comparative data
TRANSCRIPT
Better Information Means Better Care
Dr Geraint Lewis
Chief Data Officer
NHS England
• Overview of Comparative Data
• The change that Comparative Data will realise
• What changes patients and clinicians will see
• This is an opportunity for you to influence the course of this work
NHS | Presentation to [XXXX Company] | [Type Date]
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Purpose
<Link to the animation>
High quality care for all, now and for future generations
Text Text
World class dataOpen Outcomes
Greater voice and insight for patients and clinicians
More choiceand control
Transparency
Participation
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• Hospital Episode Statistics (HES) is a world-class data service containing details of all NHS hospital activity in England
• Records every inpatient ‘episode’ (1989 onwards), outpatient attendance (2003 onwards) and A&E attendance (2007 onwards)
• Invaluable research tool – tens of thousands of peer-reviewed articles and audits
Dame Edith Körner (1921-2000)
Our starting point for
world class data: HES
Uses of Comparative Data
Data can be made easier to use or more relevant by
information intermediaries
• Individuals can choose the treatments that are right for them
• Shared Decision Making• Information about treatment options
• Individuals can choose the right service provider for them
• Location and logistics• Quality and experience
• Citizens can get involved in local conversations about the design and quality of local services
• Providers, commissioners and citizens see the same information• Comparisons can provide context
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Comparative data supports
participation
Year 1 Year 2
Two years of HES data
for one individual patient
Describing: to describe patterns of hospital activity over time
Predicting: to build models that help plan services and reduce the risk of needing unplanned care
Evaluating: Using modern scientific methods to find out the success rate of preventive care
Uses of NHS Data
Comparing: to compare health needs and the use of services in different parts of the country
Auditing: to help assess the quality and safety of hospital care
Investigating: exploring what apparent links in the data are telling us
1. Variable data quality and completeness
2. Very difficult for patients to access their own data
3. Missing data:
a) No information about in-hospital prescribing, investigations, observations, etc.
b) No information about care outside hospital
c) No information about social care
Problems with HES
Questions that cannot yet
be answered using HES
• How many patients in England received chemotherapy last year?
• What proportion of patients in St. Mary’s hospital were reviewed by a consultant at least once a day?
• For patients in Birmingham versus Bristol, what was the average time between presenting to their GP with bowel symptoms to being diagnosed with colon cancer?
• What proportion of patients on Ward 20 who had highly abnormal nursing observations were reviewed by the intensive care outreach team within an hour?
UNCLASSIFIED
J F M A M J J A S O N D J F M A M J J A S O N D
Out-patient
In-patient
Emergency
Time
Leve
l o
f C
are
2011 2012
J F M A M J J A S O N D J F M A M J J A S O N D J F M A M
Out-patient
Primary Care
In-patient
Emergency
Social CareMental Health
Prescribing
TimeLeve
l of
Car
e
2011 2012 2013
× × × × × ×
J F M A M J J A S O N D J F M A M J J A S O N D J F M A M
Out-patient
Primary Care
In-patient
Emergency
Social CareMental Health
Prescribing
TimeLeve
l of
Car
e
2011 2012 2013
× × × × × ×
21:00 22:00 23:00 0:00 1:00 2 3 4 5:00 TimeLe
vel o
f Ev
ent
Pharmacy
Symptoms
Observations
Imaging
Tests
Results
Diagnoses
✚C ✚
★★ ★ ★ ★ ★✪ ✪
o oo o o
12-Jul-11
Procedures
Human Rights Act
NHS Constitution
Data Protection
Act
Health & Social
Care Act
2nd Caldicott Review
Protecting privacy
Identifiable data Potentially identifiable data
Non-identifiable data
Contains identifiers such as date of birth and postcode
Extracted into the secure environment of the HSCIC
Disclosed by the HSCIC only where there is a legal basis (e.g. section 251 approval) or with patient consent.
Contains a unique pseudonym for each person
Available only to approved organisations for approved purposes under a legal contract
Wide range of safeguards as specified by the information commissioner’s office (e.g., purpose limitation, prohibition of re-identification, time limits for destroying data, contractual penalties)
Contains aggregated or anonymous data
Published openly
Safeguards to ensure that the data are truly anonymous in line with ICO advice (e.g., small-number suppression, perturbation, rounding)
Safeguards
GP Practice
Health and Social Care Information
Centre
NHS Commissioners
& Providers, Public Health England etc.
Publication
Health Service Researchers &
analysts
PatientSection 251
Potential patient objection
Hospital, social care providers
etc.
Patients have a choice
Further information
www.england.nhs.uk/caredata
Discussion
1. What benefits could cara.data and better use of comparative data bring for patients and the public?
2. How could comparative data help citizens to hold organisations to account?
3. How do we make sure that a wide range of people are able to get involved in setting the priorities for comparative data/care.data?