DSfC - NHS North Lincolnshire CCG - IV, RS & Comm
NHS Humber and North Yorkshire ICB · Sub ICB Location
Listed under NHS Humber and North Yorkshire Integrated Care Board.
Expired The latest version ended on 30 June 2023. The September 2026 register still lists the agreement, but its term has passed.
- Reference
- DARS-NIC-90680-M5B5W
- Latest version
- v5.2
- Term of latest version
- 1 July 2020 to 30 June 2023
- Start date
- Before 30 March 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 0
Why the data was released
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so NHS North Lincolnshire CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
Invoice Validation with be conducted by North of England Commissioning Support Unit and Liaison Financial Services Ltd
Liaison Financial Services Ltd conduct an independent ad-hoc review on retrospective payments made. Investing resource, skills and experience into deeper reconciliation, this identifies overcharges already paid and recovers savings for the CCG that would otherwise be lost
NHS North Lincolnshire CCG are advised by North of England Commissioning Support Unit whether payment for invoices can be made or not.
RISK STRATIFICATION
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit
Commissioning
To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area.
NHS North Lincolnshire CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers.
The following pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registration Births and Deaths Data (CRD)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models.
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
In addition, North of England Commissioning Support Unit also receive pseudonymised GP data and Social Care data. This is pseudonymised either at source or within North of England Commissioning Support Unit acting as a data processor on behalf of each data controller. This pseudonymisation process is different to that within the DSCRO. Also, each data source will use a variation of this process so there is no linkage between these data until a common pseudonym has been applied via the DSCRO.
Processing for commissioning will be conducted by North of England Commissioning Support Unit and NHS North East Lincolnshire CCG .
Processing activities
Data must only be used for the purposes stipulated within this Data Sharing Agreement. Any additional disclosure / publication will require further approval from NHS Digital.
Data Processors must only act upon specific instructions from the Data Controller.
Data can only be stored at the addresses listed under storage addresses.
All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role.
Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from NHS Digital will not be national data.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)
The DSCRO (part of NHS Digital) will apply National Opt-outs before any identifiable data leaves the DSCRO only for the purpose of Risk Stratification.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
The only identifier available in the data set is the NHS numbers. Any further identification of the patients will only be completed by the patient’s clinician on their own systems for the purpose of direct care with a legitimate relationship.
Onward Sharing
Patient level data will not be shared outside of the CCG unless it is for the purpose of Direct Care, where it may be shared only with those health professionals who have a legitimate relationship with the patient and a legitimate reason to access the data.
Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital guidance applicable to each data set.
Segregation
Where the Data Processor and/or the Data Controller hold both identifiable and pseudonymised data, the data will be held separately so data cannot be linked.
All access to data is auditable by NHS Digital.
Data for the purpose of Invoice Validation is kept within the CEfF, and only used by staff properly trained and authorised for the activity. Only CEfF staff are able to access data in the CEfF and only CEfF staff operate the invoice validation process within the CEfF. Data flows directly in to the CEfF from the DSCRO and from the providers – it does not flow through any other processors.
Data Minimisation
Data Minimisation in relation to the data sets listed within section 3 are listed below. This also includes the purpose on which they would be applied -
For the purpose of Commissioning:
• Patients who are normally registered and/or resident within NHS North Lincolnshire CCG (including historical activity where the patient was previously registered or resident in another commissioner).
and/or
• Patients treated by a provider where NHS North Lincolnshire CCG is the host/co-ordinating commissioner and/or has the primary responsibility for the provider services in the local health economy – this is only for commissioning and relates to both national and local flows.
and/or
• Activity identified by the provider and recorded as such within national systems (such as SUS+) as for the attention of NHS North Lincolnshire CCG - this is only for commissioning and relates to both national and local flows.
For the purpose of Risk Stratification:
• Patients who are normally registered and/or resident within NHS North Lincolnshire CCG (including historical activity where the patient was previously registered or resident in another commissioner
For the purpose of Invoice Validation:
• CCG of residence and/or registration.
In addition to the dissemination of Cancer Waiting Times Data via the DSCRO, the CCG is able to access reports held within the CWT system in NHS Digital directly. Access within the CCG is limited to those with a need to process the data for the purposes described in this agreement.
A CCG user will be able to access the provider extracts from the portal for any provider where at least 1 patient for whom they are the registered CCG for that individuals GP practice appears in that setting
Although a CCG user may have access to pseudonymised patient information not related to that CCG, users should only process and analyse data for which they have a legitimate relationship (as described within Data Minimisation).
N3i Limited and North Lincolnshire Council, supply IT infrastructure and are therefore listed as data processors. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Microsoft Limited provide Cloud Services for Liaison Financial Services and do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Pulsant and IT Professional Services Ltd do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
INVOICE VALIDATION
Data Processor - North of England Commissioning Support Unit and Liaison Financial Services Ltd
1. Identifiable SUS+ Data is obtained from the SUS+ Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. The DSCRO pushes a one-way data flow of SUS+ data into the Controlled Environment for Finance (CEfF) in the North of England Commissioning Support Unit.
3. The CEfF also receive backing data from the provider.
4. The North of England Commissioning Support Unit and Liaison Financial Services Ltd carry out the following processing activities within the CEfF for invoice validation purposes:
a. Validating that the Clinical Commissioning Group is responsible for payment for the care of the individual by using SUS+ and/or backing flow data.
b. Once the backing information is received, this will be checked against national NHS and local commissioning policies as well as being checked against system access and reports provided by NHS Digital to confirm the payments are:
i. In line with Payment by Results tariffs.
ii. are in relation to a patient registered with a CCG GP or resident within the CCG area.
iii. The health care provided should be paid by the CCG in line with CCG guidance.
5. NHS North Lincolnshire CCG are notified that the invoice has been validated and can be paid. Any discrepancies or non-validated invoices are investigated and resolved between The North of England Commissioning Support Unit CEfF team and the provider meaning that no identifiable data needs to be sent to the CCG. The CCG only receives notification to pay and management reporting detailing the total quantum of invoices received pending, processed etc.
RISK STRATIFICATION
Data Processor - North of England Commissioning Support Unit
1. Identifiable SUS data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to North of England Commissioning Support Unit, who hold the SUS data within the secure Data Centre.
3. Identifiable GP Data is securely sent from the GP system to North of England Commissioning Support Unit.
4. SUS data is linked to GP data in the risk stratification tool by the data processor.
5. As part of the risk stratification processing activity, GPs have access to the risk stratification tool within the data processor, which highlights patients with whom the GP has a legitimate relationship and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
6. Once North of England Commissioning Support Unit has completed the processing, NHS North Lincolnshire CCG can access the online system via a secure connection to access the data pseudonymised at patient level.
COMMISSIONING –
The Data Services for Commissioners Regional Office (DSCRO) obtains the following data sets:
1. SUS
2. Local Provider Flows (received directly from providers)
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
3. Mental Health Minimum Data Set (MHMDS)
4. Mental Health Learning Disability Data Set (MHLDDS)
5. Mental Health Services Data Set (MHSDS)
6. Maternity Services Data Set (MSDS)
7. Improving Access to Psychological Therapy (IAPT)
8. Child and Young People Health Service (CYPHS)
9. Community Services Data Set (CSDS)
10. Diagnostic Imaging Data Set (DIDS)
11. National Cancer Waiting Times (CWT)
12. Civil Registries Data – Births and Deaths (CRD)
13. National diabetes Audit (NDA)
14. Patient Reported Outcome Measures (PROMs)
Data Processors – North of England Commissioning Support Unit & NHS North East Lincolnshire CCG
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT) Civil Registries Data – Births and Deaths (CRD) ), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to North of England Commissioning Support Unit.
2. North of England Commissioning Support Unit also receive pseudonymised GP Data and Social Care data. (See i – ix for detail).
3. North of England Commissioning Support Unit add derived fields and link data. Data is stored on a server held within North of England Commissioning Support Unit.
4. Access to the North of England Commissioning Support Unit server (data listed in point 1 and 2 only) is granted to NHS North East Lincolnshire CCG. NHS North East Lincolnshire CCG provide analysis as point 5 and between them produce different reports to produce the outputs listed at point 5.
5. North of England Commissioning Support Unit and NHS North East Lincolnshire CCG provide analysis to:
a. See patient journeys for pathways or service design, re-design and de-commissioning.
b. Check recorded activity against contracts or invoices and facilitate discussions with providers.
c. Undertake population health management
d. Undertake data quality and validation checks
e. Thoroughly investigate the needs of the population
f. Understand cohorts of residents who are at risk
g. Conduct Health Needs Assessments
6. North of England Commissioning Support Unit also apply a risk stratification algorithm to pseudonymised SUS+, Local Provider flow and GP data only. Outputs are made available to North of England Commissioning Support Unit analysts and NHS North East Lincolnshire CCG.
7. Aggregation of required data for CCG management use will be completed by North of England Commissioning Support Unit and/or NHS North East Lincolnshire CCG as instructed by the CCG.
8. Patient level data will not be shared outside of the Data Processor/Controller and will only be shared within the Data Processors on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
9. NHS North East Lincolnshire CCG are permitted to download data in points 1 and 2 to their servers and outputs from point 6.
10. The CCG securely transfer Pseudonymised data back to the provider to:
a) confirm how patients are reported in SUS, and how the commissioner can reliably group these patients into categories for points of delivery;
b) allow for granular data validation whereby a commissioner may query the SUS record, and need to pass it back to the provider for checking; and
c) to allow the provider to undertake further analysis of a cohort of their patients as requested and specified by the commissioner.
The data transferred to the provider is only that which relates directly to the data previously uploaded by that particular provider.
All access to the North of England Commissioning Support Unit server is managed via Role Based Access Controls.
North of England Commissioning Support Unit have individual data processing agreements in place with GPs, Local Authorities and the CCG, to pseudonymise data. Acting on their behalf, North of England Commissioning Support Unit pseudonymises the data as follows:
i. Identifiable GP and Social Care data is submitted to North of England Commissioning Support Unit.
ii. The data lands in a ring-fenced area.
iii. North of England Commissioning Support Unit has access to a pseudonymisation tool. North of England Commissioning Support Unit requests an organisation specific pseudonymisation key from the DSCRO. The key can only be used once. The key is specific to the individual request and the organisation it is being requested for.
iv. The data is then pseudonymised using the organisation specific pseudonymisation tool and DSCRO issued key. The identifiable data is then deleted from the ring-fenced area.
v. To enable linkage to data listed in point 1, North of England Commissioning Support Unit make a request to the DSCRO.
vi. The DSCRO then send a mapping table to North of England Commissioning Support Unit.
vii. A black box uses the mapping table to overwrite the organisation specific pseudonym with the DSCRO pseudonym to enable linkage to NHS Digital released products (under this agreement).
viii. The mapping table if then deleted.
ix. In addition, for social care data only: Social Care organisations have access to the pseudonymisation tool and can request an organisation specific pseudonymisation key from the DSCRO. The key can only be used once and is specific to that date. The organisation then submits the pseudonymised social care data to North of England Commissioning Support Unit. The data then follows from point v.
Expected output
INVOICE VALIDATION
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
– Liaison Financial Services Ltd
1. Validation of Continuing Healthcare related invoices and payments
2. Independent Identification of potential overpayments made by the CCG through invoice validation
3. Liaising with providers with a view to recouping these monies
4. Review is completed for the retrospective period from date of contract with Liaison Financial Services back to 01/04/2013.
5. Reviews take 3-9 months depending on number of claims to investigate and resolve
6. Liaison Financial Services would repeat the exercise 2-3 years later
7. CCGs could request reviews to be done more frequently
8. SUS+ would only be requested each time a review was completed, and could be requested at different times as independent reviews
RISK STRATIFICATION
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
COMMISSIONING
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
Expected measurable benefits
INVOICE VALIDATION
The invoice validation process supports the ongoing delivery of patient care across the NHS and the CCG region by:
1. Ensuring that activity is fully financially validated.
2. Ensuring that service providers are accurately paid for the patients treatment.
3. Enabling services to be planned, commissioned, managed, and subjected to financial control.
4. Enabling commissioners to confirm that they are paying appropriately for treatment of patients for whom they are responsible.
5. Fulfilling commissioners duties to fiscal probity and scrutiny.
6. Ensuring full financial accountability for relevant organisations.
7. Ensuring robust commissioning and performance management.
8. Ensuring commissioning objectives do not compromise patient confidentiality.
9. Ensuring the avoidance of misappropriation of public funds.
– Liaison Financial Services Ltd
1. Financial validation of activity
2. CCG Budget control
3. Assurances over the robustness of internal control mechanisms relating to the payment of invoices and/or suggested improvements
4. Identification and recovery of monies which would otherwise be lost
5. Meeting commissioning objectives without compromising patient confidentiality
6. The avoidance of misappropriation of public funds to ensure the ongoing delivery of patient care
7. Benefit delivered 3-9 months from receiving data, depending on number of claims to investigate and resolve
RISK STRATIFICATION
Risk stratification promotes improved case management in primary care and will lead to the following benefits being realised:
1. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.
2. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services thus allowing early intervention.
3. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required.
4. Supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework by allowing for more targeted intervention in primary care.
5. Better understanding of local population characteristics through analysis of their health and
6. healthcare outcomes
All of the above lead to improved patient experience through more effective commissioning of services.
COMMISSIONING
1. Supporting Quality Innovation Productivity and Prevention (QIPP) to review demand management, integrated care and pathways.
a. Analysis to support full business cases.
b. Develop business models.
c. Monitor In year projects.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
3. Health economic modelling using:
a. Analysis on provider performance against 18 weeks wait targets.
b. Learning from and predicting likely patient pathways for certain conditions, in order to influence early interventions and other treatments for patients.
c. Analysis of outcome measures for differential treatments, accounting for the full patient pathway.
d. Analysis to understand emergency care and linking A&E and Emergency Urgent Care Flows (EUCC).
4. Commissioning cycle support for grouping and re-costing previous activity.
5. Enables monitoring of:
a. CCG outcome indicators.
b. Financial and Non-financial validation of activity.
c. Successful delivery of integrated care within the CCG.
d. Checking frequent or multiple attendances to improve early intervention and avoid admissions.
e. Case management.
f. Care service planning.
g. Commissioning and performance management.
h. List size verification by GP practices.
i. Understanding the care of patients in nursing homes.
6. Feedback to NHS service providers on data quality at an aggregate and individual record level – only on data initially provided by the service providers.
7. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.
8. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care.
9. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required.
10. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework.
11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
12. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts
13. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
14. Providing greater understanding of the underlying courses and look to commission improved supportive networks, this would be ongoing work which would be continually assessed.
15. Insight to understand the numerous factors that play a role in the outcome for both datasets. The linkage will allow the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice.
16. Provision of indicators of health problems, and patterns of risk within the commissioning region.
17. Support of benchmarking for evaluating progress in future years.
Benefits reported so far
Not stated in the register.
Datasets on the latest version
Legal basis for provision: Health and Social Care Act 2012 – s261(2)(b)(ii); Health and Social Care Act 2012 – s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'.
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Acute-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Ambulance-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Children and Young People Health | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Civil Registration - Births | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Civil Registrations of Death | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Community Services Data Set (CSDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Community-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Demand for Service-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Diagnostic Imaging Data Set (DID) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Diagnostic Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Emergency Care-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Experience, Quality and Outcomes-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Improving Access to Psychological Therapies (IAPT) v1.5 | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Maternity Services Data Set | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health and Learning Disabilities Data Set (MHLDDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health Minimum Data Set (MHMDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health Services Data Set (MHSDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Mental Health-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| National Diabetes Audit | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Patient Reported Outcome Measures (PROMs) | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Population Data-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Primary Care Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| Public Health and Screening Services-Local Provider Flows | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| SUS for Commissioners | Anonymised - ICO Code Compliant | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
| SUS for Commissioners | Identifiable | Sensitive | Frequent Adhoc Flow | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
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.
No files recorded as released under this agreement.
Version history
The register lists each renewal of this agreement as a separate row. This site has 4 versions — earlier versions existed before this site's records begin.
DARS-NIC-90680-M5B5W-v5.2 1 July 2020 to 30 June 2023
- Title
- DSfC - NHS North Lincolnshire CCG - IV, RS & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-90680-M5B5W-v4.5
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-07-01 | |
| End date | 2023-06-30 |
Objective for processing
[3 paragraphs unchanged]
Invoice Validation with be conducted by North of England Commissioning Support
Unit.
Unit and Liaison Financial Services Ltd
Liaison Financial Services Ltd conduct an independent ad-hoc review on retrospective payments made. Investing resource, skills and experience into deeper reconciliation, this identifies overcharges already paid and recovers savings for the CCG that would otherwise be lost
[50 paragraphs unchanged]
Processing for commissioning will be conducted by North of England Commissioning Support Unit and NHS North East Lincolnshire
CCG.
CCG .
Legal Basis for Processing Data:
Data accessed under this Agreement will be processed in accordance with GDPR Article 6(1)(e) (processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller) and 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 of the Article)
Processing activities
[31 paragraphs unchanged]
N3i Limited and North Lincolnshire
Council
Council,
supply IT infrastructure and are therefore listed as data processors. They supply
[26 words unchanged]
agreement. This includes granting of access to the database[s] containing the data.
Microsoft Limited provide Cloud Services for Liaison Financial Services and do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
[2 paragraphs unchanged]
Data Processor - North of England Commissioning Support Unit
and Liaison Financial Services Ltd
[3 paragraphs unchanged]
4. The North of England Commissioning Support Unit
and Liaison Financial Services Ltd
carry out the following processing activities within the CEfF for invoice validation purposes:
[76 paragraphs unchanged]
Expected output
[7 paragraphs unchanged] – Liaison Financial Services Ltd 1. Validation of Continuing Healthcare related invoices and payments 2. Independent Identification of potential overpayments made by the CCG through invoice validation 3. Liaising with providers with a view to recouping these monies 4. Review is completed for the retrospective period from date of contract with Liaison Financial Services back to 01/04/2013. 5. Reviews take 3-9 months depending on number of claims to investigate and resolve 6. Liaison Financial Services would repeat the exercise 2-3 years later 7. CCGs could request reviews to be done more frequently 8. SUS+ would only be requested each time a review was completed, and could be requested at different times as independent reviews [59 paragraphs unchanged]
Expected measurable benefits
[11 paragraphs unchanged] – Liaison Financial Services Ltd 1. Financial validation of activity 2. CCG Budget control 3. Assurances over the robustness of internal control mechanisms relating to the payment of invoices and/or suggested improvements 4. Identification and recovery of monies which would otherwise be lost 5. Meeting commissioning objectives without compromising patient confidentiality 6. The avoidance of misappropriation of public funds to ensure the ongoing delivery of patient care 7. Benefit delivered 3-9 months from receiving data, depending on number of claims to investigate and resolve [43 paragraphs unchanged]
DARS-NIC-90680-M5B5W-v4.5 20 April 2020 to 19 April 2023
- Title
- DSfC - NHS North Lincolnshire CCG - IV, RS & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-90680-M5B5W-v3.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-04-20 | |
| End date | 2023-04-19 | |
| Acute-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Ambulance-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Children and Young People Health: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Civil Registration - Births: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Civil Registrations of Death: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Community Services Data Set (CSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Community-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Demand for Service-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Diagnostic Imaging Data Set (DID): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Diagnostic Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Emergency Care-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Experience, Quality and Outcomes-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Improving Access to Psychological Therapies Data Set_v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Maternity Services Data Set v1.5: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health Minimum Data Set (MHMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health Services Data Set (MHSDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health and Learning Disabilities Data Set (MHLDDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Mental Health-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| National Diabetes Audit: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Other Not Elsewhere Classified (NEC)-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Patient Reported Outcome Measures (PROMs): common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Population Data-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Primary Care Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| Public Health and Screening Services-Local Provider Flows: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) | |
| SUS for Commissioners: common law duty of confidentiality | Mixture of confidential data flow(s) with support under section 251 NHS Act 2006 and non-confidential data flow(s) |
Objective for processing
[53 paragraphs unchanged]
In addition, North of England Commissioning Support Unit also receive pseudonymised GP
data,
data and
Social Care
data and Consented Data.
data.
This is pseudonymised either at source or within North of England Commissioning
[40 words unchanged]
these data until a common pseudonym has been applied via the DSCRO.
Processing for commissioning will be conducted by North of England Commissioning Support Unit and NHS North East Lincolnshire CCG.
Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) will processs data for this purpose up until 31 March 2020 after which all processing by this organisation will cease.
Legal Basis for Processing Data:
Data accessed under this Agreement will be processed in accordance with GDPR Article 6(1)(e) (processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller) and 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 of the Article)
Processing activities
[28 paragraphs unchanged]
Calderdale and Huddersfield NHS Foundation Trust, Telecity, Telstra and Pulsant do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
In addition to the dissemination of Cancer Waiting Times Data via the DSCRO, the CCG is able to access reports held within the CWT system in NHS Digital directly. Access within the CCG is limited to those with a need to process the data for the purposes described in this agreement.
No other company within the Kier Group other than Kier Business Services Limited will have access to the data listed in this agreement. Once Kier Business Services and Dr Foster (hosting eMBED) have ceased processing after 31 March 2020, the CCG must ensure that a data destruction certificate is submitted to NHS Digital covering both organisations within one month.
A CCG user will be able to access the provider extracts from the portal for any provider where at least 1 patient for whom they are the registered CCG for that individuals GP practice appears in that setting
No data shall be transferred outside of the territory of use noted in this agreement. The territory of use is England and Wales.
Although a CCG user may have access to pseudonymised patient information not related to that CCG, users should only process and analyse data for which they have a legitimate relationship (as described within Data Minimisation).
N3i Limited and North Lincolnshire Council supply IT infrastructure and are therefore listed as data processors. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Pulsant and IT Professional Services Ltd do not access data held under this agreement as they only supply the building. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
[12 paragraphs unchanged]
RISK STRATIFICATION
–
[38 paragraphs unchanged]
2. North of England Commissioning Support Unit also receive pseudonymised GP
Data,
Data and
Social Care
data and Consented
data. (See i –
viii
ix
for
detail)
detail).
[13 paragraphs unchanged]
9. NHS North East Lincolnshire CCG are permitted to download data in points 1 and 2 to their servers and outputs from point
6..
6.
[7 paragraphs unchanged]
i. Identifiable
GP,
GP and
Social Care
and Consented
data is submitted to North of England Commissioning Support Unit.
[8 paragraphs unchanged]
The following processing activities are only permitted up to and including 31 March 2020:
Data Processors - North of England Commissioning Support Unit & eMBED (Dr Foster and Kier Business Services)
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT) Civil Registries Data – Births and Deaths (CRD) ), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to North of England Commissioning Support Unit through one single flow.
2. North of England Commissioning Support Unit also receive pseudonymised GP Data, Social Care data and Consented data. (See i – viii for detail)
3. North of England Commissioning Support Unit add derived fields and link data. Data is stored on a server held within North of England Commissioning Support Unit.
4. Access to the North of England Commissioning Support Unit server (data listed in point 1 and 2 only) is granted to Kier Business Services Limited (Hosting the eMBED Health Consortium) via Role Based Access Control analyse the data and then to Dr Foster Limited (Hosting the eMBED Health Consortium). Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) provide analysis as point 5 and between them produce different reports to produce the outputs listed at point 5.
5. North of England Commissioning Support Unit and Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) provide analysis to:
a. See patient journeys for pathways or service design, re-design and de-commissioning.
b. Check recorded activity against contracts or invoices and facilitate discussions with providers.
c. Undertake population health management
d. Undertake data quality and validation checks
e. Thoroughly investigate the needs of the population
f. Understand cohorts of residents who are at risk
g. Conduct Health Needs Assessments
6. North of England Commissioning Support Unit also apply a risk stratification algorithm to pseudonymised SUS+, Local Provider flow and GP data only. Outputs are made available to North of England Commissioning Support Unit analysts and Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium).
7. Aggregation of required data for CCG management use will be completed by North of England Commissioning Support Unit and/or Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) as instructed by the CCG.
8. Patient level data will not be shared outside of the Data Processor/Controller and will only be shared within the Data Processors on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
9. Kier Business Services Limited and Dr Foster (Hosting the eMBED Health Consortium) are permitted to download data in points 1 and 2 to their servers and outputs from point 6..
10. The CCG securely transfer Pseudonymised data back to the provider to:
a) confirm how patients are reported in SUS, and how the commissioner can reliably group these patients into categories for points of delivery;
b) allow for granular data validation whereby a commissioner may query the SUS record, and need to pass it back to the provider for checking; and
c) to allow the provider to undertake further analysis of a cohort of their patients as requested and specified by the commissioner.
The data transferred to the provider is only that which relates directly to the data previously uploaded by that particular provider.
Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) will not have access to the pseudonymisation tool or encryption key used for the data, therefore is unable to re-identify the data effectively rendering the data anonymous.
North of England Commissioning Support Unit have individual data processing agreements in place with GPs, Local Authorities and the CCG, to pseudonymise data. Acting on their behalf, North of England Commissioning Support Unit pseudonymises the data as follows:
i. Identifiable GP, Social Care and Consented data is submitted to North of England Commissioning Support Unit.
ii. The data lands in a ring-fenced area.
iii. North of England Commissioning Support Unit has access to a pseudonymisation tool. North of England Commissioning Support Unit requests an organisation specific pseudonymisation key from the DSCRO. The key can only be used once. The key is specific to the individual request and the organisation it is being requested for.
iv. The data is then pseudonymised using the organisation specific pseudonymisation tool and DSCRO issued key. The identifiable data is then deleted from the ring-fenced area.
v. To enable linkage to data listed in point 1, North of England Commissioning Support Unit make a request to the DSCRO.
vi. The DSCRO then send a mapping table to North of England Commissioning Support Unit.
vii. A black box uses the mapping table to overwrite the organisation specific pseudonym with the DSCRO pseudonym to enable linkage to NHS Digital released products (under this agreement).
viii. The mapping table if then deleted.
ix. In addition, for social care data only: Social Care organisations have access to the pseudonymisation tool and can request an organisation specific pseudonymisation key from the DSCRO. The key can only be used once and is specific to that date. The organisation then submits the pseudonymised social care data to North of England Commissioning Support Unit. The data then follows from point v.
Expected output
[45 paragraphs unchanged]
8. GP Practice level dashboard
reports include high flyers.
reports.
[5 paragraphs unchanged]
o Most
expensive patients
cost activity uses
(top 15%)
[14 paragraphs unchanged]
Unchanged: Expected measurable benefits.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so NHS North Lincolnshire CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
Invoice Validation with be conducted by North of England Commissioning Support Unit.
NHS North Lincolnshire CCG are advised by North of England Commissioning Support Unit whether payment for invoices can be made or not.
RISK STRATIFICATION
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit
Commissioning
To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area.
NHS North Lincolnshire CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers.
The following pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registration Births and Deaths Data (CRD)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models.
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
In addition, North of England Commissioning Support Unit also receive pseudonymised GP data and Social Care data. This is pseudonymised either at source or within North of England Commissioning Support Unit acting as a data processor on behalf of each data controller. This pseudonymisation process is different to that within the DSCRO. Also, each data source will use a variation of this process so there is no linkage between these data until a common pseudonym has been applied via the DSCRO.
Processing for commissioning will be conducted by North of England Commissioning Support Unit and NHS North East Lincolnshire CCG.
Legal Basis for Processing Data:
Data accessed under this Agreement will be processed in accordance with GDPR Article 6(1)(e) (processing is necessary for the performance of a task in the public interest or in the exercise of official authority vested in the controller) and 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 of the Article)
Expected output
INVOICE VALIDATION
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
RISK STRATIFICATION
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
COMMISSIONING
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most cost activity uses (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
DARS-NIC-90680-M5B5W-v3.2 6 August 2019 to 5 August 2020
- Title
- DSfC - NHS North Lincolnshire CCG - IV, RS & Comm
- Commercial
- No
- Sublicensing
- No
- Datasets
- 27
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); National Diabetes Audit; Other Not Elsewhere Classified (NEC)-Local Provider Flows; Patient Reported Outcome Measures (PROMs); Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
What changed from DARS-NIC-90680-M5B5W-v2.4
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Title | DSfC - NHS North Lincolnshire CCG - IV, RS & Comm | |
| Start date | 2019-08-06 | |
| End date | 2020-08-05 |
Datasets: + National Diabetes Audit; + Patient Reported Outcome Measures (PROMs)
Objective for processing
[2 paragraphs unchanged]
Invoices are submitted to the Clinical Commissioning Group (CCG) so
they
NHS North Lincolnshire CCG is
are able to ensure that the activity claimed for each patient is
[37 words unchanged]
NHS number is only used to confirm the accuracy of backing-data sets
(data from providers)
and will not be used further.
Invoice Validation with be conducted by North of England
CSU.
Commissioning Support Unit.
The
NHS North Lincolnshire
CCG are advised by North of England
CSU
Commissioning Support Unit
whether payment for invoices can be made or not.
[1 paragraph unchanged]
Risk stratification is a tool for identifying and predicting which patients are at high risk
(of health deterioration and using multiple services)
or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the
[23 words unchanged]
provides focus for future demands by enabling commissioners to prepare plans for
both individual and groups of vulnerable
patients. Commissioners can then prepare plans for patients who may require high
[5 words unchanged]
also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit
and Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium).
[2 paragraphs unchanged]
The
NHS North Lincolnshire
CCGs commission services from a range of providers covering a wide array
[6 words unchanged]
flow categories requested supports the commissioned activity of one or more providers.
[25 paragraphs unchanged]
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
[15 paragraphs unchanged]
Processing for commissioning will be conducted by North of England Commissioning Support Unit and
NHS North East Lincolnshire CCG.
Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health
Consortium).
Consortium) will processs data for this purpose up until 31 March 2020 after which all processing by this organisation will cease.
Processing activities
Data must only be used
as
for the purposes
stipulated within this Data Sharing Agreement.
Any additional disclosure / publication will require further approval from NHS Digital.
[2 paragraphs unchanged]
All access to data is managed under Role-Based Access Controls. Users can only access data authorised by their role.
Patient level data will not be linked other than as specifically detailed within this Data Sharing Agreement. Data released will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from NHS Digital will not be national data.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)
The DSCRO (part of NHS Digital) will apply National Opt-outs before any identifiable data leaves the DSCRO only for the purpose of Risk Stratification.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
The only identifier available in the data set is the NHS numbers. Any further identification of the patients will only be completed by the patient’s clinician on their own systems for the purpose of direct care with a legitimate relationship.
Onward Sharing
[1 paragraph unchanged]
All access to data is managed under Roles-Based Access Controls
Aggregated reports only with small number suppression can be shared externally as set out within NHS Digital guidance applicable to each data set.
No patient level data will be linked other than as specifically detailed within this agreement. Data will only be shared with those parties listed and will only be used for the purposes laid out in the application/agreement. The data to be released from NHS Digital will not be national data, but only that data relating to the specific locality and that data required by the applicant.
NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)
The DSCRO (part of NHS Digital) will apply Type 2 objections before any identifiable data leaves the DSCRO only for the purpose of Risk Stratification.
CCGs should work with general practices within their CCG to help them fulfil data controller responsibilities regarding flow of identifiable data into risk stratification tools.
[17 paragraphs unchanged]
For clarity, any access by BDO and Engine to data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
No other company within the Kier Group other than Kier Business Services Limited will have access to the data listed in this agreement. Once Kier Business Services and Dr Foster (hosting eMBED) have ceased processing after 31 March 2020, the CCG must ensure that a data destruction certificate is submitted to NHS Digital covering both organisations within one month.
No other company within the Kier Group other than Kier Business Services Limited will have access to the data listed in this agreement.
[1 paragraph unchanged]
Identifiable data will only be disclosed:
INVOICE VALIDATION
1) where the requesting Data Controller’s Caldicott Guardian/Senior Approving Officer has approved the disclosure
Data Processor - North of England Commissioning Support Unit
2) where the DSCRO Information Risk Owner has approved the disclosure
3) to requestor/recipients specified by the Data Controller
4) to recipients that have a legitimate relationship with the individuals identified by the data, e.g. clinician
5) using mechanisms and routes that are secure and have an appropriate legal basis for holding identifiable data
6) where there is a legal basis and it is covered by a Data Sharing Agreement that justifies its use or the data subject has consented or where there is a separate legal basis for making the dataset identifiable enabling the re-identification to take place
7) whilst continuing to respect the data subject’s preferences for data sharing
In order for identifiable data to be disclosed, all seven requirements must be met.
Where identifiable data for the same dataset to the same organisation is released by NHS Digital (via a DSCRO), relevant controls must be in place locally by the recipient organisation to ensure that identifiable data is stored separately, under strict access control provisions, from its original anonymised in accordance with the ICOACoP form and used only for the specific purpose stipulated in this agreement. There must be no efforts made by the recipient organisation to link these datasets.
Invoice Validation -
[2 paragraphs unchanged]
3. The North of England Commissioning Support Unit carry out the following processing activities within the CEfF for invoice validation purposes:
3. The CEfF also receive backing data from the provider.
4. The North of England Commissioning Support Unit carry out the following processing activities within the CEfF for invoice validation purposes:
[5 paragraphs unchanged]
4. The
5. NHS North Lincolnshire
CCG are notified that the invoice has been validated and can be
[43 words unchanged]
management reporting detailing the total quantum of invoices received pending, processed etc.
Risk Stratification - Data Processor 1 - North of England Commissioning Support Unit
RISK STRATIFICATION –
Data Processor - North of England Commissioning Support Unit
[1 paragraph unchanged]
2. Data quality management and standardisation of data is completed by the
[18 words unchanged]
Commissioning Support Unit, who hold the SUS data within the secure Data
Centre on N3.
Centre.
[3 paragraphs unchanged]
6. Once North of England Commissioning Support Unit has completed the processing,
the
NHS North Lincolnshire
CCG can access the online system via a secure
N3
connection to access the data pseudonymised at patient level.
Data Processor 2 - Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium)
1. Identifiable SUS data is obtained from the SUS Repository to the Data Services for Commissioners Regional Office (DSCRO).
2. Data quality management and standardisation of data is completed by the DSCRO and the data identifiable at the level of NHS number is transferred securely to Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium), who hold the SUS data within the secure Data Centre on N3.
3. Identifiable GP Data is securely sent from the GP system to Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium).
4. SUS data is linked to GP data in the risk stratification tool by the data processor.
5. As part of the risk stratification processing activity, GPs have access to the risk stratification tool within the data processor, which highlights patients with whom the GP has a legitimate relationship and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
6. Once Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) has completed the processing, the CCG can access the online system via a secure N3 connection to access the data pseudonymised at patient level.
[26 paragraphs unchanged]
13. National diabetes Audit (NDA)
14. Patient Reported Outcome Measures (PROMs)
Data Processors – North of England Commissioning Support Unit & NHS North East Lincolnshire CCG
[1 paragraph unchanged]
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS),
[22 words unchanged]
Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT)
and
Civil Registries Data – Births and Deaths (CRD)
), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs)
only is securely transferred from the DSCRO to North of England Commissioning Support Unit.
2. North of England Commissioning Support Unit also receive pseudonymised GP Data, Social Care data and Consented data. (See i – viii for detail)
3. North of England Commissioning Support Unit add derived fields and link data. Data is stored on a server held within North of England Commissioning Support Unit.
4. Access to the North of England Commissioning Support Unit server (data listed in point 1 and 2 only) is granted to NHS North East Lincolnshire CCG. NHS North East Lincolnshire CCG provide analysis as point 5 and between them produce different reports to produce the outputs listed at point 5.
5. North of England Commissioning Support Unit and NHS North East Lincolnshire CCG provide analysis to:
a. See patient journeys for pathways or service design, re-design and de-commissioning.
b. Check recorded activity against contracts or invoices and facilitate discussions with providers.
c. Undertake population health management
d. Undertake data quality and validation checks
e. Thoroughly investigate the needs of the population
f. Understand cohorts of residents who are at risk
g. Conduct Health Needs Assessments
6. North of England Commissioning Support Unit also apply a risk stratification algorithm to pseudonymised SUS+, Local Provider flow and GP data only. Outputs are made available to North of England Commissioning Support Unit analysts and NHS North East Lincolnshire CCG.
7. Aggregation of required data for CCG management use will be completed by North of England Commissioning Support Unit and/or NHS North East Lincolnshire CCG as instructed by the CCG.
8. Patient level data will not be shared outside of the Data Processor/Controller and will only be shared within the Data Processors on a need to know basis, as per the purposes stipulated within the Data Sharing Agreement. External aggregated reports only with small number suppression can be shared as set out within NHS Digital guidance applicable to each data set.
9. NHS North East Lincolnshire CCG are permitted to download data in points 1 and 2 to their servers and outputs from point 6..
10. The CCG securely transfer Pseudonymised data back to the provider to:
a) confirm how patients are reported in SUS, and how the commissioner can reliably group these patients into categories for points of delivery;
b) allow for granular data validation whereby a commissioner may query the SUS record, and need to pass it back to the provider for checking; and
c) to allow the provider to undertake further analysis of a cohort of their patients as requested and specified by the commissioner.
The data transferred to the provider is only that which relates directly to the data previously uploaded by that particular provider.
All access to the North of England Commissioning Support Unit server is managed via Role Based Access Controls.
North of England Commissioning Support Unit have individual data processing agreements in place with GPs, Local Authorities and the CCG, to pseudonymise data. Acting on their behalf, North of England Commissioning Support Unit pseudonymises the data as follows:
i. Identifiable GP, Social Care and Consented data is submitted to North of England Commissioning Support Unit.
ii. The data lands in a ring-fenced area.
iii. North of England Commissioning Support Unit has access to a pseudonymisation tool. North of England Commissioning Support Unit requests an organisation specific pseudonymisation key from the DSCRO. The key can only be used once. The key is specific to the individual request and the organisation it is being requested for.
iv. The data is then pseudonymised using the organisation specific pseudonymisation tool and DSCRO issued key. The identifiable data is then deleted from the ring-fenced area.
v. To enable linkage to data listed in point 1, North of England Commissioning Support Unit make a request to the DSCRO.
vi. The DSCRO then send a mapping table to North of England Commissioning Support Unit.
vii. A black box uses the mapping table to overwrite the organisation specific pseudonym with the DSCRO pseudonym to enable linkage to NHS Digital released products (under this agreement).
viii. The mapping table if then deleted.
ix. In addition, for social care data only: Social Care organisations have access to the pseudonymisation tool and can request an organisation specific pseudonymisation key from the DSCRO. The key can only be used once and is specific to that date. The organisation then submits the pseudonymised social care data to North of England Commissioning Support Unit. The data then follows from point v.
The following processing activities are only permitted up to and including 31 March 2020:
Data Processors - North of England Commissioning Support Unit & eMBED (Dr Foster and Kier Business Services)
Data quality management and pseudonymisation is completed within the DSCRO and is then disseminated as follows:
1. Pseudonymised SUS+, Local Provider data, Mental Health data (MHSDS, MHMDS, MHLDDS), Maternity data (MSDS), Improving Access to Psychological Therapies data (IAPT), Child and Young People’s Health data (CYPHS), Community Services Data Set (CSDS), Diagnostic Imaging data (DIDS), National Cancer Waiting Times Monitoring Data Set (CWT) Civil Registries Data – Births and Deaths (CRD) ), National Diabetes Audit (NDA) and Patient Reported Outcome Measures (PROMs) only is securely transferred from the DSCRO to North of England Commissioning Support Unit through one single flow.
[21 paragraphs unchanged]
All access to the North of England Commissioning Support Unit server is managed via Role Based Access Controls.
[10 paragraphs unchanged]
Expected output
[16 paragraphs unchanged]
8. Set up capitated
budgets.
budgets – budgets based on care provided to the specific population.
[4 paragraphs unchanged]
13. Produce of Theographs
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific
diseases.
diseases
[23 paragraphs unchanged]
9. All of the above segmented in to population groups
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Analysis across health and social care by patient (outputs aggregated) providing a greater understand of service interdependencies and opportunities for a single service delivery model where overlap may exist currently
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Variation reporting between primary and secondary care (e.g. where one care setting suggests the patient has a condition but the other does not potentially leading to inappropriate treatment)
11. Contract Management and Modelling
12. Delayed transfers of care analysis
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
Expected measurable benefits
[17 paragraphs unchanged]
5. Better understanding of local population characteristics through analysis of their health and
healthcare outcomes
6. healthcare outcomes
[6 paragraphs unchanged]
d. Pooled health and social care budget reporting
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types.
2. Supporting Joint Strategic Needs Assessment (JSNA) for specific disease types and patient groups
[8 paragraphs unchanged]
b.
Financial and
Non-financial validation of activity.
[6 paragraphs unchanged]
i. Understanding the care of patients in nursing
homes and social care.
homes.
[1 paragraph unchanged]
7. New commissioning and service delivery models delivered via joint health and social care teams reducing duplication
7. Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.
8. Reduction in variation of outcomes and quality of care through increased understanding of primary and secondary care interaction. E.g. if cancer treatment outcomes are poor in one area does the GP data indicate a delayed referral?
8. Improved quality of services through reduced emergency readmissions, especially avoidable emergency admissions. This is achieved through mapping of frequent users of emergency services and early intervention of appropriate care.
9. A complete understanding of service utilisation to aid capacity/demand planning across health and social care
9. Improved access to services by identifying which services may be in demand but have poor access, and from this identify areas where improvement is required.
10. Early warning of likely pressures in the wider health and system following increased activity in primary and social care giving other providers a chance to plan and react.
10. Potentially reduced premature mortality by more targeted intervention in primary care, which supports the commissioner to meets its requirement to reduce premature mortality in line with the CCG Outcome Framework.
11. Better understanding of the health of and the variations in health outcomes within the population to help understand local population characteristics.
12. Better understanding of contract requirements, contract execution, and required services for management of existing contracts, and to assist with identification and planning of future contracts
13. Insights into patient outcomes, and identification of the possible efficacy of outcomes-based contracting opportunities.
14. Providing greater understanding of the underlying courses and look to commission improved supportive networks, this would be ongoing work which would be continually assessed.
15. Insight to understand the numerous factors that play a role in the outcome for both datasets. The linkage will allow the reporting both prior to, during and after the activity, to provide greater assurance on predictive outcomes and delivery of best practice.
16. Provision of indicators of health problems, and patterns of risk within the commissioning region.
17. Support of benchmarking for evaluating progress in future years.
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so NHS North Lincolnshire CCG is are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets (data from providers) and will not be used further.
Invoice Validation with be conducted by North of England Commissioning Support Unit.
NHS North Lincolnshire CCG are advised by North of England Commissioning Support Unit whether payment for invoices can be made or not.
RISK STRATIFICATION
Risk stratification is a tool for identifying and predicting which patients are at high risk (of health deterioration and using multiple services) or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for both individual and groups of vulnerable patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit
Commissioning
To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area.
NHS North Lincolnshire CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers.
The following pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registration Births and Deaths Data (CRD)
- National Diabetes Audit (NDA)
- Patient Reported Outcome Measures (PROMs)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models.
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
In addition, North of England Commissioning Support Unit also receive pseudonymised GP data, Social Care data and Consented Data. This is pseudonymised either at source or within North of England Commissioning Support Unit acting as a data processor on behalf of each data controller. This pseudonymisation process is different to that within the DSCRO. Also, each data source will use a variation of this process so there is no linkage between these data until a common pseudonym has been applied via the DSCRO.
Processing for commissioning will be conducted by North of England Commissioning Support Unit and NHS North East Lincolnshire CCG. Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium) will processs data for this purpose up until 31 March 2020 after which all processing by this organisation will cease.
Expected output
INVOICE VALIDATION
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
RISK STRATIFICATION
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets – budgets based on care provided to the specific population.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Production of Theographs – a visual timeline of a patients encounters with hospital providers.
14. Analyse based on specific diseases
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
COMMISSIONING
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. Comparators of CCG performance with similar CCGs as set out by a specific range of care quality and performance measures detailed activity and cost reports
10. Data Quality and Validation measures allowing data quality checks on the submitted data
11. Contract Management and Modelling
12. Patient Stratification, such as:
o Patients at highest risk of admission
o Most expensive patients (top 15%)
o Frail and elderly
o Patients that are currently in hospital
o Patients with most referrals to secondary care
o Patients with most emergency activity
o Patients with most expensive prescriptions
o Patients recently moving from one care setting to another
i. Discharged from hospital
ii. Discharged from community
13. Validation for payment approval, ability to validate that claims are not being made after an individual has died, like Oxygen services.
14. Validation of programs implemented to improve patient pathway e.g. High users unable to validate if the process to help patients find the best support are working or did the patient die.
15. Clinical - understand reasons why patients are dying, what additional support services can be put in to support.
16. Understanding where patient are dying e.g. are patients dying at hospitals due to hospices closing due to Local authorities withdrawing support, or is there a problem at a particular trust.
17. Removal of patients from Risk Stratification reports.
18. Re births provide a one stop shop of information, Births are recorded in multiple sources covering hospital and home births, a chance to overlook activity.
DARS-NIC-90680-M5B5W-v2.4 30 March 2019 to 29 March 2022
- Title
- DSfC - NHS North Lincolnshire CCG; RS, IV & Comm.
- Commercial
- No
- Sublicensing
- No
- Datasets
- 25
- Files released
- 0
Datasets: Acute-Local Provider Flows; Ambulance-Local Provider Flows; Children and Young People Health; Civil Registration - Births; Civil Registrations of Death; Community Services Data Set (CSDS); Community-Local Provider Flows; Demand for Service-Local Provider Flows; Diagnostic Imaging Data Set (DID); Diagnostic Services-Local Provider Flows; Emergency Care-Local Provider Flows; Experience, Quality and Outcomes-Local Provider Flows; Improving Access to Psychological Therapies (IAPT) v1.5; Maternity Services Data Set; Mental Health and Learning Disabilities Data Set (MHLDDS); Mental Health Minimum Data Set (MHMDS); Mental Health Services Data Set (MHSDS); Mental Health-Local Provider Flows; National Cancer Waiting Times Monitoring DataSet (NCWTMDS); Other Not Elsewhere Classified (NEC)-Local Provider Flows; Population Data-Local Provider Flows; Primary Care Services-Local Provider Flows; Public Health and Screening Services-Local Provider Flows; SUS for Commissioners; SUS for Commissioners
Objective for processing
Invoice Validation
Invoice validation is part of a process by which providers of care or services get paid for the work they do.
Invoices are submitted to the Clinical Commissioning Group (CCG) so they are able to ensure that the activity claimed for each patient is their responsibility. This is done by processing and analysing Secondary User Services (SUS+) data, which is received into a secure Controlled Environment for Finance (CEfF). The SUS+ data is identifiable at the level of NHS number. The NHS number is only used to confirm the accuracy of backing-data sets and will not be used further.
Invoice Validation with be conducted by North of England CSU.
The CCG are advised by North of England CSU whether payment for invoices can be made or not.
Risk Stratification
Risk stratification is a tool for identifying and predicting which patients are at high risk or are likely to be at high risk and prioritising the management of their care in order to prevent worse outcomes.
To conduct risk stratification Secondary User Services (SUS+) data, identifiable at the level of NHS number is linked with Primary Care data (from GPs) and an algorithm is applied to produce risk scores. Risk Stratification provides focus for future demands by enabling commissioners to prepare plans for patients. Commissioners can then prepare plans for patients who may require high levels of care. Risk Stratification also enables General Practitioners (GPs) to better target intervention in Primary Care.
Risk Stratification will be conducted by North of England Commissioning Support Unit and Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium).
Commissioning
To use pseudonymised data to provide intelligence to support the commissioning of health services. The data (containing both clinical and financial information) is analysed so that health care provision can be planned to support the needs of the population within the CCG area.
The CCGs commission services from a range of providers covering a wide array of services. Each of the data flow categories requested supports the commissioned activity of one or more providers.
The following pseudonymised datasets are required to provide intelligence to support commissioning of health services:
- Secondary Uses Service (SUS+)
- Local Provider Flows
o Acute
o Ambulance
o Community
o Demand for Service
o Diagnostic Service
o Emergency Care
o Experience, Quality and Outcomes
o Mental Health
o Other Not Elsewhere Classified
o Population Data
o Primary Care Services
o Public Health Screening
- Mental Health Minimum Data Set (MHMDS)
- Mental Health Learning Disability Data Set (MHLDDS)
- Mental Health Services Data Set (MHSDS)
- Maternity Services Data Set (MSDS)
- Improving Access to Psychological Therapy (IAPT)
- Child and Young People Health Service (CYPHS)
- Community Services Data Set (CSDS)
- Diagnostic Imaging Data Set (DIDS)
- National Cancer Waiting Times Monitoring Data Set (CWT)
- Civil Registration Births and Deaths Data (CRD)
The pseudonymised data is required to for the following purposes:
Population health management:
• Understanding the interdependency of care services
• Targeting care more effectively
• Using value as the redesign principle
Data Quality and Validation – allowing data quality checks on the submitted data
Thoroughly investigating the needs of the population, to ensure the right services are available for individuals when and where they need them
Understanding cohorts of residents who are at risk of becoming users of some of the more expensive services, to better understand and manage those needs
Monitoring population health and care interactions to understand where people may slip through the net, or where the provision of care may be being duplicated
Modelling activity across all data sets to understand how services interact with each other, and to understand how changes in one service may affect flows through another
Service redesign
Health Needs Assessment – identification of underlying disease prevalence within the local population
Patient stratification and predictive modelling - to identify specific patients at risk of requiring hospital admission and other avoidable factors such as risk of falls, computed using algorithms executed against linked de-identified data, and identification of future service delivery models.
The pseudonymised data is required to ensure that analysis of health care provision can be completed to support the needs of the health profile of the population within the CCG area based on the full analysis of multiple pseudonymised datasets.
In addition, North of England Commissioning Support Unit also receive pseudonymised GP data, Social Care data and Consented Data. This is pseudonymised either at source or within North of England Commissioning Support Unit acting as a data processor on behalf of each data controller. This pseudonymisation process is different to that within the DSCRO. Also, each data source will use a variation of this process so there is no linkage between these data until a common pseudonym has been applied via the DSCRO.
Processing for commissioning will be conducted by North of England Commissioning Support Unit and Kier Business Services Limited and Dr Foster Limited (Hosting the eMBED Health Consortium).
Expected output
Invoice Validation
1. The Controlled Environment for Finance (CEfF) will enable the CCG to challenge invoices and raise discrepancies and disputes.
2. Outputs from the CEfF will enable accurate production of budget reports, which will:
a. Assist in addressing poor quality data issues
b. Assist in business intelligence
3. Validation of invoices for non-contracted events where a service delivered to a patient by a provider that does not have a written contract with the patient’s responsible commissioner, but does have a written contract with another NHS commissioner/s.
4. Budget control of the CCG.
Risk Stratification
1. As part of the risk stratification processing activity detailed above, GPs have access to the risk stratification tool which highlights patients for whom the GP is responsible and have been classed as at risk. The only identifier available to GPs is the NHS numbers of their own patients. Any further identification of the patients will be completed by the GP on their own systems.
2. GP Practices will be able to view the risk scores for individual patients with the ability to display the underlying SUS+ data for the individual patients when it is required for direct care purposes by someone who has a legitimate relationship with the patient.
CCGs will be able to:
3. Target specific vulnerable patient groups and enable clinicians with the duty of care for the patient to offer appropriate interventions.
4. Reduce hospital readmissions and targeting clinical interventions to high risk patients.
5. Identify patients at risk of deterioration and providing effective care.
6. Reduce in the difference in the quality of care between those with the best and worst outcomes.
7. Re-design care to reduce admissions.
8. Set up capitated budgets.
9. Identify health determinants of risk of admission to hospital, or other adverse care outcomes.
10. Monitor vulnerable groups of patients including but not limited to frailty, COPD, Diabetes, elderly.
11. Health needs assessments – identifying numbers of patients with specific health conditions or combination of conditions.
12. Classify vulnerable groups based on: disease profiles; conditions currently being treated; current service use; pharmacy use and risk of future overall cost.
13. Produce of Theographs
14. Analyse based on specific diseases.
In addition:
- The risk stratification tool will provide aggregate reporting of number and percentage of population found to be at risk.
- Record level output (pseudonymised) will be available for commissioners (of the CCG), pseudonymised at patient level. Onward sharing of this data is not permitted.
Commissioning
1. Commissioner reporting:
a. Summary by provider view - plan & actuals year to date (YTD).
b. Summary by Patient Outcome Data (POD) view - plan & actuals YTD.
c. Summary by provider view - activity & finance variance by POD.
d. Planned care by provider view - activity & finance plan & actuals YTD.
e. Planned care by POD view - activity plan & actuals YTD.
f. Provider reporting.
g. Statutory returns.
h. Statutory returns - monthly activity return.
i. Statutory returns - quarterly activity return.
j. Delayed discharges.
k. Quality & performance referral to treatment reporting.
2. Readmissions analysis.
3. Production of aggregate reports for CCG Business Intelligence.
4. Production of project / programme level dashboards.
5. Monitoring of acute / community / mental health quality matrix.
6. Clinical coding reviews / audits.
7. Budget reporting down to individual GP Practice level.
8. GP Practice level dashboard reports include high flyers.
9. All of the above segmented in to population groups
10. Analysis across health and social care by patient (outputs aggregated) providing a greater understand of service interdependencies and opportunities for a single service delivery model where overlap may exist currently
11. Variation reporting between primary and secondary care (e.g. where one care setting suggests the patient has a condition but the other does not potentially leading to inappropriate treatment)
12. Delayed transfers of care analysis
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. 4 versions: DARS-NIC-90680-M5B5W-v2.4, DARS-NIC-90680-M5B5W-v3.2, DARS-NIC-90680-M5B5W-v4.5, DARS-NIC-90680-M5B5W-v5.2
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October 2022
Succeeded Applicant organisation: NHS North Lincolnshire CCG succeeded by NHS Humber and North Yorkshire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.Succeeded Data controllers: NHS North Lincolnshire CCG succeeded by NHS Humber and North Yorkshire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.
-
December 2022
Register-wide edit DARS-NIC-90680-M5B5W-v2.4, DARS-NIC-90680-M5B5W-v3.2, DARS-NIC-90680-M5B5W-v4.5, DARS-NIC-90680-M5B5W-v5.2 — 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-90680-M5B5W, “DSfC - NHS North Lincolnshire CCG - IV, RS & Comm”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-90680-m5b5w/ (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-90680-M5B5W to see the original rows.