Integrated Intelligence in Kent
Dr Abraham P George
Consultant / Asst Dir in Public Health
abraham.george@kent.gov.uk
Context
• Huge NHS and public sector funding gap
• Public sector services expected to discharge statutory
functions with ever shrinking budgets
• Growing need for ‘whole system’ understanding how
money and resources are being utilised for population
health and wellbeing
• Greater insight required to develop higher value
models of care that can meet the funding crisis
The answer: Integrated Commissioning enabled through Integrated Intelligence
Purpose of capability
1. Meet the Health and Social Care funding and care gaps head on
2. Provide a means of designing and assessing the whole systems impact of strategic
programmes such as:
• Kent Integration Pioneer Programme
• Facing the Challenge
• Better Care Fund
Citizen
Needs
A
All Kent health, well being, public and private-voluntary services
Health
Visi ng
& School
Nursing
Educa on
Primary
Care
Children’s
Social Care
Urgent
Care
OOH
Care
Adult
Social
Care
Secondary
Care
District
Council
3rd
Sector
District
Council
Housing
Providers
Mental
Health
Community
Health
Ambulance
Fire &
Rescue
Police
Citizen
Outcomes
B
MOSAIC, ONS, other demographic data; surveys, social media, blogs
Understanding citizen journeys across health, social care and all services to enable commissioners to:
• Truly understand the impact of all health and public services, their interplay and behaviours upon the outcomes for
citizens
• Think cross-agency and cross-agency budget to identify the most effective ways of co-ordinating investment to create
more value for money towards short, medium and long term outcomes
• Understand behaviour of citizens and adapt the behaviour of the system to enable them to participate in their optimal
outcomes
Slide 3
Local Profile
• >1.5 million population
• Governance of
commissioning at multiple
levels
• 1 County Council, 7 CCGs,
12 districts, 4 acute trusts, 1
community health trust,
mental health trust, >200
practices
• Public Health Observatory
team
• Well networked with other
intelligence teams
–
–
–
–
JSNA development
Health & Social Care Maps
Local needs assessments
Other analyses
Public Health involvement till date
• Work started in 2012 – QIPP LTC programme
• Whole population profiling using risk stratification
– Burden of multiple morbidities
– Impact on service utilisation - ‘Crisis curve’
– Modelling how benefits of integrated care could be realised
• Delivery of national YOC programme in Kent - implementation at sub
Kent / CCG level
• Submission of linked datasets (using NHS numbers) to national team
for analysis
• Contribution to national guidance eg. designing linked datasets by
MONITOR, new capitated funding model by NHS IQ
• Contribution to Kent Pioneer and BCF plans
• Already using linked datasets for other purposes eg. service evaluation
• Currently working with local intelligence in developing whole system
intelligence dashboards, mapping and linking other non NHS data
Kent whole population dataset report
http://www.nhsiq.nhs.uk/resource-search/publications/population-level-commissioningfor-the-future.aspx
Key Challenges
• Information Governance is a key challenge
– Current approach to data sharing has been difficult – different
expert opinions on how share / link data
– National policy on data sharing for ‘indirect care’ is evolving eg.
role of ‘DSCROs’, Department Health consultation on
‘Accredited Safe Havens’
• Data quality and accessibility
– Good support from provider organisations
– Quality / completeness of data variable across different
organisations
• Commissioner buy-in
– Still some way off in application toward CCG plans
– Difficult to change mind-set of commissioning capacity towards
outcomes.
Next Steps
• Application for ‘accredited safe haven’ status (it’s
complicated….)
• Explore what other public sector routine data is being
collected eg. Fire and Rescue, Probation, Police
• Networking with other local intelligence teams –
harness their skills and expertise
• Develop technical solutions for IT architecture, ‘safe
haven arrangements’, system modelling tools
• Building up Year of Care programme in Kent – our
‘flagship’ of the integrated intelligence work
Key Messages
• Opportunity to capitalise ‘big data’ in public sector
• Importance of person level linked datasets using NHS
numbers
• Using technology to accelerate the linking of data from
disparate sources
• Understanding the role of intelligence to develop higher
value models of care to incentivise prevention and
improve population health and wellbeing
• Opportunity for business intelligence teams to work
together develop whole system intelligence
Thank you