Outcome evaluation of Offender Liaison and Diversion Trial Schemes
RAND Europe Community Interest Company · Research
Expired The latest version ended on 10 December 2022. The September 2026 register still lists the agreement, but its term has passed.
- Reference
- DARS-NIC-66034-M7B8W
- Latest version
- v3.2
- Term of latest version
- 11 December 2020 to 10 December 2022
- Start date
- Before 28 June 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 121
Why the data was released
Objective for processing
RAND Europe has been commissioned by the Department of Health to undertake an evaluation of the National Model for Liaison and Diversion (L&D) services in England. This follows a previous evaluation of the implementation of the National Model undertaken by RAND Europe from April 2014 to August 2015.
The legal basis for processing the information from NHS Digital is Article 6 (1)(F) of the GDPR - ‘Legitimate Interest’. Article 6(1)(f) of the GDPR provides that it is lawful to process the personal data of a data subject where the “processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child. For the case of this agreement, this legal basis is applicable because RAND's client, the Department of Health and Social Care has contracted RAND to undertake this study. The study cannot be conducted without access to this information from NHS Digital and PHE. As the data will be pseudonymised at various stages during the study individuals will not be practicably identifiable except by RAND Europe. Individuals’ interests will not be affected in any way. RAND have undertaken a legitimate interests assessment, which has been submitted in support of this agreement.
Article 9(2)(j)
(processing is 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)
The data are required for research purposes in the public interest - meeting the conditions in the DPA 2018 Schedule 1 Part 1 (4) - which GDPR Recital 52(2) determines is an appropriate derogation from the prohibition on processing special categories of personal data.
RAND having had the research funded by the Department of Health and Social Care (following a peer review of the funding application) and having the study approved by the Health Research Authority (which includes a review of the merit of the study) provides evidence of the scientific merit and quality of the research as well as the appropriate safeguards.
Liaison and Diversion (L&D) services aim to identify people experiencing mental health and substance misuse problems, and learning disabilities (among other vulnerabilities) as they pass through the criminal justice system (CJS) to ensure the service user's health and other needs are known about and that they are referred to services to address these needs. L&D schemes aim to improve outcomes for the service user group and to save money through the provision of accurate, appropriate and timely information to inform the decisions of the CJS.
The use of NHS Digital data will help RAND Europe in fulfilling its mission which is to improve health and health care systems, by providing policymakers with objective, empirically based research to inform decision making.
RAND Europe requires Hospital Episode Statistics Accident & Emergency Data, Mental Health Data (including the Mental Health Minimum Data Set [MHMDS], Mental Health and Learning Disabilities Data Set [MHLDDS] , and Mental Health Services Data Set [MHSDS]) and the Improving Access to Psychological Therapies data set to understand whether the L&D service has had an impact on health service utilisation by service users (research question 2). At the time of writing, as explained further below, RAND have successfully recruited a cohort and undertaken an initial data match, providing the feasibility and value of this evaluation
Developing the work undertaken in the first implementation evaluation, the Department of Health requires an outcome evaluation of the Liaison and Diversion (L&D) Trial scheme, which has been implemented in 25 areas of England. These 25 sites are made up of 10 ‘wave 1 roll-out’ sites (operating since April 2014) 15 ‘wave 2 roll-out’ sites (since April 2015).
The evaluation looks at the L&D service in 29 sites in England. The National Model was launched in 10 sites in 2014 covering 11 Wave 1 sites (where the National Model was rolled-out in 2014) and 18 Wave 2 sites (where the National Model was rolled-out in 2015). RAND will deliver the waves 1 and 2 and evaluate the implementation of the national model in the first 10 sites (referred to as the ‘wave 1 evaluation’1)
Between December 2016 and September 2017, individuals in L&D services in these 29 areas of England were asked to consent to participate in the evaluation. To answer the research questions the evaluation intends to use information about consenting individuals held in the following datasets:
• The Police National Computer (PNC).
• Courts Service (HMCTS)
• National Drug Treatment Monitoring Database (NDTMS).
• Mental Health Datasets (including MHMDS, MHLDDS and MHSDS)
• Improving Access to Psychological Therapies (IAPT).
• Hospital Episode Statistics A&E (HES A&E).
At this point in the study RAND have produced a number of progress reports for the Department of Health/ NHS England using matched data from PNC, Courts Service, NDTMS, Mental Health Data and HES A&E. Undertaking these matches and descriptive analysis of the data has shown that:
• The match is possible.
• Across all the matched data sets, the resulting sample sizes are likely to be large enough to detect small differences.
Based on these matches, RAND have undertaken feasibility assessments of the approach to analysis presented in the original project plan. RAND concluded a baseline controlled model approach should be taken. This approach aims to use statistical techniques to look at whether referral to L&D is associated with changes in the outcomes of interest (relevant to the research questions), while controlling for other factors that might cause these outcomes. The disadvantage of this approach, when compared to the original analysis plan, is that it is more difficult to conclude with certainty that the L&D service was the cause of any changes in outcomes. However, it will make use of the extensive data available and use statistical techniques to estimate how likely it is that any changes in trends were caused by the L&D service.
This agreement also seeks data to support Work package 3: Health Service Utilisation.
The objective of this work package is to understand whether the L&D service has an impact on health service utilisation by users. The study will use the same approach to generating the counterfactual as for the reconviction and diversion analysis – employing both a before-and-after design and a quasi experimental design using a matched comparison group. Importantly the answers to the research questions below will ascertain whether getting people who are in the criminal justice system signposted to the rights services will have a positive impact on their health and in turn have a knock on effect on the system as a whole.
The aims of the evaluation are to address the following research questions:
1. What impact, if any, does the implementation of the National Model of L&D have on reconviction?
2. What impact, if any, does the implementation of the National Model of L&D have on health service utilisation?
3. If any impacts on offending and health care utilisation are found, what is the economic effect of those?
4. How have any impacts of the National Model of L&D been achieved?
5. What impact, if any, does the implementation of the National Model of L&D have on diversion from the criminal justice system?
The study intends to gather information about health service utilisation from the following datasets:
• HES A&E dataset
• Mental Health Datasets (including MHMDS, MHLDDS, MHSDS)
• IAPT
RAND are requesting access to individual-level data because RAND need to understand the behaviour of a defined cohort, and because RAND will link data about these individual received from NHS Digital to data received from Public Health England and the Ministry of Justice.
RAND recruited individuals to the study between December 2016 and September 2017.
The ‘before’ period for the evaluation is 2011-2016. The ‘after’ period is October 2017 to the end of 2018.
A&E data for the period 2011/12 to 2017/18 allowed RAND to receive data that relates to the period after the intervention was experienced by the cohort.
MHMDS data was provided for the period 2011/12 to 2013/14 and Mental Health and Learning Disabilities Data Set for 2014/15 - 2017/18. MHSDS (the upversion of the MHMDS and MHLDDS) dataset was provided for 2017/18.
IAPT data (Improving Access to Psychological Therapies Data Set) from 2012/2013 until 2017/2018 was provided under a previous iteration of this Agreement and spans a relevant period before and after the intervention was received, which is needed to answer the research questions.
RAND have requested data for a defined cohort of service users who have consented to be part of the evaluation and have only selected relevant variables and the years necessary to address the research questions.
RAND Europe is a not-for-profit research organisation that helps to improve policy and decision making through research and analysis. Whilst RAND Europe have offices based in England and the EU for the purposes of this application no data will be processed outside of England and Wales. RAND is the Data Controller who also processes data for the purposes described in this Agreement. No other organisations process the data for this purpose. The Department of Health & Social Care (DHSC) commission the work, however, DHSC are not a data controller, as they have no influence on the research. In regard to participants’ details: (name, data of birth, gender, NHS number) and participants’ records in national databases (shared by Government departments), which include unique identifiers, RAND Europe is the data controller, responsible for deciding the use of the data. The DHSC do not instruct RAND about how to use the data.
Processing activities
All organisations party to this agreement must 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).
RAND Europe have in place its own internal user agreements that staff working with data on projects must sign prior to being provided access to any data. These agreements are project specific and clearly set out the data use restrictions by which researchers must abide.
RAND transferred the following identifiers to NHS Digital for linkage to RAND Europe's cohort (for which recruitment has now closed) to enable the matching:
NHS number
Date of Birth
Sex
Study ID
No other identifiers were sent to NHS Digital.
The raw unprocessed data (L&D Personal Data Sheet) will be stored on a dedicated area of RAND’s secure server, separate to all the other datasets created during the course of this project, including Dataset A. Dataset A will include the unique study ID but other identifiable data such as name and address will have been removed from this dataset. The unique study ID will be used to link the various datasets.
Data cleaning and pre-processing will be conducted by the members of the RAND Europe research team. Pre-processing will include the following: linking episodes to create a dataset delineated by admissions. The Mental Health Data (all datasets) ; Improving Access to Psychological Therapies (IAPT), and the Hospital Episode Statistics (HES) A&E dataset will be linked to data from the Police National Computer (PNC) and the National Drug Treatment Monitoring System (NDTMS) by RAND Europe based on a unique study identifier. This creates Data set C.
Data Set A is the data from separate L&D sites combined and cleaned. Unique study identifier assigned to participating service users by RAND in preparation for sending to NHS Digital
Data Set B is the cohort data which has been linked to NHS Digital data - including IAPT Data and all versions of Mental Health Data (MHLDDS and MHMDS - and MHSDS which will be disseminated under this version of the agreement), and HES data by NHS Digital.
Data Set C, is data from the Police National Computer (PNC) and the National Drug Treatment Monitoring System (NDTMS) by RAND Europe based on a unique study identifier, linked to set B.
Arrangements are in place so that research team members involved in analysis of Dataset B and Dataset C will not have access to the L&D Personal Data Sheet. Only two people at RAND Europe will have access to the Personal Data Sheet which links name, date of birth and gender to the unique study identifier. Only those 2 people will have the password for the Personal Datasheet file and access to that part of the server. The following description of the processing activity applies to the data set received from NHS Digital.
Data Set B.
RAND will use data set B and C to undertake extensive description of the cohort and its use of services over time.
RAND also intend to undertake more sophisticated data analysis: RAND plan to use a baseline controlled model approach, which aims to use statistical techniques to look at whether referral to L&D is associated with changes in the outcomes of interest (relevant to the research questions), while controlling for other factors that might cause these outcomes. Furthermore, a more descriptive and sophisticated processing activity will allow RAND to address the research questions.
An initial analysis will be undertaken to describe the population of L&D service users. This population is poorly characterised at present, in terms of understanding of their previous health care utilisation and criminal justice history. This analysis will draw on historical data from April 2012.
The evaluation will employ two analysis strategies to examine the outcomes from the L&D schemes.
1. Before and after comparison:
This analysis will be undertaken for all of the study sample (service users in both wave 1 and wave 2 sites who have consented to the data being shared with the research team). Outcomes would be compared for the 12 months period before entry into the service (back to 2012) and the 12 months after the date of entry of the service user into the L&D service.
2. Retrospective comparison group:
A second form of analysis will be to compare L&D service users in the wave 1 sites (the treatment group) with a similar population of individuals who have not used the L&D service (the control group). The control group will be drawn from individuals in the wave 2 sites, but ONLY looking at the period BEFORE they entered the L&D service. Individuals who eventually end up in an L&D service in a wave 2 site are likely to share many characteristics with individuals using the L&D service in the wave 1 sites. This approach to constructing a comparison group is unusual, but was considered the best in the circumstances, and was signed off by independent academic reviewers of RAND’s application for funding for this study from the Department of Health.
The results of the analysis will be presented at an aggregated level and RAND Europe will suppress any small numbers in line with the HES analysis guide.
RAND Europe will be the sole data controller and data processor. All data will be securely stored on a dedicated server at the RAND Europe offices in Cambridge (England). Access to the data is managed by the Information Controller; internal HES user agreements are in place and staff working on the project have to sign this agreement prior to being provided access to the data. These agreements are project specific and clearly set out the data use restrictions by which they must abide. NHS England and Department of Health and Social Care will not have access to any of the unprocessed data, when findings are shared with NHS England these will be presented at an aggregated form.
For data from the Mental Health (MHSDS, MHLDDS, MHMDS) data sets, and any Mental Health data linked to HES or SUS, the following disclosure control rules will be applied:
• National-level figures only may be presented unrounded, without small number suppression
• Suppress all numbers between 0 and 5
• Round all other numbers to the nearest 5
• Percentages can be calculated based on unrounded values, but need to be rounded to the nearest integer in any outputs
• In addition for Learning Disability data in Mental Health (MHSDS, MHLDDS, MHMDS), the England-level data also must apply the suppression of all numbers between 0 and 5, and rounding of other numbers to the nearest 5.
RAND will link the data received from NHS Digital with that received from Ministry of Justice and Public Health England to create a data set including criminal justice, drug treatment and health service use by the RAND cohort
All data will be handled in accordance with the specific NHS Digital Terms and Conditions associated with the data.
There will be no data linkage undertaken with NHS Digital data provided under this agreement that is not already noted in the agreement.
Expected output
A final report is the primary output, subject to peer review and formal approval from the Department of Health and Social Care (who fund the research project).
The final report submission was planned for October 2019. Due to various factors it was ultimately submitted to DHSC in July 2020. The report has been under peer review since then, but this has now been completed and expected to finalise and publish the report in the first quarter of 2021. However, there is a need to retain access to the data to address any subsequent queries and complete academic publications, as detailed below.
ii. RAND plan to submit to journals such as:
· The Lancet
· The BMJ
· Health Services Research and Policy
· BMJ Quality and Safety
· Health and Justice
· Criminal behaviour and mental health
iii. Summary report/ key findings briefing. Aimed at practitioner audiences capturing main points.
However, the key audience for the report findings is NHS England, as they commission L&D services and will use the study findings to inform decisions about future implementation and operation of the service.
iv. Conference papers and presentations: again, given at a range of conferences targeting a range of academic and practitioner disciplines.
The research team have worked closely with NHS England team throughout the research study to achieve recruitment of participants and to ensure that the findings are relevant to key policy questions. NHS England have only seen outputs and not had any data processing or controllership responsibilities.
Programme Board – who have cross departmental links with key policymakers nationally and regionally.
iii. Additional dissemination activities are likely to include:
• Briefing the final results to policy makers from interested departments (Health, Justice, PHE, Home Office, DWP).
• Attendance at events or conferences to disseminate findings to practitioner, policy and/or academic audiences.
• Writing blogs or short policy briefs.
• Briefing the cross-departmental L&D Programme Board.
During the study RAND Europe are keeping L&D service staff across the country informed about progress through updates in regular L&D Bulletins produced by NHS England. Details can be found here https://www.england.nhs.uk/commissioning/health-just/liaison-and-diversion/news/programme-updates/
Expected measurable benefits
This research study has been commissioned by the DHSC specifically to inform the design, implementation and operation of liaison and diversion schemes. It is planned (and this is on-track at time of writing) that L&D services will be accessible to 100% of the population by March 2020. Therefore, the findings from this study are likely to directly benefit the provision of care at a large scale across the country.
(ii) Benefit to a vulnerable group with little service provision: The prevalence of mental health and other vulnerabilities among those in the criminal justice system (CJS) is a matter of concern to policymakers. L&D schemes aim to improve outcomes for offenders suffering from these difficulties and to save money through the provision of accurate, timely information to the CJS. The key benefits are threefold, (i) getting people who are in the criminal justice system signposted to the right services will have a positive impact on the person's own health and wellbeing, thus benefiting their mental and physical health. With this there is more of a likelihood of these individuals leading a less chaotic lifestyle. (ii) With the better allocation and management of signposting people in this group to the right services there will be a benefit of a reduced burden on health and social care services, less movement of resources and better management of service. (iii) Getting people who are in the criminal justice system connected to the right services could divert the individuals for re-conviction thus benefiting the CJS with fewer re-convictions entering the system.
(iii) In summary getting people who are in the criminal justice system signposted to the right services will have a positive impact on their own health and a positive impact on the use of health and social care services. As such there is potential benefit to reduce burden on health and social care services for those people who are in the criminal justice system. These people are more likely to lead chaotic and complex lives if the L&D scheme can improve the outcomes for these people through better allocation of health services then the whole system will benefit.
It is clearly in the public interest to ensure that the provision of L&D services is as effective as possible – to improve the health and wellbeing outcomes of this population and to enhance the efficient use of health care resources.
The study has been designed to answer questions that are relevant to those commissioning and delivering the L&D service.
Since this is a study commissioned by the DHSC and the results are delivered directly to NHS England (the National Commissioner's of L&D) and will be disseminated to regional commissioners and the managers of individual services, there is a clear route through which the outputs will deliver the benefits.
The data request to NHS Digital is central to RAND's project. Without this data RAND cannot answer the research questions and therefore cannot provide the evidence NHS England has called for to inform NHS England's commissioning of L&D services.
The study seeks to understand the health care utilisation of the cohort of individuals using L&D services. This has never been done before and little is known about the trajectories of the population through different health services. For example, RAND's interim reports suggest that this population are very high frequency users of A&E services, raising the possibility that an intervention such as the L&D service could have significant benefits if it is able to reduce the use of emergency services.
This research is about a clearly defined cohort of services users, and is undertaken directly for those commissioning and delivering the service. The findings will inform NHS decision making about commissioning and will be used to inform businesses cases to HMT for funding. By March 2020 L&D services will be accessible to 100% of the population, so there is a potential for a wide-spread, national impact. NHS England, regional commissioners and local service managers will be able to use RAND's findings to inform the design of L&D schemes and other decisions.
In looking at measuring policy change, the benefits of this work could be captured by: feedback from NHS England; changes to the design of the L&D scheme to which RAND's report contributed; reference to the evaluation findings in submissions to treasury.
Benefits reported so far
To date, the study has produced three progress reports and findings and a draft final report that have been presented to the Department of Health and Social Care and NHS England. The key benefits of these reports is that, for the first time, the L&D Programme Board were provided with rigorous information about the criminal justice histories and health service utilisation of the cohort of service users targeted by the L&D service. The key findings from the final report are:
1. L&D service intervention comes at a point of 'crisis' - where drug use, self-reported offending and health service utilisation has peeked - and, as intended, effectively engages individuals with multiple vulnerabilities.
2. Prior contact with the criminal justice system does not predict health service utilisation, suggesting health vulnerabilities lead to criminal justice system contacts not vice versa.
3. Accessing Liaison and Diversion (L&D) services is not associated with a subsequent decrease in offending, but nor is it associated with an increase.
4. Following use of L&D services, the likelihood of receiving a custodial sentence is approximately halved. This contributes to the L&D programme contributing savings of between £13.1 million and £41.5 million.
These findings are of benefit for the Programme Board to understand this, in order to realise the scheme's potential benefits. As yet RAND have only published preliminary results, so these findings have not been used to directly inform policy, as of yet. However, findings have been presented to DHSC and NHS England via oral presentations.
Datasets on the latest version
Legal basis for provision: Health and Social Care Act 2012 - s261 - 'Other dissemination of information'
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Hospital Episode Statistics Accident and Emergency (HES A and E) | Identifiable | Non-Sensitive | One-Off | Consent (Reasonable Expectation) |
| Improving Access to Psychological Therapies (IAPT) v1.5 | Identifiable | Sensitive | One-Off | Consent (Reasonable Expectation) |
| Mental Health and Learning Disabilities Data Set (MHLDDS) | Identifiable | Sensitive | One-Off | Consent (Reasonable Expectation) |
| Mental Health Minimum Data Set (MHMDS) | Identifiable | Sensitive | One-Off | Consent (Reasonable Expectation) |
| Mental Health Services Data Set (MHSDS) | Identifiable | Sensitive | One-Off | Consent (Reasonable Expectation) |
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.
Patient opt-outs were not applied to any of the 121 files released under this agreement, across every version. About opt-outs
No files recorded as released under the latest version. 121 were released under earlier versions, shown in the version history.
Version history
The register lists each renewal of this agreement as a separate row. This site has 3 versions — earlier versions existed before this site's records begin.
DARS-NIC-66034-M7B8W-v3.2 11 December 2020 to 10 December 2022
- Title
- Outcome evaluation of Offender Liaison and Diversion Trial Schemes
- Commercial
- No
- Sublicensing
- No
- Datasets
- 5
- Files released
- 0
Datasets: Hospital Episode Statistics Accident and Emergency (HES A and E); Improving Access to Psychological Therapies (IAPT) v1.5; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS)
What changed from DARS-NIC-66034-M7B8W-v2.4
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-12-11 | |
| End date | 2022-12-10 | |
| Hospital Episode Statistics Accident and Emergency (HES A and E): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Hospital Episode Statistics Accident and Emergency (HES A and E): type of data | Identifiable | |
| Improving Access to Psychological Therapies Data Set_v1.5: legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Improving Access to Psychological Therapies Data Set_v1.5: type of data | Identifiable | |
| Mental Health Minimum Data Set (MHMDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health Minimum Data Set (MHMDS): type of data | Identifiable | |
| Mental Health Services Data Set (MHSDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health Services Data Set (MHSDS): type of data | Identifiable | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): legal basis | Health and Social Care Act 2012 - s261 - 'Other dissemination of information' | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): type of data | Identifiable |
Objective for processing
[34 paragraphs unchanged]
Mental Health data (MHSDS) and IAPT data will be provided under this version of the agreement.
RAND are requesting access to individual-level data because RAND need to understand the behaviour of a defined cohort, and because RAND will link data about these individual received from NHS Digital to data received from Public Health England and the Ministry of Justice.
As in RAND's original agreement, RAND are requesting individual-level data because RAND need to understand the behaviour of a defined cohort, and because RAND will link data about these individual received from NHS Digital to data received from Public Health England and the Ministry of Justice.
[2 paragraphs unchanged]
RAND have already received
A&E data for the period 2011/12 to
2017/18.This has
2017/18
allowed RAND to receive data that relates to the period after the intervention was experienced by the cohort.
RAND have already received
MHMDS data
was provided
for the period 2011/12 to 2013/14 and Mental Health and Learning Disabilities Data Set for 2014/15 -
2015/16. RAND are now requesting under this version of the agreement the
2017/18.
MHSDS (the upversion of the MHMDS and MHLDDS) dataset
was provided
for
2017/18 relevant to the ‘after’ period.
2017/18.
RAND have not previously received IAPT data. Under this version of the agreement,
IAPT data (Improving Access to Psychological Therapies Data Set) from 2012/2013 until 2017/2018
will be disseminated. The justification for
was provided under a previous iteration of
this
is that it
Agreement and
spans a relevant period before and after the intervention was received, which is needed to answer the research questions.
[1 paragraph unchanged]
RAND Europe is a not-for-profit research organisation that helps to improve policy
[27 words unchanged]
be processed outside of England and Wales. RAND is the Data Controller
and Processor,
who
make all
also processes data for
the
decisions about how
purposes described in this Agreement. No other organisations process
the data
will be processed.
for this purpose.
The Department of Health & Social Care (DHSC) commission the work, however,
[54 words unchanged]
The DHSC do not instruct RAND about how to use the data.
Processing activities
[2 paragraphs unchanged]
RAND
will transfer
transferred
the following identifiers to NHS Digital for linkage to RAND Europe's cohort (for which recruitment has now closed) to enable the
matching, no other identifiable data will be transferred to NHS Digital Data :
matching:
[4 paragraphs unchanged]
No other identifiers
will be
were
sent to NHS Digital.
[26 paragraphs unchanged]
Expected output
A final
report. This will be
report is the primary output,
subject to peer review and formal approval from the Department of Health and Social Care (who fund the research project).
The final report submission was planned for October 2019. Due to various factors it was ultimately submitted to DHSC in July 2020. The report has been under peer review since then, but this has now been completed and expected to finalise and publish the report in the first quarter of 2021. However, there is a need to retain access to the data to address any subsequent queries and complete academic publications, as detailed below.
[17 paragraphs unchanged]
The final report will be submitted in October 2019. Findings in relation to each of the aims outlined in the objectives for processing will be included in RAND Europe's final report.
[1 paragraph unchanged]
Benefits reported
To date, the study has produced three progress
reports.
reports and findings and a draft final report that have been presented to the Department of Health and Social Care and NHS England.
The key benefits
of
these reports is that, for the first time, the L&D Programme Board
[13 words unchanged]
utilisation of the cohort of service users targeted by the L&D service.
The key findings from the final report are:
For example, RAND's descriptive analysis provided evidence that this population are much higher users of A&E services than the general population - providing the possibility that L&D are targeting a costly group.
1. L&D service intervention comes at a point of 'crisis' - where drug use, self-reported offending and health service utilisation has peeked - and, as intended, effectively engages individuals with multiple vulnerabilities.
It also could show that L&D service intervention comes at a point of 'crisis' - where drug use, self-reported offending and health service utilisation has peeked. Again, it is of benefit for the Programme Board to understand this, in order to realise the scheme's potential benefits. As yet, RAND do not have any health data relating to the time after RAND's cohort used the L&D service.
2. Prior contact with the criminal justice system does not predict health service utilisation, suggesting health vulnerabilities lead to criminal justice system contacts not vice versa.
RAND do have ‘after’ data from the national drug treatment data base. RAND's analysis of data collected about RAND's cohort from drug treatment services, show that self-rated psychological health and quality of life on average falls about 2 points on a 0-20 scale in the two years before L&D referral, recovering to about baseline levels after the referral.
3. Accessing Liaison and Diversion (L&D) services is not associated with a subsequent decrease in offending, but nor is it associated with an increase.
The descriptive analysis of the mental health data previously received from NHS Digital finds that service utilisation increases in the evaluation cohort in the years before L&D, reflecting that contact with L&D may occur at a point of crisis for many individuals. As yet RAND have only published preliminary results, so they have not been used to inform policy, as of yet.
4. Following use of L&D services, the likelihood of receiving a custodial sentence is approximately halved. This contributes to the L&D programme contributing savings of between £13.1 million and £41.5 million.
These findings are of benefit for the Programme Board to understand this, in order to realise the scheme's potential benefits. As yet RAND have only published preliminary results, so these findings have not been used to directly inform policy, as of yet. However, findings have been presented to DHSC and NHS England via oral presentations.
Unchanged: Expected measurable benefits.
DARS-NIC-66034-M7B8W-v2.4 11 December 2019 to 10 December 2020
- Title
- Outcome evaluation of Offender Liaison and Diversion Trial Schemes
- Commercial
- No
- Sublicensing
- No
- Datasets
- 5
- Files released
- 120
Datasets: Hospital Episode Statistics Accident and Emergency (HES A and E); Improving Access to Psychological Therapies (IAPT) v1.5; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS)
What changed from DARS-NIC-66034-M7B8W-v1.10
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2019-12-11 | |
| End date | 2020-12-10 | |
| Improving Access to Psychological Therapies Data Set_v1.5: sensitivity | Sensitive |
Datasets: + Mental Health Services Data Set (MHSDS)
Objective for processing
[8 paragraphs unchanged]
RAND Europe requires Hospital Episode Statistics Accident &
Emergency,
Emergency Data, Mental Health Data (including the
Mental Health Minimum Data
Set,
Set [MHMDS], Mental Health and Learning Disabilities Data Set [MHLDDS] , and Mental Health Services Data Set [MHSDS]) and the
Improving Access to Psychological Therapies data
set
to understand whether the L&D service has had an impact on health
[25 words unchanged]
an initial data match, providing the feasibility and value of this evaluation
[6 paragraphs unchanged]
• Mental Health
Services
Datasets
(MHSDS)
(including MHMDS, MHLDDS and MHSDS)
[2 paragraphs unchanged]
At this point in the study RAND have produced a number of
[5 words unchanged]
of Health/ NHS England using matched data from PNC, Courts Service, NDTMS,
MHSDS
Mental Health Data
and HES A&E. Undertaking these matches and descriptive analysis of the data has shown that:
[13 paragraphs unchanged]
• MHMDS
• Mental Health Datasets (including MHMDS, MHLDDS, MHSDS)
[1 paragraph unchanged]
Mental Health
data (MHSDS)
and IAPT data will be provided
at a later date.
under this version of the agreement.
[3 paragraphs unchanged]
RAND have already received A&E data for the period 2011/12 to
2016/17.
2017/18.This has allowed
RAND
are now requesting additional
to receive
data
for 2017/18, which
that
relates to the period after the intervention was experienced by the cohort.
RAND have already received MHMDS data for the period 2011/12 to
2013/14 and Mental Health and Learning Disabilities Data Set for 2014/15 -
2015/16.
When available,
RAND
would like to request data covering
are now requesting under this version of
the
period 2017/2018 –
agreement the MHSDS (the upversion of the MHMDS and MHLDDS) dataset for 2017/18
relevant to the ‘after’ period.
RAND have not previously received IAPT
data, however, when available RAND would like
data. Under this version of the agreement, IAPT data (Improving Access
to
request data
Psychological Therapies Data Set)
from
2011/12
2012/2013
until
2017/2018.
2017/2018 will be disseminated.
The justification for this is that it spans a relevant period before and after the intervention was received, which is needed to answer the research questions.
[2 paragraphs unchanged]
Processing activities
[9 paragraphs unchanged]
Data cleaning and pre-processing will be conducted by the members of the
[9 words unchanged]
linking episodes to create a dataset delineated by admissions. The Mental Health
Minimum
Data
Set (MHMDS);
(all datasets) ;
Improving Access to Psychological Therapies (IAPT),
when available;
and the Hospital Episode Statistics (HES) A&E dataset will be linked to
[17 words unchanged]
Europe based on a unique study identifier. This creates Data set C.
[1 paragraph unchanged]
Data Set B is the cohort data which has been linked to NHS Digital
data - including
IAPT
Data and all versions of
Mental
Health,
Health Data (MHLDDS and MHMDS - and MHSDS
which
is pending future dissemination,
will be disseminated under this version of the agreement),
and HES data by NHS Digital.
Data Set C, is data from the Police National Computer (PNC) and the National Drug Treatment Monitoring System (NDTMS) by RAND Europe based on a unique study identifier, linked to set B.
Arrangements are in place so that research team members involved in analysis of Dataset B and Dataset C will not have access to the L&D Personal Data Sheet. Only two people at RAND Europe will have access to the Personal Data Sheet which links name, date of birth and gender to the unique study identifier. Only those 2 people will have the password for the Personal Datasheet file and access to that part of the server. The following description of the processing activity applies to the data set received from NHS Digital. Data Set B.
Data Set C, is data from the Police National Computer (PNC) and the National Drug Treatment Monitoring System (NDTMS) by RAND Europe based on a unique study identifier, linked to set B.
Arrangements are in place so that research team members involved in analysis of Dataset B and Dataset C will not have access to the L&D Personal Data Sheet. Only two people at RAND Europe will have access to the Personal Data Sheet which links name, date of birth and gender to the unique study identifier. Only those 2 people will have the password for the Personal Datasheet file and access to that part of the server. The following description of the processing activity applies to the data set received from NHS Digital.
Data Set B.
[19 paragraphs unchanged]
Unchanged: Expected output, Expected measurable benefits, Benefits reported.
Objective for processing
RAND Europe has been commissioned by the Department of Health to undertake an evaluation of the National Model for Liaison and Diversion (L&D) services in England. This follows a previous evaluation of the implementation of the National Model undertaken by RAND Europe from April 2014 to August 2015.
The legal basis for processing the information from NHS Digital is Article 6 (1)(F) of the GDPR - ‘Legitimate Interest’. Article 6(1)(f) of the GDPR provides that it is lawful to process the personal data of a data subject where the “processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child. For the case of this agreement, this legal basis is applicable because RAND's client, the Department of Health and Social Care has contracted RAND to undertake this study. The study cannot be conducted without access to this information from NHS Digital and PHE. As the data will be pseudonymised at various stages during the study individuals will not be practicably identifiable except by RAND Europe. Individuals’ interests will not be affected in any way. RAND have undertaken a legitimate interests assessment, which has been submitted in support of this agreement.
Article 9(2)(j)
(processing is 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)
The data are required for research purposes in the public interest - meeting the conditions in the DPA 2018 Schedule 1 Part 1 (4) - which GDPR Recital 52(2) determines is an appropriate derogation from the prohibition on processing special categories of personal data.
RAND having had the research funded by the Department of Health and Social Care (following a peer review of the funding application) and having the study approved by the Health Research Authority (which includes a review of the merit of the study) provides evidence of the scientific merit and quality of the research as well as the appropriate safeguards.
Liaison and Diversion (L&D) services aim to identify people experiencing mental health and substance misuse problems, and learning disabilities (among other vulnerabilities) as they pass through the criminal justice system (CJS) to ensure the service user's health and other needs are known about and that they are referred to services to address these needs. L&D schemes aim to improve outcomes for the service user group and to save money through the provision of accurate, appropriate and timely information to inform the decisions of the CJS.
The use of NHS Digital data will help RAND Europe in fulfilling its mission which is to improve health and health care systems, by providing policymakers with objective, empirically based research to inform decision making.
RAND Europe requires Hospital Episode Statistics Accident & Emergency Data, Mental Health Data (including the Mental Health Minimum Data Set [MHMDS], Mental Health and Learning Disabilities Data Set [MHLDDS] , and Mental Health Services Data Set [MHSDS]) and the Improving Access to Psychological Therapies data set to understand whether the L&D service has had an impact on health service utilisation by service users (research question 2). At the time of writing, as explained further below, RAND have successfully recruited a cohort and undertaken an initial data match, providing the feasibility and value of this evaluation
Developing the work undertaken in the first implementation evaluation, the Department of Health requires an outcome evaluation of the Liaison and Diversion (L&D) Trial scheme, which has been implemented in 25 areas of England. These 25 sites are made up of 10 ‘wave 1 roll-out’ sites (operating since April 2014) 15 ‘wave 2 roll-out’ sites (since April 2015).
The evaluation looks at the L&D service in 29 sites in England. The National Model was launched in 10 sites in 2014 covering 11 Wave 1 sites (where the National Model was rolled-out in 2014) and 18 Wave 2 sites (where the National Model was rolled-out in 2015). RAND will deliver the waves 1 and 2 and evaluate the implementation of the national model in the first 10 sites (referred to as the ‘wave 1 evaluation’1)
Between December 2016 and September 2017, individuals in L&D services in these 29 areas of England were asked to consent to participate in the evaluation. To answer the research questions the evaluation intends to use information about consenting individuals held in the following datasets:
• The Police National Computer (PNC).
• Courts Service (HMCTS)
• National Drug Treatment Monitoring Database (NDTMS).
• Mental Health Datasets (including MHMDS, MHLDDS and MHSDS)
• Improving Access to Psychological Therapies (IAPT).
• Hospital Episode Statistics A&E (HES A&E).
At this point in the study RAND have produced a number of progress reports for the Department of Health/ NHS England using matched data from PNC, Courts Service, NDTMS, Mental Health Data and HES A&E. Undertaking these matches and descriptive analysis of the data has shown that:
• The match is possible.
• Across all the matched data sets, the resulting sample sizes are likely to be large enough to detect small differences.
Based on these matches, RAND have undertaken feasibility assessments of the approach to analysis presented in the original project plan. RAND concluded a baseline controlled model approach should be taken. This approach aims to use statistical techniques to look at whether referral to L&D is associated with changes in the outcomes of interest (relevant to the research questions), while controlling for other factors that might cause these outcomes. The disadvantage of this approach, when compared to the original analysis plan, is that it is more difficult to conclude with certainty that the L&D service was the cause of any changes in outcomes. However, it will make use of the extensive data available and use statistical techniques to estimate how likely it is that any changes in trends were caused by the L&D service.
This agreement also seeks data to support Work package 3: Health Service Utilisation.
The objective of this work package is to understand whether the L&D service has an impact on health service utilisation by users. The study will use the same approach to generating the counterfactual as for the reconviction and diversion analysis – employing both a before-and-after design and a quasi experimental design using a matched comparison group. Importantly the answers to the research questions below will ascertain whether getting people who are in the criminal justice system signposted to the rights services will have a positive impact on their health and in turn have a knock on effect on the system as a whole.
The aims of the evaluation are to address the following research questions:
1. What impact, if any, does the implementation of the National Model of L&D have on reconviction?
2. What impact, if any, does the implementation of the National Model of L&D have on health service utilisation?
3. If any impacts on offending and health care utilisation are found, what is the economic effect of those?
4. How have any impacts of the National Model of L&D been achieved?
5. What impact, if any, does the implementation of the National Model of L&D have on diversion from the criminal justice system?
The study intends to gather information about health service utilisation from the following datasets:
• HES A&E dataset
• Mental Health Datasets (including MHMDS, MHLDDS, MHSDS)
• IAPT
Mental Health data (MHSDS) and IAPT data will be provided under this version of the agreement.
As in RAND's original agreement, RAND are requesting individual-level data because RAND need to understand the behaviour of a defined cohort, and because RAND will link data about these individual received from NHS Digital to data received from Public Health England and the Ministry of Justice.
RAND recruited individuals to the study between December 2016 and September 2017.
The ‘before’ period for the evaluation is 2011-2016. The ‘after’ period is October 2017 to the end of 2018.
RAND have already received A&E data for the period 2011/12 to 2017/18.This has allowed RAND to receive data that relates to the period after the intervention was experienced by the cohort.
RAND have already received MHMDS data for the period 2011/12 to 2013/14 and Mental Health and Learning Disabilities Data Set for 2014/15 - 2015/16. RAND are now requesting under this version of the agreement the MHSDS (the upversion of the MHMDS and MHLDDS) dataset for 2017/18 relevant to the ‘after’ period.
RAND have not previously received IAPT data. Under this version of the agreement, IAPT data (Improving Access to Psychological Therapies Data Set) from 2012/2013 until 2017/2018 will be disseminated. The justification for this is that it spans a relevant period before and after the intervention was received, which is needed to answer the research questions.
RAND have requested data for a defined cohort of service users who have consented to be part of the evaluation and have only selected relevant variables and the years necessary to address the research questions.
RAND Europe is a not-for-profit research organisation that helps to improve policy and decision making through research and analysis. Whilst RAND Europe have offices based in England and the EU for the purposes of this application no data will be processed outside of England and Wales. RAND is the Data Controller and Processor, who make all the decisions about how the data will be processed. The Department of Health & Social Care (DHSC) commission the work, however, DHSC are not a data controller, as they have no influence on the research. In regard to participants’ details: (name, data of birth, gender, NHS number) and participants’ records in national databases (shared by Government departments), which include unique identifiers, RAND Europe is the data controller, responsible for deciding the use of the data. The DHSC do not instruct RAND about how to use the data.
Expected output
A final report. This will be subject to peer review and formal approval from the Department of Health and Social Care (who fund the research project).
ii. RAND plan to submit to journals such as:
· The Lancet
· The BMJ
· Health Services Research and Policy
· BMJ Quality and Safety
· Health and Justice
· Criminal behaviour and mental health
iii. Summary report/ key findings briefing. Aimed at practitioner audiences capturing main points.
However, the key audience for the report findings is NHS England, as they commission L&D services and will use the study findings to inform decisions about future implementation and operation of the service.
iv. Conference papers and presentations: again, given at a range of conferences targeting a range of academic and practitioner disciplines.
The research team have worked closely with NHS England team throughout the research study to achieve recruitment of participants and to ensure that the findings are relevant to key policy questions. NHS England have only seen outputs and not had any data processing or controllership responsibilities.
Programme Board – who have cross departmental links with key policymakers nationally and regionally.
iii. Additional dissemination activities are likely to include:
• Briefing the final results to policy makers from interested departments (Health, Justice, PHE, Home Office, DWP).
• Attendance at events or conferences to disseminate findings to practitioner, policy and/or academic audiences.
• Writing blogs or short policy briefs.
• Briefing the cross-departmental L&D Programme Board.
The final report will be submitted in October 2019. Findings in relation to each of the aims outlined in the objectives for processing will be included in RAND Europe's final report.
During the study RAND Europe are keeping L&D service staff across the country informed about progress through updates in regular L&D Bulletins produced by NHS England. Details can be found here https://www.england.nhs.uk/commissioning/health-just/liaison-and-diversion/news/programme-updates/
Benefits reported
To date, the study has produced three progress reports. The key benefits these reports is that, for the first time, the L&D Programme Board were provided with rigorous information about the criminal justice histories and health service utilisation of the cohort of service users targeted by the L&D service.
For example, RAND's descriptive analysis provided evidence that this population are much higher users of A&E services than the general population - providing the possibility that L&D are targeting a costly group.
It also could show that L&D service intervention comes at a point of 'crisis' - where drug use, self-reported offending and health service utilisation has peeked. Again, it is of benefit for the Programme Board to understand this, in order to realise the scheme's potential benefits. As yet, RAND do not have any health data relating to the time after RAND's cohort used the L&D service.
RAND do have ‘after’ data from the national drug treatment data base. RAND's analysis of data collected about RAND's cohort from drug treatment services, show that self-rated psychological health and quality of life on average falls about 2 points on a 0-20 scale in the two years before L&D referral, recovering to about baseline levels after the referral.
The descriptive analysis of the mental health data previously received from NHS Digital finds that service utilisation increases in the evaluation cohort in the years before L&D, reflecting that contact with L&D may occur at a point of crisis for many individuals. As yet RAND have only published preliminary results, so they have not been used to inform policy, as of yet.
DARS-NIC-66034-M7B8W-v1.10 28 June 2019 to 27 June 2020
- Title
- Outcome evaluation of Offender Liaison and Diversion Trial Schemes
- Commercial
- No
- Sublicensing
- No
- Datasets
- 4
- Files released
- 1
Datasets: Hospital Episode Statistics Accident and Emergency (HES A and E); Improving Access to Psychological Therapies (IAPT) v1.5; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS)
Objective for processing
RAND Europe has been commissioned by the Department of Health to undertake an evaluation of the National Model for Liaison and Diversion (L&D) services in England. This follows a previous evaluation of the implementation of the National Model undertaken by RAND Europe from April 2014 to August 2015.
The legal basis for processing the information from NHS Digital is Article 6 (1)(F) of the GDPR - ‘Legitimate Interest’. Article 6(1)(f) of the GDPR provides that it is lawful to process the personal data of a data subject where the “processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child. For the case of this agreement, this legal basis is applicable because RAND's client, the Department of Health and Social Care has contracted RAND to undertake this study. The study cannot be conducted without access to this information from NHS Digital and PHE. As the data will be pseudonymised at various stages during the study individuals will not be practicably identifiable except by RAND Europe. Individuals’ interests will not be affected in any way. RAND have undertaken a legitimate interests assessment, which has been submitted in support of this agreement.
Article 9(2)(j)
(processing is 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)
The data are required for research purposes in the public interest - meeting the conditions in the DPA 2018 Schedule 1 Part 1 (4) - which GDPR Recital 52(2) determines is an appropriate derogation from the prohibition on processing special categories of personal data.
RAND having had the research funded by the Department of Health and Social Care (following a peer review of the funding application) and having the study approved by the Health Research Authority (which includes a review of the merit of the study) provides evidence of the scientific merit and quality of the research as well as the appropriate safeguards.
Liaison and Diversion (L&D) services aim to identify people experiencing mental health and substance misuse problems, and learning disabilities (among other vulnerabilities) as they pass through the criminal justice system (CJS) to ensure the service user's health and other needs are known about and that they are referred to services to address these needs. L&D schemes aim to improve outcomes for the service user group and to save money through the provision of accurate, appropriate and timely information to inform the decisions of the CJS.
The use of NHS Digital data will help RAND Europe in fulfilling its mission which is to improve health and health care systems, by providing policymakers with objective, empirically based research to inform decision making.
RAND Europe requires Hospital Episode Statistics Accident & Emergency, Mental Health Minimum Data Set, Improving Access to Psychological Therapies data to understand whether the L&D service has had an impact on health service utilisation by service users (research question 2). At the time of writing, as explained further below, RAND have successfully recruited a cohort and undertaken an initial data match, providing the feasibility and value of this evaluation
Developing the work undertaken in the first implementation evaluation, the Department of Health requires an outcome evaluation of the Liaison and Diversion (L&D) Trial scheme, which has been implemented in 25 areas of England. These 25 sites are made up of 10 ‘wave 1 roll-out’ sites (operating since April 2014) 15 ‘wave 2 roll-out’ sites (since April 2015).
The evaluation looks at the L&D service in 29 sites in England. The National Model was launched in 10 sites in 2014 covering 11 Wave 1 sites (where the National Model was rolled-out in 2014) and 18 Wave 2 sites (where the National Model was rolled-out in 2015). RAND will deliver the waves 1 and 2 and evaluate the implementation of the national model in the first 10 sites (referred to as the ‘wave 1 evaluation’1)
Between December 2016 and September 2017, individuals in L&D services in these 29 areas of England were asked to consent to participate in the evaluation. To answer the research questions the evaluation intends to use information about consenting individuals held in the following datasets:
• The Police National Computer (PNC).
• Courts Service (HMCTS)
• National Drug Treatment Monitoring Database (NDTMS).
• Mental Health Services Datasets (MHSDS)
• Improving Access to Psychological Therapies (IAPT).
• Hospital Episode Statistics A&E (HES A&E).
At this point in the study RAND have produced a number of progress reports for the Department of Health/ NHS England using matched data from PNC, Courts Service, NDTMS, MHSDS and HES A&E. Undertaking these matches and descriptive analysis of the data has shown that:
• The match is possible.
• Across all the matched data sets, the resulting sample sizes are likely to be large enough to detect small differences.
Based on these matches, RAND have undertaken feasibility assessments of the approach to analysis presented in the original project plan. RAND concluded a baseline controlled model approach should be taken. This approach aims to use statistical techniques to look at whether referral to L&D is associated with changes in the outcomes of interest (relevant to the research questions), while controlling for other factors that might cause these outcomes. The disadvantage of this approach, when compared to the original analysis plan, is that it is more difficult to conclude with certainty that the L&D service was the cause of any changes in outcomes. However, it will make use of the extensive data available and use statistical techniques to estimate how likely it is that any changes in trends were caused by the L&D service.
This agreement also seeks data to support Work package 3: Health Service Utilisation.
The objective of this work package is to understand whether the L&D service has an impact on health service utilisation by users. The study will use the same approach to generating the counterfactual as for the reconviction and diversion analysis – employing both a before-and-after design and a quasi experimental design using a matched comparison group. Importantly the answers to the research questions below will ascertain whether getting people who are in the criminal justice system signposted to the rights services will have a positive impact on their health and in turn have a knock on effect on the system as a whole.
The aims of the evaluation are to address the following research questions:
1. What impact, if any, does the implementation of the National Model of L&D have on reconviction?
2. What impact, if any, does the implementation of the National Model of L&D have on health service utilisation?
3. If any impacts on offending and health care utilisation are found, what is the economic effect of those?
4. How have any impacts of the National Model of L&D been achieved?
5. What impact, if any, does the implementation of the National Model of L&D have on diversion from the criminal justice system?
The study intends to gather information about health service utilisation from the following datasets:
• HES A&E dataset
• MHMDS
• IAPT
Mental Health and IAPT data will be provided at a later date.
As in RAND's original agreement, RAND are requesting individual-level data because RAND need to understand the behaviour of a defined cohort, and because RAND will link data about these individual received from NHS Digital to data received from Public Health England and the Ministry of Justice.
RAND recruited individuals to the study between December 2016 and September 2017.
The ‘before’ period for the evaluation is 2011-2016. The ‘after’ period is October 2017 to the end of 2018.
RAND have already received A&E data for the period 2011/12 to 2016/17. RAND are now requesting additional data for 2017/18, which relates to the period after the intervention was experienced by the cohort.
RAND have already received MHMDS data for the period 2011/12 to 2015/16. When available, RAND would like to request data covering the period 2017/2018 – relevant to the ‘after’ period.
RAND have not previously received IAPT data, however, when available RAND would like to request data from 2011/12 until 2017/2018. The justification for this is that it spans a relevant period before and after the intervention was received, which is needed to answer the research questions.
RAND have requested data for a defined cohort of service users who have consented to be part of the evaluation and have only selected relevant variables and the years necessary to address the research questions.
RAND Europe is a not-for-profit research organisation that helps to improve policy and decision making through research and analysis. Whilst RAND Europe have offices based in England and the EU for the purposes of this application no data will be processed outside of England and Wales. RAND is the Data Controller and Processor, who make all the decisions about how the data will be processed. The Department of Health & Social Care (DHSC) commission the work, however, DHSC are not a data controller, as they have no influence on the research. In regard to participants’ details: (name, data of birth, gender, NHS number) and participants’ records in national databases (shared by Government departments), which include unique identifiers, RAND Europe is the data controller, responsible for deciding the use of the data. The DHSC do not instruct RAND about how to use the data.
Expected output
A final report. This will be subject to peer review and formal approval from the Department of Health and Social Care (who fund the research project).
ii. RAND plan to submit to journals such as:
· The Lancet
· The BMJ
· Health Services Research and Policy
· BMJ Quality and Safety
· Health and Justice
· Criminal behaviour and mental health
iii. Summary report/ key findings briefing. Aimed at practitioner audiences capturing main points.
However, the key audience for the report findings is NHS England, as they commission L&D services and will use the study findings to inform decisions about future implementation and operation of the service.
iv. Conference papers and presentations: again, given at a range of conferences targeting a range of academic and practitioner disciplines.
The research team have worked closely with NHS England team throughout the research study to achieve recruitment of participants and to ensure that the findings are relevant to key policy questions. NHS England have only seen outputs and not had any data processing or controllership responsibilities.
Programme Board – who have cross departmental links with key policymakers nationally and regionally.
iii. Additional dissemination activities are likely to include:
• Briefing the final results to policy makers from interested departments (Health, Justice, PHE, Home Office, DWP).
• Attendance at events or conferences to disseminate findings to practitioner, policy and/or academic audiences.
• Writing blogs or short policy briefs.
• Briefing the cross-departmental L&D Programme Board.
The final report will be submitted in October 2019. Findings in relation to each of the aims outlined in the objectives for processing will be included in RAND Europe's final report.
During the study RAND Europe are keeping L&D service staff across the country informed about progress through updates in regular L&D Bulletins produced by NHS England. Details can be found here https://www.england.nhs.uk/commissioning/health-just/liaison-and-diversion/news/programme-updates/
Benefits reported
To date, the study has produced three progress reports. The key benefits these reports is that, for the first time, the L&D Programme Board were provided with rigorous information about the criminal justice histories and health service utilisation of the cohort of service users targeted by the L&D service.
For example, RAND's descriptive analysis provided evidence that this population are much higher users of A&E services than the general population - providing the possibility that L&D are targeting a costly group.
It also could show that L&D service intervention comes at a point of 'crisis' - where drug use, self-reported offending and health service utilisation has peeked. Again, it is of benefit for the Programme Board to understand this, in order to realise the scheme's potential benefits. As yet, RAND do not have any health data relating to the time after RAND's cohort used the L&D service.
RAND do have ‘after’ data from the national drug treatment data base. RAND's analysis of data collected about RAND's cohort from drug treatment services, show that self-rated psychological health and quality of life on average falls about 2 points on a 0-20 scale in the two years before L&D referral, recovering to about baseline levels after the referral.
The descriptive analysis of the mental health data previously received from NHS Digital finds that service utilisation increases in the evaluation cohort in the years before L&D, reflecting that contact with L&D may occur at a point of crisis for many individuals. As yet RAND have only published preliminary results, so they have not been used to inform policy, as of yet.
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. 3 versions: DARS-NIC-66034-M7B8W-v1.10, DARS-NIC-66034-M7B8W-v2.4, DARS-NIC-66034-M7B8W-v3.2
-
October 2021
Renamed Applicant organisation: RAND Europe now named RAND Europe Community Interest Company. Not counted as a change.Renamed Data controllers: RAND Europe now named RAND Europe Community Interest Company. Not counted as a change.
-
December 2022
Register-wide edit DARS-NIC-66034-M7B8W-v1.10, DARS-NIC-66034-M7B8W-v2.4 — 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-66034-M7B8W, “Outcome evaluation of Offender Liaison and Diversion Trial Schemes”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-66034-m7b8w/ (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-66034-M7B8W to see the original rows.