Benchmarking in UDAL

Digital Health and Care Wales (DHCW) requires access to NHS England Data for the purpose of creating a benchmarking dashboard. The purpose of this dashboard is to enable Health Boards in Wales to be able to compare their own metrics with others across Wales and England.

The following NHS England Data will be accessed:

• Secondary Uses Services Admitted Patient Care, Accident & Emergency, and Outpatients data – necessary because these cover the core areas that are required by DHCW to fulfil their purpose.

The level of the Data will be pseudonymised.

The Data will be minimised as follows:

• Limited to Data between April 2019 and latest available. Data is required for this period to ascertain any trends compared with historic values and to maximise the ability to understand how the numbers are changing over time. This time period covers the COVID-19 pandemic to allow for a comparison with figures before the COVID-19 pandemic.

The Data will cover all uses of English hospital services. This coverage is required to enable the creation of benchmarking dashboard metrics covering nearly all conditions, mortality, data quality, quality, efficiency, etc, some of which are quite specialised. It will also allow for the creation of comparable peer groups for the hospitals in Wales.

DHCW is the controller as the organisation responsible for ensuring that the Data will only be processed for the purpose described above.

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

Article 6(1)(e) -processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller.

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

Article 9(2)(h) - processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3.

No data will flow to NHS England for the purposes of this Data Sharing Agreement (DSA).

NHS England will provide DHCW with access to Data via the Unified Data Access Layer (UDAL) “Data Share” service*. UDAL is a data management system within NHS England that enables patient data to be processed and made available for analytical purposes.

*The "Data Share" Service entails a data provider (NHS England UDAL) and a data consumer (DHCW’s data platform), where the provider (NHS England) is in control of who receives data, when it is updated and how frequently.

NHS England will provide access to the relevant records from the SUS datasets to DHCW. The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient. DHCW will extract subsets of the data where required to support the creation of the benchmarking dashboards. Data accessed under this DSA will be stored on a separate server to the Data supplied under DARS-NIC-660630-L4H3T. Only certain DHCW employees will have access to the Data, and these data sets are not to be linked.

The Data will be stored on servers at NHS England (UDAL) and DHCW.

DHCW does not store data on the cloud at present.

The Data will not be transferred to any other location.

The Data will be accessed onsite at the premises of DHCW, and by authorised personnel via remote access.

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

For remote access:

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

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

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

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

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

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

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

The Data will not leave England/Wales at any time.

Remote processing will be from locations within England/Wales. The data will not leave England/Wales at any time.

Access is restricted to employees of DHCW.

All personnel accessing the Data have been appropriately trained in data protection and confidentiality.

The Data will not be linked with any other data.

There will be no requirement and no attempt to reidentify individuals when using the Data.

Analysts from DHCW will process the Data for the purposes described in ‘Objective for Processing’.

The expected outputs of the processing will be the ability for Health Boards across Wales to be able to benchmark a wide range of key metrics such as mortality.

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

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

• Benchmarking dashboard

The target dates for production and dissemination of the outputs are before the end of 2024. The benchmarking dashboards will be an ongoing resource.

The use of the data could:

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

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

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

• advance understanding of the need for, or effectiveness of, preventative health and care measures for particular populations or conditions.

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

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

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

The services provided to the Health Boards are expected to identify improvement opportunities which the Health Boards may then exploit by making changes to systems, processes, resources, or infrastructure to improve patient experience and care.

Specific benefits to the public are expected to be improved services across Wales as Health Boards better understand how their own figures compare to others across England and Wales, and are able to make appropriate changes to their services as a result.

It is hoped that publication of the dashboard will add to the body of evidence that is considered by organisations and individual care practitioners charged with making policy decisions or decisions on treatment for or within the NHS.

All of the outputs will remain within NHS Wales and Welsh Government, but will be promoted within these areas.

Yielded Benefits is not a requirement for new applications.