Health and Social Care Data Integration and
Intelligence Project
Readiness Sessions
HSCDIIP – Readiness Sessions
•
Welcome and Introductions
•
Policy Context
•
Background to HSCDIIP
•
Information to Support Integration
•
State of Readiness – What we’ve been doing
•
Helping you get there – What you need to do
•
Timelines and Future Phases
•
Close
Policy Context
Integrating Health and
Social Care in Scotland
Alison Taylor
Head of Strategy and Delivery
Integration of Health and Social Care
Why integrate?
•
People should be supported to live well at
home or in the community for as much time as
they can
•
People should have a positive experience of
health and social care when they need it
Building blocks for integration
1) A guiding principle:
“. . . effective services must be designed with and for people and communities
– not delivered ‘top down’ for administrative convenience”
The Christie Commission Report
Commission on the future delivery of public services, June 2011
2) A single commissioner and budget for health and social care
3) Legislation:
– The Public Bodies (Joint Working) (Scotland) Act 2014
Public Bodies (Joint Working) (Scotland) Act (2014)
• Principles for integrated health and social care
• Nationally agreed outcomes for health and wellbeing
• Integrated governance arrangements for health and social care: delegation
to a body corporate or lead agency
• Integrated budgets for health and social care
• Integrated oversight of delivery
• Strategic planning
• Localities
Integrated Resources: approximate scale
14.0
Scotland Total
=£12.3bn
12.0
10.0
Minimum to be delegated to
Integration Authorities
=£7.7bn
£bn
8.0
6.0
4.0
2.0
0.0
Hospital
Community Health
FHS & Prescribing
Social Work
Strategic planning and
performance reporting (slide 1)
Partnerships will need information to:
•Map existing care pathways by geography, care group etc.
•Link outcomes to resources
•Measure effectiveness of new interventions
•Review and report on performance
Strategic planning and
performance reporting (slide 2)
Partnerships will need support for:
•Analysis
•Modelling future pathways and financial impact of strategic
needs assessment
•Financial planning
Data for integration
CHI
SIMD
Linked Health and
Social care file at
an individual
service user level
(Activity & Costs)
A&E
Outpatients
Inpatients
Deaths
Day cases
Social Care
SPARRA
Prescribing
Age/gender
Linked File
http://blogs.scotland.gov.uk/health-and-social-care-integration
Background to HSCDIIP
Information to Support Integration
Data for integration
CHI
SIMD
Linked Health and
Social care file at
an individual
service user level
(Activity & Costs)
A&E
Outpatients
Inpatients
Deaths
Day cases
Social Care
SPARRA
Prescribing
Age/gender
Linked File
Information to Support Integration –
What we Have Now
• Resource Utilisation - mapped total spend (£)
• Health based activity information
• Disease specific groups (diabetes / dementia)
• Profiling service users
– Delayed Discharges
– High Resource Individuals
• Partnership Variation
• Basic Pathway Analysis
Information: What we have now
£11.7bn
£11.7bn
Understand Variation in Spend
All Partnerships (All Ages) per weighted capita
Dash Board 1 - Partnership Resource
Mapping
Trends: Community prescribing costs,
per weighted capita by GP practice,
2010/11 - 2012/13
Variation: H&SC weighted
expenditure by GP practice
Dashboard 2 - Partnership & Practice
Resource and Activity
• Delayed Discharge Information available by;
• Partnership
• Number of delays
• Delay type (standard / code 9)
• Bed days occupied
• Resource consumption (£)
• All ages / 75+
• Rates (partnership & Scotland) per head population
• What do you think the average cost of a delay
(per day)? £188 per day (standard)
Bed Days
£205 per day (code 9s)
Standard: 421,157
• How much do you think is lost to •delays
across
Approx £102m • Code 9: 111,342
Scotland?
• Example of Partnership X
• During 2013/14 cost of delay = £4.6m
• Bed days lost during year = 19,200
• Equivalent to 54 beds (2 wards?)
Dashboard 3 – Delayed Discharges
Identify areas of high resource use to
help first year of planning
Identify areas of high resource use to
help first year of planning
Hospital & GP prescribing resources 2012/13
100%
90%
80%
£2.6bn
70%
4,322,546
60%
50%
40%
30%
£2.6bn
20%
10%
0%
102,628
High Resource Individuals (HRIs)
• Across Scotland 2% of the population utilise 50%
of health resource
• Spend on HRIs £24,700/year vs average £1,200
• Most extra cost is due to emergency hospital
admissions
o Almost 4.5m
emergency bed days
• HRIs account for
around half of all
geriatric, psychiatric
and GP beds
Dashboard 4 – HRIs
Example Developments
Breakout Session
Dementia: Prevalence
Dementia: Costs
Dementia: Further analysis
Last six months of life:
Hospital utilisation
Where we are heading
•
Future Analytical ‘Tools’
 Impact analysis (evaluation)
 Cost Benefit analysis
 Predictive Analysis
 Scenario Planning
•
Pathway Analysis
Predictive
Analytics/
Scenario
Planning
Naive
model
J
Em admission
(gen med; 3 days;
£1,323)
Invest
in
ACPs?
Better
model
?
F
M
A
Em admission
(resp med;
procedure;
4 days; £1721)
Diagnosed CHD
M
J
J
A
S
O
A&E (£103)
Em admission
(gen med; 24 days; £8,042)
Delayed
Discharge (Home)
N
D
Future Planned Developments
• Standard Reports via HSCDIIP Dashboard
 High level annual mapping (£) – 2010/11 to 2013/14
 IP/DC detailed annual mapping – 2013/14
 HRIs (Partnership level) – 2013/14
 Delayed Discharges – 2012/13 to 2013/14
• Financial Information for Hospital Planning
 Existing acute financial/activity mapping by hospital
 Above, with addition of month up to Mar 2014 (activity for
Apr-Dec 2014)
Future Planned Developments
• Standard Reports via HSCDIIP Dashboard Development
 IP/DC detailed mapping (time trend) - 2010/11 to 2013/14  HRI (Time Trend & Individual Level)
 Locality Level information




GP Practice level Information
Social Care Activity & Costs
Community Health Activity & Costs
Detailed Annual Mapping for:
o A&E
o Outpatient
o Prescribing
Future Planned Developments
• Care Group Developments
 Multi-morbidity
 Last Six Months of Life
 Waste Indicators
• Other Planned Care Group Developments
 Falls
 Drug and Alcohol
 Cancer
• Pathway Analysis
 Delayed Discharges
 High Resource Individuals
 Visualisation
Q&A
State of Readiness – What we’ve been doing
Engagement
Social Care
Dataset
IT
Information
Governance
• Understand User Needs
• Meeting with Key Stakeholder groups and LAs
• Co-Production / Development
• Running dataset development workshops with LAs
• Developing the Dataset and Definitions
• National Consultation
• Business Case, Business Requirements
• Functional Specification and UAT
• File Specification
• Information Sharing Protocol
• Service Level Agreement
• Privacy Impact Assessment
Social Care Dataset and Data Submission
• Social care dataset and definitions ratified by Project Board in
December 2014
• Dataset split into 10 sections; demographics must be returned
with every submission
• Data to be submitted on a quarterly basis; except SDS
• Each file should be submitted as a separate .csv file
(transferred through SFTP)
• Each file must contain client/service user Social Care ID
• Basic validation built into submission process
• Data walkthroughs
Social Care Data submissions
Anticipated to be sent via Globalscape
•
Support for Set up and use
•
Authorised Users
•
Security Statement
Access Levels and Authorisation
Level
Data Accessed
Scotland
This allows the user to only see
aggregated data for Scotland. The
information is not broken down to
Region, Partnership level, etc.
Example
Scotland Av.
Unnamed LA
Partnership - Aggregate
This allows the user to see aggregated
data at Scotland level, labelled data for
their own Partnership and the Region
within which that Partnership is
located. They will also see unlabelled
data for all other Partnerships in Scotland.
Partnership – Detail
This allows the user to see data at
Scotland level, labelled data for their own
Partnership and the Region within which
that Partnership is located. They will also
see labelled data for every General
Practice in their Partnership area. Note: GP
level is the geographic location which GP surgeries
cover and is not GP data
Unnamed LA
Unnamed LA
Unnamed LA
Partnership Av
GP Prac1 GP Prac2 GP Prac3 GP Prac4 GP Prac5 GP Prac6
• Users will apply for access using the User Access System
• Access can only be approved by your designated
authoriser, and should mirror local practice.
• Following authorisation, ISD will provide the user with an
individual user name and password to allow them to
securely access Tableau at the agreed level
• Renewals are automatically sent out every 6 months.
Information Governance
Underpins the whole health and social care integration project
• SASPI template used
• Data Sharing Agreement in place to support original
IRF type work
• Data Processing Agreement in place for CHI seeding
(where required)
•
Alignment with the Scottish Government
Information
Sharing Framework
•
Privacy Impact Assessment
•
Privacy Advisory committee (PAC)
•
CHI Advisory Group (CHIAG)
The Information Sharing Protocol (ISP)
• Developed specifically for HSCDIIP
• Allows Councils to send their data to NSS ISD for linkage
with existing health datasets
• Supports the details and specific purposes for
sharing with NSS ISD
• Includes the personal information being shared as well
as the required operational procedures and legal
justification
• Will specify signatories from all parties
• Highlights the proposed analytical outputs
• Fit-For-Purpose
• Will be reviewed in 15/16 to take account of new /
changing partnership requirements
Stakeholder Engagement Includes:
• Caldicott Forum
• CHIAG
• Local Authority Legal Teams
• Information Commissioner
• Society of Local Authority
Solicitors and Administrators
(SOLAR)
• LA and HB Chief Executives
• Senior Solicitor, Central Legal
Office (NHS)
• Information Sharing Board
(ISB) & Interoperability
Working Group (IWG)
• Directors of Public Health
• Data Protection and Freedom
of Information Officers Group
• NHS IG Forum
• Chief Officers
• Partnerships, Health Boards
and Local Authorities
• Local Information Security
Teams
• Local Joint Information
Groups
Service Level Agreement
• A Service Level Agreement (SLA) accompanies the ISP and
sets out the services NSS ISD will provide to Partnerships
The SLA also
• Describes the available Access Levels
• Captures the names of those agreed locally as those able
to authorise access within each partnership area (in
accordance with local practice)
• Sets out the quarterly submission details and agreed dates
to send data to NSS ISD
For consideration
• Who is responsible for signing-off your ISP?
- Who should we be sending the document to i.e. Chief Exec, Chief
Officer, Caldicott Guardian, all 3?
- Is there someone locally who would be responsible for co-ordinating
partnership sign-off?
• What are your local processes for agreeing who should get
access to what information as part of the SLA?
- Do different staff need different access levels?
- Who within your area would know which staff need access to which data?
- Who / How will this be co-ordinated within your partnership?
• Who will your named contact be for ISD discussions on the
ISP and SLA?
To discuss your requirements or for further
information on the ISP or SLA, please contact
Margaret Parsons
Margaretparsons1@nhs.net
Or telephone 0131 275 6528
Q&A
Helping you get there –
What do you need to do
What you need to do
• Contact us to arrange dates for face-to-face walkthroughs with your
partnership
• Identify those responsible for signing-off a) the ISP b) the SLA
SLA sign-off requires you to
–
Identify local authorisers who will approve which staff get access to what
information
– Agree the sections of the Social Care dataset to be submitted to ISD routinely
– Identify who will be submitting data through the SFTP
• Once authorised individual staff need to apply for their Tableau logins
& passwords
Helping
you getsupport?
there –
Other
available
What do you need to do
Local Intelligence Support Team (LIST)
•
Scottish Government funded initiative
•
Piloted to date in 3 Local Authorities/Partnerships
•
Complement existing teams
•
Initial focus to provide analytical resource based within Partnerships
•
Complements and supports the HSCDIIP project, helping to transform
data into evidence for action
Local Intelligence Support Team (LIST)
Where we are at…
• All Chief Officers of H&SC Partnerships contacted offering
support.
• Initial meetings taking place with Partnerships:
 Assess needs and priorities
 Strategic plans
 Information Framework
• Recruitment of staff
Further information will be made available via ISD website
www.isdscotland.org Or email: nss.LIST@nhs.net
Future Phases
Future Phases
•
Business as Usual
•
Social Care data set evolution
•
Addressing the Data Gaps
•
Personal Outcomes
•
Links to other areas (Third Sector)
•
Digital Technology
•
Evidence in to Action (WhatWorksScotland)
•
Wider community planning
Close – Thank You!