months and have plans to expand into the Australian health market imminently.

These changes will be driven by the evidence, enabled by the data and analytics function who have been working with Hospital Episode Statistics data since it first became available. Every member of the data team has over a decade of experience working specifically with this data providing benchmarking, quality and safety reporting into NHS organisations, indeed two members of the team have over 30 years of healthcare data experience each. Additionally, the wider healthcare planning team has extensive experience of working with similar patient level data, sourced directly from NHS providers as well as diagnostic, surgical, pathology, primary care and prescribing data.

Clients and stakeholders of Archus Limited range from policy makers and commissioners to estates professionals and clinical staff (e.g. NHS England & Improvement, Buckinghamshire Health, Princess Alexandra, Somerset Federation). The team are experts in healthcare sector: infrastructure management; data; analysis; and interpretation, to enable Archus Limited to communicate with all stakeholders involved in healthcare delivery the necessary evidence to ensure efficacy.

What Archus Limited does:

Archus Limited's services are organised as four pillars: Strategic Advisory; Strategic Property Consultancy; Programme and Project Management; and Technical Advisory.

The Strategic Advisory team provide a range of services including clinical pathway development, optimised resource planning, space and infrastructure planning, demand trends analysis, workforce planning, clinical transformation and demand and capacity modelling to primary care, mental health and secondary/tertiary services.

The Strategic Property Consultancy is involved in acquisitions and disposals, lease management, strategic estate planning, portfolio management, and valuations & appraisals. This team supports healthcare clients in managing such competing priorities as the delivery of high-quality care, operational delivery, financial sustainability and a future-proofed flexible estate with expert consultancy backed up with data analytics.

The Programme and Project Management team, work with NHS healthcare customers at pre-construction and construction stages and handle transformation and change management projects. Successfully delivering projects requires a system-wide understanding of the clinical landscape, the financial framework, and the characteristics of the operational estate.

The Technical Advisory team are involved with business case delivery, financial analysis, technical authoring, and design guidance along with assurance reviews. Archus Limited has been trusted to develop three of the five 'ministerial priority' documents to aid the New Hospital Programme schemes. The documents are:

- Patient Flow Improvements

- Intelligent Hospitals

- Sustainability and Net Zero Carbon

Archus Limited has worked with NHS England on guidance for 'intelligent hospitals' as well as working with partners to deliver the COVID-19 design guidance that supported the Nightingale delivery programme.

Who Archus Limited works with:

In the last two years, Archus Limited have worked with over 130 NHS organisations in every country and region of the UK. The English providers and commissioners Archus Limited have worked with are outlined in the list below, national bodies are named while other organisations are categorised into Specialist Hospitals, Acute Trusts, Community Hospitals, Mental Health Providers, ICSs, CCGs GPs and Support Services.

National

Department of Health and Social Care

Health Education England

NHS Property Services Limited

NHS Trust Development Authority

NHS England

Midlands

Acute - 12

Community Hosp - 4

Mental Health - 5

CCG - 8

Support - 2

North of England

Acute - 11

Specialist - 3

Community Hosp - 3

Mental Health - 2

CCG - 4

GP - 1

East of England

Acute - 1

CCG - 2

London

Acute - 8

Specialist - 1

Community Hosp - 3

Mental Health - 3

ICS - 1

CCG - 5

Support - 1

Southwest of England

Acute - 5

Community Hosp - 3

Mental Health - 5

CCG - 4

GP - 5

Support - 2

South of England

Acute - 10

Community Hosp - 2

Mental Health - 3

ICS - 1

CCG - 8

GP – 1

International

Ireland – 9

Canada – 4

Australia – 1

The contribution to Archus Limited’s revenue by territory is:

UK 82%

Ireland 16%

Canada 1%

Australia <1%

What data is being requested:

Archus Limited are requesting four Hospital Episode Statistics (HES) record-level datasets with patient and consultant identifiers pseudonymised:

• Admitted Patient Care (APC)

• Outpatients (OP)

• Critical Care (CC)

• Accident and Emergency (A&E) / Emergency Care Dataset (ECDS)

The Strategic Advisory analytics team have reviewed the available data items by dataset and removed all sensitive data items (except ethnic category code in ECDS) along with any items which have no relevance to the proposed processing and subsequent analysis. Therefore, the request has been minimised to the set of data items that are required in order to carry out the analyses detailed below. Ethnic category code is necessary to ensure Archus Limited are able to help organisations identify inequality of delivery and access to healthcare services within their catchment area.

Full England coverage is required as Archus Limited provide services to national bodies, as well as specialist organisations with national reach such as Alder Hey Children's hospital, the Moorfield Eye hospital and Christies. Additionally, to be able to provide an appropriate benchmarked peer, subsets of activity at secondary providers that also deliver tertiary services (such as Guy’s and St Thomas’s) is necessary to ensure it is possible to identify what ‘good looks like’. Most importantly, the move to Integrated Care Boards and the catastrophic pressures caused by the COVID-19 pandemic mean that whole health economy solutions are necessary to prevent failure at every level of delivery. This is not possible with subsets of the data and could result in the propagation of inequality of delivery resulting from a silo view of demand.

Five financial years (2019/20 - 2023/24) are requested to allow for the analysis of trends, the impact of organisational mergers, and service reconfiguration following COVID-19 pandemic and well as providing the pre-COVID-19 position. These datasets will provide Archus Limited with the best available coverage of secondary care activity in England upon which to base its planning advice to healthcare organisations. HES data represents a national view of patient encounters with secondary care services which supports analysis of flows across inpatient, outpatient and emergency settings and between hospitals. This national picture will help Archus Limited to provide the best planning advice to NHS organisations needing to build new facilities or reconfigure existing buildings and services for the benefit of the populations they serve.

To summarise, HES is the nationally recognised source of cleansed data available for England and therefore the best way to define the baseline volumes of activity by setting (inpatient, day case, outpatient, emergency department and critical care), service (surgery, medicine, maternity, emergency care) and demography (deprivation, ethnicity, frailty and age). Increasingly NHS organisations are requesting the additional perspective gained from comparison with similar organisations to themselves, therefore Archus Limited wishes to offer this ability to support organisations to drive improvements in healthcare provision.

Why Archus Limited needs HES data:

This agreement will enable Archus Limited to support NHS and international healthcare organisations in the planning of service delivery, identifying where activity does not meet the expected need and validated via comparison with the performance of other peer NHS organisations. The data would also be used to populate the software tools Archus Limited uses to generate reports for its clients. The primary objective for obtaining HES and Emergency Care Data Set (ECDS) data is to give the company the ability to provide analyses to clients which include comparisons with selected peer hospitals and the highlighting of best practice.

HES and ECDS data will be used to populate Archus Limited tools with volumes of patient activity by setting, service and demography over an agreed period. The tools then model these volumes and apply projections of future population within the organisation's catchment along with other assumptions which impact the future activity of the organisation. These are brought together by the tool to provide a view of the amount of accommodation of each type (for example, wards, beds, operating theatres, endoscopy rooms, outpatient consulting rooms and waiting areas, operating rooms, birthing suites, staff rooms) the future facility will require. Other assumptions will include options for improvements in efficiency and modernisation of patient pathways which are derived from the HES and ECDS data of peer organisations. Tools will be accessible to Archus Limited consultants for the purposes of creating client reports which are delivered at the end of each project and by subscription to Archus Limited’s clients.

Archus Limited want to process patient-level HES and ECDS data to provide customers with reliable insight to inform demand and capacity models, studies into patient flows to tertiary, regional or national centres, to provide evidence of best practice, to investigate health inequalities and potential unmet needs, and to inform service improvement and transformation to efficiently and effectively meet the future healthcare needs of the population. Archus Limited projects include those to remodel selected services within hospitals so it is essential that Archus Limited have access to the clinical and patient management detail each patient encounter so that the correct cohort of patients can be selected and the impact of alterations in patient pathways can be modelled.

Archus Limited will be able to project scenarios based on the performance of a peer group of comparable NHS organisations. Peer groups are selected hospitals which, after analysis, are deemed to have a similar workload and case mix to the hospital Archus Limited are providing services to. This type of comparison is used to give client NHS organisations a realistic target to improve and indication of the potential unmet need in the population. Archus Limited projects include analysis on expected future activity which takes into account population projections and the impact of service improvement or reconfiguration.

Outputs which are aggregated with small numbers suppressed are shared with healthcare organisations in workshops involving key stakeholders (NHS executives, senior managers and clinical teams). Demand and capacity models are then translated into functional content which forms the basis for a schedule of accommodation. This is then costed and the facility design is developed.

The goal is to help the NHS improve through support and advice on the reconfiguration of services and buildings (infrastructure) to best suit the populations it serves. Examples of evidence that can be provided with HES and ECDS data are: peer group length of stay for specific conditions or procedures; waiting times for procedures; emergency readmission rates following surgery; the impact of moving services from an inpatient or day case setting to outpatient over time; the likely unmet need of each strata of the population etc.

Information Governance:

Archus Limited has carried out a legitimate interests assessment to review the purpose for which the data will be used, the necessity of using the data and balancing test to consider the impact on individuals' interests and rights. This will be maintained over the period Archus Limited holds data from NHS England.

Legal Basis under UK General Data Protection Regulation (GDPR) Article 6 (1)(f) - Archus Limited considers that the processing of information relating to individuals who have had encounters with hospital providers is required in order to achieve its legitimate interest in providing consultancy services to healthcare providers to improve decision-making around the provision of future healthcare infrastructure and service configuration. Archus Limited have conducted a Legitimate Interests Assessment to support this application.

The purpose test is met because Archus Limited are pursuing a legitimate interest in processing HES data to provide performance and efficiency targets to NHS organisations to improve decision making around the provision of healthcare which in turn benefits patients who use healthcare services. The necessity test is satisfied because the HES data Archus Limited are applying for is the only reliable and comprehensive all England dataset that is available which meets the requirements of the stated purpose. Archus Limited have reviewed the data items available and only selected those required by the analytics team to achieve the stated purposes. The balancing test is satisfied because the risk has been reduced as far as is feasible through minimising the request for sensitive data items, the use of pseudonymisation and suppression of small numbers in any output created from the HES data. Reviewing the responses to this legitimate interested assessment, Archus Limited considers that the processing of information relating to individuals who have had encounters with hospital providers is required to achieve its legitimate interest in providing consultancy services to healthcare providers to improve decision-making around the provision of future healthcare infrastructure. The nature of the data being processing and the purposes for which it is being used are considered to be low risk. Any small risks will be mitigated by appropriate safeguards and controls which will be in place before the initial receipt of the data.

Legal Basis under UK GDPR Article 9 (2)(j) - Archus Limited considers the processing necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject. Specifically, it is in the public interest that NHS organisations are supported with the most accurate insight available, which currently is HES data. The processing is not likely to cause substantial damage or distress to any data subject because the datasets requested are pseudonymised and will only be disseminated to client organisations with small numbers suppressed. Processing with respect to a particular data subject will not be carried out. Archus Limited meets the health or social care purposes conditions as set out in Section 2 of Part 1 of Schedule 1 of the Data Protection Act 2018 because the purpose is clearly aimed at providing organisations with insight around the provision of health care and treatment and around the management of health care services.

Archus Limited will be the sole controller who also processes the data. No controller or processor of data mentioned in this agreement will attempt to re-identify data subjects in the data disseminated under this agreement.

Archus Limited will develop tools to provide a geographical view of projected catchment growth and therefore projected admissions and other encounters with the Health Service in the future. The tools will present aggregations of HES data with the rules of suppression applied on the fly before displaying on the screen. Archus Limited team members will be required to read and abide by the Archus Limited Information Security for NHS England data policy which covers disclosure control guidance. Future Archus Limited tools will be developed using the same principles.

No record level data is provided to any third party organisation in any format. The only output will be aggregated data with small numbers supressed as described and in line with the HES Analysis Guide.

The data will not be used to target sales individuals towards specific healthcare professionals and the data will not be used within sales collateral used by sales/marketing teams this includes sales brochures, emails, direct mailing or advertising of pharmaceutical products.

Archus Limited understands that NHS England require the maintenance of an outputs register, this is a list of the organisations who have commissioned the work to be carried out with NHS England data, together with confirmation that a data sharing agreement or Contract is in place with each Organisation.

This information will be made available to NHS England upon request. Archus Limited does not provide access to or extracts from the record level dataset to any third party. Any data provided will only be used by Archus Limited for the purposes, activities, and outputs defined in this Agreement.

What will be produced as a result of the data processing

The HES data will be used to underpin an approach to service redesign, facilities management and operational reporting based on ‘place’ and population rather than provider. The changing nature of the health economy in the UK means that previous aggregations are no longer meaningful or informative when it comes to predicting what activity will need to be planned for in the next one, five and ten years, so in order to plan for the future, historical data will need to be cut differently, and hypothetical models built and tested. These models will need to iterate and be refined in the light of changing best practice and service pressures until they enable good decisions to be taken by commissioners. The data will contribute towards a number of specific outputs, including reports, dashboards, presentations and web applications.

What level of data will be contained in the outputs

The reported outputs will be aggregated, rounded and small number suppressed, Archus Limited will stratify patients and populations based on the characteristics decided upon in conjunction with Archus Limited clients. In advance of the construction of the models, it is known that the aggregation will include condition, place, demography, service and facility. What is not yet known is how the redesign and formation of the ICBs will change elements of the broad categories above. Services need to meet the demands of future populations in an environment that is not yet fully mapped out. Having the data at the level of granularity requested will enable Archus Limited to iterate through the scenarios that the ICBs plan with Archus Limited until the most beneficial output is determined. Additionally, it will mean that Archus Limited can continue to iterate through these design options with the ICBs to ensure that if decisions need to be taken based on new evidence and clearer understanding of population needs, the evidence is there in support.

Exploitation of results/outputs

The various outputs will have different levels of ‘access’, but fundamental to Archus Limited's approach is transparency. Archus Limited will make available to the client the factors that have gone into the building the models that have been applied to the data to generate the results. Archus Limited will ensure that there is full knowledge transfer to the client so that they are able to articulate clearly how the requirements and recommendations have been generated. When preparing models and predicting activity for the future, small differences at the input stage grow exponentially as they processed through. In order to comply fully with the rules set out, at the stage the numbers are reported to the client, the suppression and rounding will be applied.

Reporting will be through portable document format (PDF) and presentations, which will not be linked to the data in any way, but as much as possible clients will be able to interact with the information through interactive tools developed by Archus Limited. Proprietary software developed by Archus Limited will link to the underlying data but will be controlled via role-based access in the product. The link would never be available to customers - so they can't access the underlying data, only the aggregated output.

The client will retain ownership of the reports produced and are free to distribute as they see fit. The outputs Archus Limited provide will comply with the HES disclosure control rules so that the learning and best practice can be freely shared.

Target dates for outputs

This process is going to be iterative as indicated above. Elements of the benefits could be realised within the first three to six months, as the team is very familiar with the data and historically valuable indicators that can be derived. Archus Limited will be able to process and present the information quickly to the benefit of Archus Limited clients. However Archus Limited anticipate that this process will not be complete in the life of this agreement. Archus Limited hope to demonstrate reliability to NHSD and renew Archus Limited's access to this data annually in perpetuity. This will enable Archus Limited to continue to refine the models produced and ensure that Archus Limited clients can monitor their performance against the predictions over time and react in an agile fashion to changes in the population’s health and social care needs.

Archus Limited have not yet achieved any yielded benefits as there were delays in data processing whilst approval was sought to use Snowflake data warehouse technology to carry out the processing activities detailed in this Agreement. However, some benchmarking information has been used to demonstrate to NHS clients how we HES data will be used to benefit them and significant progress has been made in developing a demand and capacity approach that will support hospitals in 'right sizing' their services.

Archus Limited works with the NHS and Health & Safety Executive to quantify what the United Kingdom’s healthcare needs are likely to be in future and how those needs will be met. Increasingly this requires whole health economy understanding to enable service redesign and recovery.

Who are Archus Limited:

Archus Limited works nationally to define what people, services and estates the NHS needs and how to get the most from them. Archus Limited are specialists, providing support at every stage of the asset and system lifecycle, working across the UK to deliver wider system thinking and strategy. Archus Limited's end-to-end advice brings clarity to any healthcare project as the team is made up of over 95 health planners, clinicians, project managers, strategic property advisors and technical specialists working together to develop strategies for future service delivery and to implement changes in health systems.

These changes will be driven by the evidence, enabled by the data and analytics function who have been working with Hospital Episode Statistics data since it first became available. Every member of the data team has over a decade of experience working specifically with this data providing benchmarking, quality and safety reporting into NHS organisations, indeed two members of the team have over 30 years of healthcare data experience each. Additionally, the wider healthcare planning team has extensive experience of working with similar patient level data, sourced directly from NHS providers as well as diagnostic, surgical, pathology, primary care and prescribing data.

Clients and stakeholders of Archus Limited range from policy makers and commissioners to estates professionals and clinical staff (e.g. NHS England & Improvement, Buckinghamshire Health, Princess Alexandra, Somerset Federation). The team are experts in healthcare sector: infrastructure management; data; analysis; and interpretation, to enable Archus Limited to communicate with all stakeholders involved in healthcare delivery the necessary evidence to ensure efficacy.

What Archus Limited does:

Archus Limited's services are organised as four pillars: Strategic Advisory; Strategic Property Consultancy; Programme and Project Management; and Technical Advisory.

The Strategic Advisory team provide a range of services including clinical pathway development, optimised resource planning, space and infrastructure planning, demand trends analysis, workforce planning, clinical transformation and demand and capacity modelling to primary care, mental health and secondary/tertiary services.

The Strategic Property Consultancy is involved in acquisitions and disposals, lease management, strategic estate planning, portfolio management, and valuations & appraisals. This team supports healthcare clients in managing such competing priorities as the delivery of high-quality care, operational delivery, financial sustainability and a future-proofed flexible estate with expert consultancy backed up with data analytics.

The Programme and Project Management team, work with NHS healthcare customers at pre-construction and construction stages and handle transformation and change management projects. Successfully delivering projects requires a system-wide understanding of the clinical landscape, the financial framework, and the characteristics of the operational estate.

The Technical Advisory team are involved with business case delivery, financial analysis, technical authoring, and design guidance along with assurance reviews. Archus Limited has been trusted to develop three of the five 'ministerial priority' documents to aid the New Hospital Programme schemes. The documents are:

- Patient Flow Improvements

- Intelligent Hospitals

- Sustainability and Net Zero Carbon

Archus Limited has worked with NHS England on guidance for 'intelligent hospitals' as well as working with partners to deliver the COVID-19 design guidance that supported the Nightingale delivery programme.

Who Archus Limited works with:

In the last two years, Archus Limited have worked with over 130 NHS organisations in every country and region of the UK. The English providers and commissioners Archus Limited have worked with are outlined in the list below, national bodies are named while other organisations are categorised into Specialist Hospitals, Acute Trusts, Community Hospitals, Mental Health Providers, ICSs, CCGs GPs and Support Services.

National

Department of Health and Social Care

Health Education England

NHS Property Services Limited

NHS Trust Development Authority

NHS England

Midlands

Acute - 12

Community Hosp - 4

Mental Health - 5

CCG - 8

Support - 2

North of England

Acute - 11

Specialist - 3

Community Hosp - 3

Mental Health - 2

CCG - 4

GP - 1

East of England

Acute - 1

CCG - 2

London

Acute - 8

Specialist - 1

Community Hosp - 3

Mental Health - 3

ICS - 1

CCG - 5

Support - 1

Southwest of England

Acute - 5

Community Hosp - 3

Mental Health - 5

CCG - 4

GP - 5

Support - 2

South of England

Acute - 10

Community Hosp - 2

Mental Health - 3

ICS - 1

CCG - 8

GP - 1

What data is being requested:

Archus Limited are requesting four Hospital Episode Statistics (HES) record-level datasets with patient and consultant identifiers pseudonymised:

• Admitted Patient Care (APC)

• Outpatients (OP)

• Critical Care (CC)

• Accident and Emergency (A&E) / Emergency Care Dataset (ECDS)

The Strategic Advisory analytics team have reviewed the available data items by dataset and removed all sensitive data items (except ethnic category code in ECDS) along with any items which have no relevance to the proposed processing and subsequent analysis. Therefore, the request has been minimised to the set of data items that are required in order to carry out the analyses detailed below. Ethnic category code is necessary to ensure Archus Limited are able to help organisations identify inequality of delivery and access to healthcare services within their catchment area.

Full England coverage is required as Archus Limited provide services to national bodies, as well as specialist organisations with national reach such as Alder Hey Children's hospital, the Moorfield Eye hospital and Christies. Additionally, to be able to provide an appropriate benchmarked peer, subsets of activity at secondary providers that also deliver tertiary services (such as Guy’s and St Thomas’s) is necessary to ensure it is possible to identify what ‘good looks like’. Most importantly, the move to Integrated Care Boards and the catastrophic pressures caused by the COVID-19 pandemic mean that whole health economy solutions are necessary to prevent failure at every level of delivery. This is not possible with subsets of the data and could result in the propagation of inequality of delivery resulting from a silo view of demand.

Five financial years are requested to allow for the analysis of trends, the impact of organisational mergers, and service reconfiguration following COVID-19 pandemic and well as providing the pre-COVID-19 position. These datasets will provide Archus Limited with the best available coverage of secondary care activity in England upon which to base its planning advice to healthcare organisations. HES data represents a national view of patient encounters with secondary care services which supports analysis of flows across inpatient, outpatient and emergency settings and between hospitals. This national picture will help Archus Limited to provide the best planning advice to NHS organisations needing to build new facilities or reconfigure existing buildings and services for the benefit of the populations they serve.

To summarise, HES is the nationally recognised source of cleansed data available for England and therefore the best way to define the baseline volumes of activity by setting (inpatient, day case, outpatient, emergency department and critical care), service (surgery, medicine, maternity, emergency care) and demography (deprivation, ethnicity, frailty and age). Increasingly NHS organisations are requesting the additional perspective gained from comparison with similar organisations to themselves, therefore Archus Limited wishes to offer this ability to support organisations to drive improvements in healthcare provision.

Why Archus Limited needs HES data:

This agreement will enable Archus Limited to support NHS organisations in the planning of service delivery, identifying where activity does not meet the expected need and validated via comparison with the performance of other peer NHS organisations. The data would also be used to populate the software tools Archus Limited uses to generate reports for its clients. The primary objective for obtaining HES and Emergency Care Data Set (ECDS) data is to give the company the ability to provide analyses to clients which include comparisons with selected peer hospitals and the highlighting of best practice.

The tools used are models developed in Microsoft products and a demand and capacity tool Archus Limited has partnered with Coplug to develop. Coplug are a software development company with specific expertise in urban planning and data science. Archus Limited will act as controller of the HES and ECDS data and provide Coplug with aggregated extracts which will be used to populate the demand and capacity tool in line with the Data Processing Agreement that will exist between Archus Limited and Coplug. This agreement will make clear the purpose for which the data extracts may be used and the arrangements for secure deletion. Coplug will act on the instruction of Archus Limited only, therefore Coplug are not a Data Controller. Coplug are a Data Processor in this relationship as documented in this application. These tools are currently used internally within Archus Limited to provide client reports as opposed to being directly accessed by the client.

HES and ECDS data will be used to populate Archus Limited in-house tools with volumes of patient activity by setting, service and demography over an agreed period. The tools then model these volumes and apply projections of future population within the organisation's catchment along with other assumptions which impact the future activity of the organisation. These are brought together by the tool to provide a view of the amount of accommodation of each type (for example, wards, beds, operating theatres, endoscopy rooms, outpatient consulting rooms and waiting areas, operating rooms, birthing suites, staff rooms) the future facility will require. Other assumptions will include options for improvements in efficiency and modernisation of patient pathways which are derived from the HES and ECDS data of peer organisations. The term 'in-house tools' means that they are used by authorised members of the Archus Limited project team as opposed to clients. Archus Limited consultants use the tools to create material for the client report which is delivered at the end of each project.

Archus Limited want to process patient-level HES and ECDS data to provide customers with reliable insight to inform demand and capacity models, studies into patient flows to tertiary, regional or national centres, to provide evidence of best practice, to investigate health inequalities and potential unmet needs, and to inform service improvement and transformation to efficiently and effectively meet the future healthcare needs of the population. Archus Limited projects include those to remodel selected services within hospitals so it is essential that Archus Limited have access to the clinical and patient management detail each patient encounter so that the correct cohort of patients can be selected and the impact of alterations in patient pathways can be modelled.

Archus Limited will be able to project scenarios based on the performance of a peer group of comparable NHS organisations. Peer groups are selected hospitals which, after analysis, are deemed to have a similar workload and case mix to the hospital Archus Limited are providing services to. This type of comparison is used to give client NHS organisations a realistic target to improve and indication of the potential unmet need in the population. Archus Limited projects include analysis on expected future activity which takes into account population projections and the impact of service improvement or reconfiguration.

Outputs which are aggregated with small numbers suppressed are shared with healthcare organisations in workshops involving key stakeholders (NHS executives, senior managers and clinical teams). Demand and capacity models are then translated into functional content which forms the basis for a schedule of accommodation. This is then costed and the facility design is developed.

The goal is to help the NHS improve through support and advice on the reconfiguration of services and buildings (infrastructure) to best suit the populations it serves. Examples of evidence that can be provided with HES and ECDS data are: peer group length of stay for specific conditions or procedures; waiting times for procedures; emergency readmission rates following surgery; the impact of moving services from an inpatient or day case setting to outpatient over time; the likely unmet need of each strata of the population etc.

Information Governance:

Archus Limited has carried out a legitimate interests assessment to review the purpose for which the data will be used, the necessity of using the data and balancing test to consider the impact on individuals' interests and rights. This will be maintained over the period Archus Limited holds data from NHS England.

Legal Basis under UK General Data Protection Regulation (GDPR) Article 6 (1)(f) - Archus Limited considers that the processing of information relating to individuals who have had encounters with hospital providers is required in order to achieve its legitimate interest in providing consultancy services to healthcare providers to improve decision-making around the provision of future healthcare infrastructure and service configuration. Archus Limited have conducted a Legitimate Interests Assessment to support this application.

The purpose test is met because Archus Limited are pursuing a legitimate interest in processing HES data to provide performance and efficiency targets to NHS organisations to improve decision making around the provision of healthcare which in turn benefits patients who use healthcare services. The necessity test is satisfied because the HES data Archus Limited are applying for is the only reliable and comprehensive all England dataset that is available which meets the requirements of the stated purpose. Archus Limited have reviewed the data items available and only selected those required by the analytics team to achieve the stated purposes. The balancing test is satisfied because the risk has been reduced as far as is feasible through minimising the request for sensitive data items, the use of pseudonymisation and suppression of small numbers in any output created from the HES data. Reviewing the responses to this legitimate interested assessment, Archus Limited considers that the processing of information relating to individuals who have had encounters with hospital providers is required to achieve its legitimate interest in providing consultancy services to healthcare providers to improve decision-making around the provision of future healthcare infrastructure. The nature of the data being processing and the purposes for which it is being used are considered to be low risk. Any small risks will be mitigated by appropriate safeguards and controls which will be in place before the initial receipt of the data.

Legal Basis under UK GDPR Article 9 (2)(j) - Archus Limited considers the processing necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject. Specifically, it is in the public interest that NHS organisations are supported with the most accurate insight available, which currently is HES data. The processing is not likely to cause substantial damage or distress to any data subject because the datasets requested are pseudonymised and will only be disseminated to client organisations with small numbers suppressed. Processing with respect to a particular data subject will not be carried out. Archus Limited meets the health or social care purposes conditions as set out in Section 2 of Part 1 of Schedule 1 of the Data Protection Act 2018 because the purpose is clearly aimed at providing organisations with insight around the provision of health care and treatment and around the management of health care services.

Archus Limited will be the sole controller who also processes the data. No controller or processor of data mentioned in this agreement will attempt to re-identify data subjects in the data disseminated under this agreement. Archus Limited have a strategic partnership with Coplug to develop a tool to provide a geographical view of projected catchment growth and therefore projected admissions and other encounters with the Health Service in the future. To drive this tool, Archus Limited will provide Coplug with aggregated views of an organisation's data from its HES record level data. Archus Limited have listed Coplug as a data processor in this application. The data provided by Archus Ltd to CoPlug will never be at more granular geographical details than LSOA. Because the Coplug tool will need to slice and dice these views, it is proposed that these aggregations are provided without small number suppression on the basis that Coplug will develop functionality within the tool to perform the suppression and rounding on the fly before displaying on screen. The data will be further aggregated by CoPlug and rules of suppression applied following the most up to date guidance from NHSE, before being exposed to the client interface. Archus Limited will ensure that data is handled according to the latest HES disclosure rules. Archus Limited will determine the purpose and means of processing data with Coplug operating under their instruction. Archus Limited will take responsibility for ensuring the quality of Coplug software used to provide output for client reports. This includes the testing of the implementation of disclosure controls in the Coplug software. Archus Limited team members will be required to read and abide by the Archus Limited Information Security Management for NHS England data policy which covers disclosure control guidance.

No record level data is provided to any third party organisation in any format. The only output will be aggregated data with small numbers supressed as described and in line with the HES Analysis Guide.

The data will not be used to target sales individuals towards specific healthcare professionals and the data will not be used within sales collateral used by sales/marketing teams this includes sales brochures, emails, direct mailing or advertising of pharmaceutical products.

Archus Limited understands that NHS England require the maintenance of an outputs register, this is a list of the organisations who have commissioned the work to be carried out with NHS England data, together with confirmation that a data sharing agreement or Contract is in place with each Organisation.

This information will be made available to NHS England upon request. Archus Limited does not provide access to or extracts from the record level dataset to any third party. Any data provided will only be used by Archus Limited for the purposes, activities, and outputs defined in this Agreement.

What will be produced as a result of the data processing

The HES data will be used to underpin an approach to service redesign, facilities management and operational reporting based on ‘place’ and population rather than provider. The changing nature of the health economy in the UK means that previous aggregations are no longer meaningful or informative when it comes to predicting what activity will need to be planned for in the next one, five and ten years, so in order to plan for the future, historical data will need to be cut differently, and hypothetical models built and tested. These models will need to iterate and be refined in the light of changing best practice and service pressures until they enable good decisions to be taken by commissioners. The data will contribute towards a number of specific outputs, including reports, dashboards and presentations.

What level of data will be contained in the outputs

The reported outputs will be aggregated, rounded and small number suppressed, Archus Limited will stratify patients and populations based on the characteristics decided upon in conjunction with Archus Limited clients. In advance of the construction of the models, it is known that the aggregation will include condition, place, demography, service and facility. What is not yet known is how the redesign and formation of the ICBs will change elements of the broad categories above. Services need to meet the demands of future populations in an environment that is not yet fully mapped out. Having the data at the level of granularity requested will enable Archus Limited to iterate through the scenarios that the ICBs plan with Archus Limited until the most beneficial output is determined. Additionally, it will mean that Archus Limited can continue to iterate through these design options with the ICBs to ensure that if decisions need to be taken based on new evidence and clearer understanding of population needs, the evidence is there in support.

Exploitation of results/outputs

The various outputs will have different levels of ‘access’, but fundamental to Archus Limited's approach is transparency. Archus Limited will make available to the client the factors that have gone into the building the models that have been applied to the data to generate the results. Archus Limited will ensure that there is full knowledge transfer to the client so that they are able to articulate clearly how the requirements and recommendations have been generated. When preparing models and predicting activity for the future, small differences at the input stage grow exponentially as they processed through. In order to comply fully with the rules set out, at the stage the numbers are reportED to the client, the suppression and rounding will be applied.

Reporting will be through portable document format (PDF) and presentations, which will not be linked to the data in any way, but as much as possible clients will be able to interact with the information through Microsoft interactive tools and CoPlug. CoPlug is proprietary software and so the link to the underlying data can be controlled via role-based access in the product. The link would never be available to customers - so they can't access the underlying data, only the aggregated reports.

The client will retain ownership of the reports produced and are free to distribute as they see fit. The outputs Archus Limited provide will comply with the HES disclosure control rules so that the learning and best practice can be freely shared.

Target dates for outputs

This process is going to be iterative as indicated above. Elements of the benefits could be realised within the first three to six months, as the team is very familiar with the data and historically valuable indicators that can be derived. Archus Limited will be able to process and present the information quickly to the benefit of Archus Limited clients. However Archus Limited anticipate that this process will not be complete in the life of this agreement. Archus Limited hope to demonstrate reliability to NHSD and renew Archus Limited's access to this data annually in perpetuity. This will enable Archus Limited to continue to refine the models produced and ensure that Archus Limited clients can monitor their performance against the predictions over time and react in an agile fashion to changes in the population’s health and social care needs.

Yielded Benefits is not a requirement for new applications.