Health and Growth Accelerator (HGA) Programme National Evaluation

NHS England and the Office for National Statistics (ONS) require access to NHS England data for the purpose of conducting a preliminary analytical view of the Health and Growth Accelerator (HGA) Programme, which is a service commissioned by Integrated Care Boards (ICBs).

Evaluating the effectiveness of NHS services commissioned by ICBs is in line NHSE’s statutory duties to secure continuous improvement in the quality of services provided to individuals under Section 13E of the NHS Act 2006.

ONS requires access to health data to carry out its functions in accordance with the Statistics and Registration Service Act 2007 (SRSA). Section 45A(1) of the SRSA states that a public authority to which the Section applies may disclose to the Board any information held by the authority in connection with its functions. Specifically, ONS’ role in this programme is to provide statistical services namely the function to collect, adapt, and develop data under Section 22(2)(d) of the Statistics Registration and Service Act 2007 (SRSA).

ONS employees are subject to the confidentiality provisions in the SRSA 2007 that protect the confidentiality of personal information held by ONS. It is a criminal offence to wrongfully disclose personal information held by ONS.

The HGA Programme aims to tackle health-driven economic inactivity and currently comprises three ICBs which have been selected as pilots - West Yorkshire, South Yorkshire, North East and North Cumbria. These ICBs have selected providers to offer specific interventions such as those targeting mental health, musculoskeletal, cardiometabolic conditions to help keep people in work or help them return to work.

Tackling the crisis in health-driven economic inactivity is going to be one of the key ways to improve population health, strengthen communities and grow the economy over the next five years and beyond. 145,000 people are flowing from employment into health-driven inactivity each year. Reducing this growth in health-driven economic inactivity requires preventing and managing ill health in society: stopping health problems from becoming work problems. This provides a clear outcome metric to galvanise action on prevention and improved population health.

Getting it right will help tackle health inequalities, reduce the elective backlog, implement the NHS 10 Year Plan, operationalise neighbourhood health and the shift to prevention and also enable Integrated Care Systems (ICSs) to deliver one of their four key purposes which is supporting broader social and economic development.

Robust evaluation of the HGA programme is the key condition for funding of the programme by His Majesty’s Treasury (HMT). The purpose of the preliminary analytical view will give plausibility of the HGA Programme achieving its overall outcome (employment) target in 2025.

This preliminary analytical view will be provided using the HGA minimum data collection linked to the ONS administrative data available to NHS England analysts in ONS Integrated Data Service (IDS). The linking of the HGA data collection to the ONS data is for the purposes of:

(i) minimising the burden of collecting socio-demographic and employment data (including past history) by the ICB providers and

(ii) to add to the administrative data some key information on whether individuals were exposed to the HGA interventions and if so which one(s).

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

NHS England will provide the relevant records from the Health and Growth Minimum Data set to ONS. The Data will contain directly identifying data items including NHS Number which are required to link the Data at record level with data already held by the recipient.

ONS will link the HGA Minimum Data Set and the ONS Administrative Data Set (HMRC and Census 2021) and anonymise this linked data set to create the anonymised HGA Evaluation Data Set in the IDS platform. This dataset will be made available to NHS England analysts only.

ONS will not be using the Anonymised HGA Evaluation Data Set for any purposes other than those defined in this DSA.

The Data will not be linked with any other Data.

The Data will not be transferred to any other location.

The Data will be stored on IDS at ONS.

The IDS resides within Google Cloud Platform (GCP). Google UK Limited provide cloud services to ONS.

ONS stores Data on the Cloud provided by Amazon Web Services (AWS).

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

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

For remote access:

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

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

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

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

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

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

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

In order to access IDS, the NHS England analysts need to have an "Accredited researcher" status.

ONS are not permitted to share the data with any third parties.

The expected outputs of the processing will be:

A report of findings to NHSE HGA programme and HMT to bid for multi-year funding of the Accelerators in the Autumn Budget 2025.

A report and presentation of findings to the Accelerator ICBs

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:

• Results will be shared with the NHSE Health and Growth Accelerator Programme team, the Accelerator ICBs and HMT

• In the longer-term these preliminary findings are intended to feed into the wider Health and Growth Accelerator Programme as featured in the 10-year Health Plan for England

• Workshops involving NHSE and ICBs (TBC) on the likely expected outcomes of the HGA

• Direct bilateral engagement with HMT to make a bid for multi-year funding of the HGA – October-November 2025

None of the above will be publicly reported due to the preliminary nature of the analysis.

Health-related economic inactivity has reached record levels in UK with 2.8m people saying they are economically inactive due to long-term sickness. Around 300,000 working-age people a year move from being in employment to being economically inactive with a work-limiting health condition. There has also been a 64% increase in the last decade of people who are in work who have a work-limiting health condition. As well as impacting the health of the population, this is significantly affecting the health of our public finances. Tackling this crisis is key to improving our nation’s health, strengthening our communities and growing the economy now and in the future. The issue of health-driven economic inactivity is of great importance to the HMG as demonstrated by the Get Britain Working White Paper. The HGA programme had to go through rigorous testing of the analytical arguments and modelling with HMT before being approved and granted funding.

The NHS is addressing this challenge through the ‘Health and Growth Accelerators’. These Accelerators are three local health systems (North East and North Cumbria, South Yorkshire and West Yorkshire) who have local autonomy to test new ways of supporting people to prevent their health problems becoming work problems and allow them to live healthy independent lives. The Health and Growth Accelerator programme is the first time that the NHS has been held accountable for work outcomes.

The use of the data could:

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

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

• 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 such as obesity and diabetes.

• 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.

If successful, these Accelerators will either keep 4,250 people in work or return 4.250 people to work, who would have otherwise been economically inactive due to their health. NHS England and ONS also expect improvements in health outcomes for the patients who took up interventions offered by the Health and Growth Accelerator ICBs.

The early quantitative assessment of the programme is proposed to support NHSE’s bid for additional funding for this programme and the evaluation of the programme will offer novel insights into the effectiveness of health interventions for work outcomes and will play a crucial role in shaping the future of the Health and Growth Accelerators’ programme across the country as envisaged in the recently published 10-year Health Plan for England.

Yielded Benefits is not a requirement for new applications.