NATIONAL INFORMATION GOVERNANCE BOARD FOR HEALTH AND SOCIAL CARE
NIGB
NIGB IG Collaborative Workshops
The Reality of Delivering the Information Revolution
Break out Sessions
Consultation
#NIGB #HSCIG
Leeds – Birmingham - London
Public Health in Transition
NIGB Information Governance
Collaborative Workshops 2012
Jürgen Schmidt (jurgen.schmidt@dh.gsi.gov.uk)
Robert Kyffin (robert.kyffin@dh.gsi.gov.uk)
Public Health England Transition Team
Presentation overview
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Roles, responsibilities and relationships in the new health and
social care system
Information requirements of public health
Information governance framework: current arrangements,
issues and actions
Local public health intelligence
Commissioning landscape and the roles of PHE and the
NHSCB
Public health intelligence business model
Issues for PHE
Issues for Local Government and the NHS
Public Health England – role and functions
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Responsible for delivering a new integrated public health
service providing support and expert advice to national
government, Local Authorities and the NHS
PHE will work with partners across the health and social care
system to:
– deliver, support and enable improvements to health and wellbeing, particularly in the areas set out in the Public Health
Outcomes Framework
– lead on the design, delivery and maintenance of systems to
protect the population against existing and future threats to health
PHE’s overall mission is to protect and improve health and wellbeing, and reduce inequalities in health outcomes
Three main business functions: delivering services, leading for
public health, and developing the public health workforce
Public Health England – structure and
relationships
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PHE will have a national headquarters supported by a network
of regions (aligned to the NHSCB and CLG regions), centres
(broadly comparable to the NHSCB area teams) and a
nationally managed but regionally distributed network of
evidence and intelligence teams – final configurations and
functions all to be decided
Relationship with the NHSCB:
– a Compact is being negotiated to establish collaborative
strategic goals and working relationships
– PHE will provide advice on NHS priorities and service
specifications for public health services such as screening and
immunisation
– PHE will provide a public health and information and intelligence
service to the NHSCB
Public Health England – structure and
relationships
Relationship with Local Government:
• DsPH and their teams in Local Authorities are taking on a wide
range of public health responsibilities including:
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producing the Joint Strategic Needs Assessment
providing a healthcare public health advice service
ensuring health protection plans are in place
commissioning NHS Health Checks and some clinical services
such as sexual health and child health services
– scrutinising and challenging NHS performance eg. screening
PHE will provide advice and support in undertaking these
responsibilities through national leadership role and provision of
the local ‘proposition’ ie. support offer
Public health uses of identifiable information
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Public health uses identifiable information in three main ways:
– Surveillance: to monitor current and emerging threats to health,
identify trends in health behaviours and risk factors, detect
unusual patterns of disease, monitor outcomes
– Health intelligence: to provide public health practitioners,
commissioners, policy makers and the public with information and
intelligence on the challenges, threats and risks to health
– Direct provision and quality assurance of services: to manage the
delivery of high quality and safe screening, cancer, immunisation
and other public health services
Identifiable information is required to avoid double counting,
enable the use of capture-recapture techniques, link records,
and support service delivery
Public Health England – information
governance framework
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PHE sender organisations have the following legal and
statutory permissions to use identifiable information:
– Cancer screening: the NHS bowel, breast and cervical cancer
screening programmes have s251 approval
– Cancer Registries: cancer registration is covered by Section 2 of
the Control of Information Regulations 2002
– National Treatment Agency: NDTMS data is collected with
consent
– Non-cancer screening: the NHS Abdominal Aortic Aneurysm and
NHS Sickle Cell and Thalassaemia Screening Programmes have
s251 approval; other programmes such as the NHS Newborn
Hearing Screening Programme collect data with consent
– Other disease registers: the English Congenital Anomaly
Registers have s251 approval
Public Health England – information
governance framework (cont.)
– Health Protection Agency: the Public Health (Control of Disease)
Act 1984 (as amended by the Health and Social Care Act 2008)
and its associated Regulations (2010), the Sexually Transmitted
Diseases Directions 2000, Section 3 of the Health Service
(Control of Patient Information) Regulations 2002, the Health
Protection Act 2004, the Health and Social Care Act 2008
(Regulated Activities) Regulations 2010, and the Health
Protection (Notification) Regulations 2010 cover health protection
uses; specific HPA programmes also have s251 class approval
Public Health England – information
governance challenges
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Key information governance challenges facing public health:
– Omissions from the framework: eg. cancer and non-cancer
screening programmes do not have statutory support to use
identifiable information for service delivery so rely on s251
– Discontinuities within the framework: eg. ambiguities in the legal
interpretation of the Sexual Health Directions 2000 have led NIGB
to state that s251 support cannot apply to the use of data on
sexually transmitted diseases by the HPA
– Issues of interpretation and application: eg. “other risks to public
health” in the Control of Patient Information Regulations 2002
narrowly interpreted to mean health protection rather than a wider
range of public health risks
– Unintended adverse impacts of the framework: eg. evidence from
the NHS Dental Epidemiology Programme that move to an explicit
consent model has reduced response rates
Public Health England – information
governance requirements
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Secure legal basis needs to be established for defined public
health uses of identifiable information
Balance to be struck between public benefits and public disbenefits of public health access to identifiable information
Work currently underway in PHE to develop the information
governance framework:
– PHE working with DH, NHSCB and other partners to propose
amendments to Regulations 2 and 3 of the Health Service
(Control of Patient Information) Regulations 2002
– PHE working with DH, NHSCB and the HRA on the legacy of
s251 and the future advisory and decision functions
– PHE working with HSCIC on the Code of Practice for Handling
Confidential Information (covering anonymisation, disclosure,
retention etc. standards), and on safe haven arrangements and
data linkage services
Context for local public health intelligence work
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What are the relevant changes?
– Physical move and changed functions of DsPH and their teams
– Local Authority public health responsibilities
– Local ‘proposition’ ie. support offer
Formal requirements:
– NHS planning guidance for 2012/13: To agree arrangements on
public health information requirements and information
governance by September 2012
– PHE transition guidance checklist item: Are plans in place to
ensure access to IT systems, sharing of data and access to
health intelligence in line with information governance and
business requirements during transition and beyond?
Business continuity – what does the future look
like?
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Emerging commissioning landscape
– Functions and data flows, including data sharing and the
integration of health and social care data
– Changes to the IT environment, including the NHSCB DMICs
– Changes to the information governance environment
PHE contribution to the system
– Functions: data requirements, informatics (governance, standards
and quality), surveillance strategy
– Products and tools around data, evidence and experience (PHOF,
DPH Annual Reports, JSNAs)
– Partnership work with IC, NICE, ONS
– Guidance on use of both PHE and non-PHE products
– Responsive ad hoc service based on PHE products and other
relevant sources of public health intelligence
System connectivity
Home
office
DCLG
others
DWP
HMRC
GSI
Government
gateway
PSI
gateway
GCSX
Gateway
Citizen
Local
authorities
N3
CJSM
PNN
others
The Commissioning Intelligence Model
NHSCB
Commissioning
Intelligence Model
Types of Services
Tools/Data
Types of Services
S8.01: Demographic forecasting & disease trends (Provenance:
D8.01: Programme budgeting (comparative spend on
disease conditions) & marginal analysis, PBMA Atlas,
SPOT, SHAPE (Provenance: HB)
D8.02: Health investment packs, QIPP (Provenance: HB)
S1.01: Health needs / Joint Strategic Needs Assessment/
Impact assessments (data & analytical input) (Provenance: AF/WS290911)
HB)
S8.04: Forecasting and future projections of expected
activity. (Provenance: HB)
S8.05: Cost Benefits analysis of current activity vs.
alternatives (Provenance: HB)
S8.06: Strategic secondary analysis of 'How Healthy' and
'How much?' (Provenance: HB)
D8.03: Pathway modelling inc ROI calculators, return
on investment tools (Provenance: HB)
D8.04: Results and secondary analysis of other
questions, design making support etc (Provenance: HB)
D8.05: Quality of life & well being measures e.g.
QALYs (Provenance: CH181011)
D8.06: DH Programme Budgeting tool / Spend and
Outcome Tool (Provenance: CH181011)
S8.07: Track and react to patient expectation (Provenance: HB)
S8.08: Manage Programme Portfolio (Provenance: CH181011)
S8.09: Programme budgeting (comparative spend on
disease conditions) (Provenance: CH181011)
D8.07: Patient expectation information (Provenance: CH181011)
Q8.01: Are our strategic
objectives aligned across
the health economy inc
social care?
Q8.02: What will be the
impact of demographic and
disease pattern change?
Q8.03: How can we make
QIPP savings of £XXXm?
Provenance: HB
Provenance: WS270911
Provenance: HB
(Provenance: AF)
S1.05: Geographic analysis and mapping, socio-demographic
analysis. (Provenance: AF/HB)
S1.06: Identification of at-risk groups (e.g. Communities (inc
Travellers), Carers etc) (Provenance: Auth)
S1.07: Informing the public about keeping healthy,
prevention resources (Provenance: HB/CH)
S1.08: Research, surveys, audits, peer reviews (Provenance: HB/
WS290911)
S1.09: Managing needs of Stakeholders (e.g. Care Home,
Community, Health Education) (Provenance: WS290911)
D1.06: Deprivation indices (Index of
Multiple Deprivation). (Provenance: AF)
D1.07: Access to and familiarity with wide
range of Public Health data sources,
Benchmarking and comparison tools (e.g.
NHS Atlas of Variation, NCHOD, Local
tools). (Provenance: CH181011)
D1.08: Dynamic ethnicity data analysis
across all aspects of care. Wider equality
indicators including disability, sexual
orientation etc (Provenance: HB)
D1.09: Data on wider determinants, social
service, HPA (Provenance: HB)
D1.10: Predictive disease monitoring
(Provenance: WS270911)
Q1.01: How healthy/
unhealthy is my
population relative to
benchmarks?
Q1.02: What health
conditions are changing
most?
Q1.03: Who is at greatest
risk of disease/acute
admission to hospital?
Provenance: AF/WS290911
Provenance: V10
Provenance: AF/WS290911
Provenance: HB
Types of Services
S7.04: Performance reporting.
(Provenance: AF)
S7.05: Providing comparative outcome
monitoring inc Patient and Public Data
(Provenance: HB)
S7.06: Production of Board level reports,
presentations and profiles (Provenance: CH181011)
D7.01: Performance & Public Health
metrics, frameworks and dashboards
(Provenance: AF)
D7.02: Activity & cost baseline and
tracking data (Provenance: AF)
D7.03: Impact analysis & evaluation
using statistical tools (Provenance: AF)
D7.05: Public Health Observatory tools
including survey tools (Provenance: HB)
D7.06: Data outputs from all other
dimensions (as appropriate) (Provenance: CH181011)
D7.07: Data required for Programme Gov
inc Benefits Mgmt, Plans etc (Provenance: CH181011)
Q8.09: What barriers
exist that prevent change
(e.g. org/cultural)?
Provenance: WS270911
Q7.01: When a service
change is implemented,
what was the outcome,
cost and quality for this
and to other services?
S6.03: System-wide activity & cost
modelling (Provenance: AF)
S6.06: Review evidence base (e.g.
National Comparators, NICE, etc)
(Provenance: V13)
S6.07: Capture & manage
stakeholder feedback/outcomes
Provenance: AF
Provenance: WS270911
Provenance: AF
Q1.07: Who would benefit
most from a disease
management programme?
Q1.08: What causes
patients most distress?
Provenance: WS270911
8. What are our
future plans?
Reduce unmet need by
anticipating future priorities and
improving decisions about
resource allocation, by ensuring
planned services reflect changing
needs and demands of local
population
Q7.08: Did we meet
our targets and can
we sustain them?
Provenance: AF
Q7.03: What's the
combined impact of all
our interventions for
patients, the services &
health economy?
Q7.09: What are the
benefits of the
changes?
Q7.06: Have we
reduced inequalities?
embedded in the cycle of
continuous improvement to
improve patient experience
Q6.01: What would be the
impact, in activity flows and
costs, of making a proposed
change to a clinical pathway?
6. How could
things be better?
Q6.07: What are
our drivers for
change and have
we engaged with
stakeholders (inc
Patients)
Provenance: AF
Q6.02: What will be the
combined impact, in cost
and activity, of a whole set
of service changes and
productivity measures?
Developing new pathways and/
or decommissioning services to
improve safety, quality,
effectiveness of care and
maximise financial benefit
Provenance: WS270911
D6.07: Data outputs from all other
dimensions (as appropriate) (Provenance:
What
questions
do we
need to
answer?
5. Are my
providers
delivering what
they agreed?
Improve commissioning
Provenance: HB
Provenance: AF
decisions through better
information and information
analysis
Q6.05: Do we need to
procure services from
alternative providers, or
work in partnership with
other stakeholders to be
more efficient for
provision and
procurement?
2. What's really
happening in this
system?
Information available at right time
and to the right person to protect
the vulnerable and ensure the right
care is given to reduce duplication
and improve integration of care
D6.09: Staff surveys, appraisals,
complaints, incidents and SUIs (Provenance:
Provenance: AF/WS290911
Provenance: CCG
3. How Much?
Improved financial information
(including budgeting and planning)
to ensure resource is given to
appropriate care provider for the
treatment given and ultimately
there is better transparency of
financial flows to support improved
commissioning decisions
Provenance: AF
Q3.08: What is the
projected liability for our
referred population?
Provenance: WS021211
4. How do we
Compare?
S5.05: Contract development (Provenance: MT)
S5.06: Performance Management and support for
service improvement (inc Negative impacts and
Data Management) (Provenance: MT)
S5.07: Utilisation reviews, PbR Audits, Clinical
Decision Support (Provenance: WS290911)
S5.08: Basic budget reporting (Provenance: CH181011)
S5.09: Contract validation, challenge (Provenance: CH181011)
S5.10: SUS validation with GP Practice Systems
(Provenance: CH181011)
Q3.02: How much do
individual service- lines/
pathways cost compared
to budget?
Q3.03: Is cost aligned to
volume, quality and
outcome?
Types of Services
S3.01: Service-level costing (e.g. by
Specialty, HRG chapter, Diagnostic
chapter) (Provenance: AF)
S3.02: Budget planning, development &
forecasting (Provenance: AF/WS290911)
S3.03: Budget Reporting & Variance
analysis (Provenance: AF)
S3.04: Price verification (provider
costings) & reconciliation to contract,
automated invoice validation (Provenance: AF/CCG)
S3.05: Comparative Provider cost
analysis (Provenance: AF)
Provenance: V13
Challenge our current state
through proactive benchmarking
and comparison in order to
improve clinical outcomes
Q3.09: How much are we
spending on inequalities?
Provenance: WS290911
Q3.04: Are we
maximising value for
money? (e.g. community
provision vs. acute care)
Tools/Data
D3.02: Current and historic Provider
Activity and Cost data-sets (SUS & Local
Contract Mgmt systems) (Provenance: V10)
Q4.01: Where is there
clinical / activity / cost /
outcome variation vs local,
national, international, best
practice?
Q5.06: Can we distinguish
between Provider 'pull'
and Primary Care 'Push'
Q5.07: Are Providers
sending datasets to agreed
standards and frequency?
(If not, are there sanctions
in place?)
Tools/Data
D5.01: Data warehouse integration and
reconciliation of Activity/Cost and Provider
contracting reports (Provenance: AF)
D5.02: Contract Monitoring reporting by
Provider (Provenance: CH181011)
D5.05: LA, Primary care and Voluntary/third
sector (Provenance: WS270911)
D5.06: Referral Data
(Provenance: CH181011)
D5.07: CQUINS (Provenance: CH181011)
D5.08: Insight into provider sustainability
(Provenance: V10)
D5.09: Patient Feedback (Provenance: V12)
Q4.02: Are we delivering
national standards of care
for: patient experience,
quality and outcomes?
D3.03: Tariff / Pricing tables, PBR rules
and algorithms (local and national),
Prescribing costs (Provenance: CH181011)
D3.05: Robust timely referral activity
Provenance: AF/WS290911
(Provenance: WS290911)
D3.07: Reference Cost Data (Provenance: CH181011)
Q4.05: How do we compare
for value for money, outcomes
and productivity against
similar areas/ best practice
over time?
Q4.04: Do current
pathways reflect
evidence-based good
practice?
Provenance: AF
Provenance: AF/WS290911
Provenance: V13
Types of Services
Tools/Data
S4.01: Practice level, regional, and national
benchmarking of disease prevalence, activity,
productivity and costs. (Provenance: AF)
D4.01: Age-sex-deprivation standardised comparative
data at Practice level for commissioned activity (inc
practice specialism). (Provenance: AF)
D4.02: Primary Care data extracts providing integrated
analysis with Acute activity, e.g. prevalence rates vs.
Admissions. (Provenance: AF)
Provenance: CCG
S5.04: Provider level-analysis of ‘how much’ and
‘how good’? (Provenance: AF)
Provenance: AF/WS290911
Q3.07: Where are the
most severe cost
pressures?
D3.06: Referral templates with expected
costs (Provenance: CH181011)
Q5.04: What service lines
are above or below plan why?
Types of Services
S5.03: Invoice validation, challenge (Provenance: CH181011)
Q3.01: How much is my
budget? How much am I
spending compared to
plan?
Provenance: WS270911
Provenance: V13
S5.01: Analytical support to Contract monitoring &
analysis (Provenance: AF)
S5.02: Provider activity validation & Data Quality
review (Provenance: AF)
Provenance: AF
V10)
Q5.02: What elements of
the billed activity can we
challenge?
Q5.05: Are providers
overlooking agreements
on Threshold
Management?
Provenance: V12
Q3.06: Is activity being
priced at the correct
amount?
(Provenance: WS021211)
Provenance: AF
D3.01: SUS reporting & analysis webservice, including Budget reports. (Provenance:
Provenance: V13
Q5.08: Do our provider
contracts reflect patient
requirements?
Provenance: AF
Q2.06: How much
random variation in
activity do we observe?
Provenance: AF
V10)
D6.10: External information e.g.
Market intelligence (Provenance: V13)
Q2.05: Where are the
bottlenecks?
Provenance: V13
Q5.03: Are providers
delivering on serviceimprovement, quality
(cquins) patient experience
and waiting-times targets?
(Provenance: V10)
Q2.10: To what
degree are
patients able to
make informed
decisions about
their care?
Q5.01: What is the
current performance
against plan?
Provenance: MT/HB/WSS290911
D6.08: Stakeholder feedback
including external sources such as
Social Media and Public Enquiries
D2.03: Current, historic and planned Provider
Activity and Cost data-sets (SUS & Local Contract
Mgmt Systems e.g. Maternity, Mental Health,
Local Auth etc) (Provenance: V10)
D2.05: Waiting times/list data (Provenance: AF)
D2.06: Patient level datasets with updates inc:
decisions made in secondary care – reasons for
treatment/changes/referrals/delays /test results
and outcomes (Provenance: HB)
D2.07: External Sources such as Social Media
Provenance: AF
Q6.06: How do we
compare with
evidence and
guidance for process,
outcomes and patient
experience?
Q6.03: Would 'Scenario A'
improve patient flows and
productivity more than
'Scenario B'?
CH181011)
D2.02: SUS data, including acute activity & costs,
referrals with clinical reason, CAB, 'PatientJourney' analysis. (Provenance: CH181011)
Provenance: AF/WS290911
Provenance: AF
(Provenance: AF/HB)
(Provenance: WS270911)
Q2.04: What are the
current flows and
pathways and are
patients using the
right ones?
Provenance: CCG
7. What difference
have we made?
Ensuring patient feedback is
Provenance: WS290911
Provenance: HB
Tools/Data
D2.01: Near/real time information - activity &
financial for A&E, OOHs, MIU, Acute and
Community Admissions etc (Provenance: CH181011)
Provenance: AF
Q2.09: What is the
impact of patient choice
on Provider volumes?
Provenance: V12
Provenance: HB
S2.13: Track patient experience (Provenance: CH181011)
Q2.03: Is demand
really going up? By
how much?
Q2.07: What is the
demand today for urgent
care, and who do I need
to target to keep out of
hospital?
Provenance: AF
S6.08: Clinical governance and
complaints handling (Provenance: V10)
Tools/Data
(Provenance: WS290911)
S2.12: Management of Urgent Care Monitoring/
Dashboards (Provenance: CH181011)
Q2.02: How long are
patients waiting for
treatment?
1. How Healthy?
Reducing health inequalities and
improving health outcomes now
and in the future
Q7.10: What is the
impact of change on
other services &
stakeholders?
Q7.05: Have we
improved outcomes?
S2.09: Indicators to track progress throughout
pathways reasons/decisions for referrals, patient
experience and outcomes.
Provenance: AF
Provenance: HB
Provenance: AF/WS290911
(Provenance: HB)
Provenance: AF
Provenance: WS270911
Provenance: AF
D6.03: Forecast analysis and planning
projections (Provenance: AF/HB)
D6.04: Service structure audit and
improvement support. (Provenance: AF/HB)
D6.05: Prescribing decision support
data (Provenance: HB)
D6.06: Capture & processing of
patient experience and outcomes
throughout pathways, inc PROMS
AF)
S2.07: Provide access to patient medical records
Q2.01: Why have we
got financial
pressures?
Q1.10: What are the
preventable conditions
contributing to our
premature mortality?
Provenance: WS270911
Provenance: AF/HB/WS290911
(Provenance: WS290911)
D6.01: Pathway data (Provenance: AF)
D6.02: Contract activity and cost
Types of Services
S2.01: Trend and statistical analysis (activity,
cost, SPC) (Provenance: AF)
S2.02: Capacity and demand analysis, patient
flow modelling, waiting times analysis (Provenance: AF)
S2.05: Analytics support to Clinical audit. (Provenance:
Provenance: AF
Q1.09: What proportion
of disease is avoidable?
Provenance: HB
Types of Services
Q1.06: Who are the
sickest people and where
do they live?
Provenance: CH181011
Q7.07: How did our patients
rate their experience of our
services?
S6.01: Pathway & scenario modelling
(inc Audit of Admission thresholds
and service structure) (Provenance: AF)
S6.02: Contract modelling (Provenance: AF)
Q1.05: What diseases kill
most people and which
are the biggest burden?
Provenance: WS290911
Q8.10: Are our
investments distributed
across all sectors to best
meet the needs of our
population?
Q7.02: Can I isolate the
'cause and effect' of an
individual initiative?
Tools/Data
Q1.04: How is the local
population going to
change in future?
Provenance: HB
Q8.07: Have we got the
balance correct between
national, local and patient
expectations?
S7.01: Programme and project
monitoring. (Provenance: AF)
S7.02: Providing comparative cost and
activity monitoring (Provenance: AF)
S7.03: Metrics reporting. (Provenance: AF)
Q8.06: What activity
should we contract for to
deliver the service
changes / cost efficiencies
needed?
Q8.05: Given our budget,
how can we decide how
much to invest/disinvest in
services?
Provenance: HB
The CIM Model is a
consolidated view of the
different types of
commissioning
intelligence
requirements needed to
support evidence based
commissioning
decisions
S1.03: Demographic forecasting & disease trends.
(Provenance: AF)
Q8.04: How will
changes in technologies
(IT, drugs etc) impact
us?
•
Tools/Data
D1.01: Population, migration, birth,
mortality and morbidity statistics and
projections (ONS, Exeter, QOF, Primary
Care, SUS, Prevalence modelling tools,
Census) (Provenance: AF/WS290911)
D1.02: Public Health Data Observatory /
Local Information Systems / JSNA / Cancer
Registry / Qualitative Data inc Voluntary &
Third sector (Provenance: AF/HBWS290911)
D1.03: Risk Stratification tools and models:
Patients at Risk of Readmission (PARR),
Combined Predictive Model, Adjusted
Clinical Groups. (Provenance: AF)
D1.04: Socio-demographic classification
system (e.g. Mosaic, Health foundations DH segmentation tool). (Provenance: AF/WS290911)
D1.05: Mapping and geo-spatial software
S1.02: Risk profiling & prediction. (Provenance: AF)
Overarching
Concepts
O0.01 Interpretation, contextualisation,
exploitation and stakeholder communication
O0.02 Data collected at patient level
O0.03 Holistic Analyses - Full System view rather
than isolated segments
O0.04 Flexible tariffs
O0.05 Master Data Administration (inc Common
currencies & agreed standardisation techniques)
O0.06 Timeliness and quality of data
O0.07 Data definitions and standards
O0.08 Interoperability
O0.09 Knowledge Management
O0.10 Integrated ways of working
O0.11 Development of Metrics
O0.12 Simplify presentation appropriate to
audience
Draft for Discussion Only
S4.02: Analysis and presentation of
productivity indicators by programme /
project. (Provenance: AF)
S4.03: Clinical Pathway mapping and
modelling and cost comparators (Provenance: AF/
WS290911)
S4.04: Providing evidence and information on
comparative health outcomes. (Provenance: AF/WS290911)
S4.05: Statistical analysis of variation and
correlations e.g. Statistical Process Control
(Provenance: CH181011)
D4.03: Comparative benchmarking tools (e.g. QOF
Data sets, NHS Comparators, NHS Atlas of Variation,
Better Care Better Value indicators). (Provenance: CH181011)
D4.05: Benchmarked GP referrals analysis. (Provenance: AF/HB)
D4.06: Practice profiles (Needing national standards)
(Provenance: HB)
D4.07: National Guidance, PROMS, Utilisation reviews
(Provenance: CH181011)
Filename: Commissioning Intelligence Model V13.vsd
Version Date
Comment
1.
Aug 11 Original from Andrew Fenton
2.
15/9/11 Added comments from Ming Tang, Helen Brown and responses to the IFC
document
3.
21/9/11 Added comments from Shahid Ali and benefits from Jo Butterfield
4.
27/9/11 Tidied version for workshops
5
28/9/11 With comments from London Workshop
6.
14/10/11 Added comments from workshop and consultation feedback
7.
19/10/11 After linking data to services (CH & HB)
8.
28/11/11 Q8.3 to include QIPP
9.
5/12/11 Amendments after CSO workshop on 2/12/11
10.
9/12/11 Amendments after ref group review
Version
11.
12.
13.
Date
Comment
14/12/11 Amendments to support Business Analysis Team
14/12/11 Further amendments after CSO workshop on 2/12/11
19/1/12 Text changes from Gavin McIntosh
Business model
Data management capabilities could be provided by specialist
integration centres supporting CSSs and CCGs using an
integrated commissioning data model
Secure Data
Extraction &
Transfer
External Data Sources
SUS
GP
MH
Community
Conformed Master
Data Mgt
Data
Upload &
Integration
Integrated
Data Store
ETL Layer
Data
Validation
&
Processing
Other...
1. Multiple Data Sources; Extract,
Load& Transfer:
• National (secondary usage)
• Direct
• Agreed Standards & business
rules for cleansing & validation
Business
Intelligence
Layer
Data &
Reports
Applica
tions
Analysis
2. Data Integration & Normalisation
• Conformed dimensions used to link data sets
• Stored data can now be ‘mined’ for BI reporting,
benchmarks & available for other applications
• Requires dimension schemas (logic for how data
can be linked)
• Data linkages relate to key questions for BI
Security & Presentation Layer
•
Access
Layer
- B2B Users
- End users
3. BI Presentation & Security Layer
• User friendly, timely and flexible data
elements & reports
• Configurable analysis and comparative
benchmarks
• Applications that support decision making
& workflow
• Security layer reflects user access rights /
role authorisation
National Bodies
Sub-national
National
incl: NHSCB, PHE, Research, Commercial, CQC, Monitor & Public
National Data Feeds
IC
Safe haven
Local & National Data Feeds
DMIC x ~10
Safe haven
Small no CCGs
doing own
intelligence
Local
DMICs may also
provide data
to wider stakeholders
CCGs
CCG
x~250
CSS
X~25
LAPH
CCG
X~150
Issues for Public Health England
•
•
•
•
•
•
•
PHE contribution
PHE ‘proposition’ to support local areas
PHE organisational design
Information governance
National data requirements
PHE advice and input to the NHS Commissioning Board
PHE evidence and intelligence teams and the Health & Social
Care Information Centre
NATIONAL INFORMATION GOVERNANCE BOARD FOR HEALTH AND SOCIAL CARE
NIGB
NIGB IG Collaborative Workshops
The Reality of Delivering the Information Revolution
Break out Sessions
Consultation
#NIGB #HSCIG
Leeds – Birmingham - London
Information: to share or not share?
Information Governance Review
Karen Thomson
Information Governance Lead
21
Review overview
• Scope – when consent needed, how record
consent / dissent, ensuring a secure basis in law
for processing, IG in the new landscape
• 15 panel members different backgrounds
• Evidence gathering – verbal, written, lit review –
thematic
• Questions for direct care and commissioning on
website – www.caldicott2.dh.gov.uk
22
Headlines - Direct Care
• Agreed common terminology would be helpful –
CHRE volunteered to lead
• Clarity about when the social worker is part of
the care team and covered by implied consent
• When non-registered professions e.g. HCA are
covered by implied consent
• A better understanding of what is within the
social contract of implied consent
• And of the need to make this explicit to patients
and service users
23
Headlines - Commissioning
• Need for large quantities of data to create
an innovative culture
• Commissioning Intelligence Model will
involve setting up CSSs and DMICs &
access to PID
• Desire to make IG an enabler –
information is an asset – IG adds value
thro data quality and protecting this asset
24
Headlines - Commissioning
• Role of CQC – not an IG regulator –
context of quality of care and managing
clinical risk only
• Consideration of the future of the toolkit &
usefulness for commissioners
• Lack of clarity about data controller / data
processor relationships
25
Inputting to the Review
• Any questions about the Review?
•
•
•
•
Dates for evidence sessions on website
Public Health session – yesterday
Adult Social Care – 4 July Manchester
Face to face sessions to end of October –
written evidence over the summer
• 3 questions sent in advance and in your pack for
you to consider
• Capture key elements and include in a report on
this event to the IGR Panel
26
Questions asked
• Your key concerns around IG in future?
• Concerns are you hearing from patients,
service users and carers?
• Concerns from H&SC orgs, clinicians,
practitioners & researchers?
• Your concerns about the use of identifiable
data for purposes other than direct care
27
Thank you!
28
NATIONAL INFORMATION GOVERNANCE BOARD
No such thing as a
free lunch
NIGB
• First break (11-11.30)
– MetaCompliance: room 3 (ground floor)
– Egress Switch: room 145 (1st floor)
– FairWarning Audit: room 123 (1st floor)
• Lunch break (1.30 – 2.00)
– Imprivata: room 3 (ground floor)
– Mastek: room 123 (1st floor)
NATIONAL INFORMATION GOVERNANCE BOARD FOR HEALTH AND SOCIAL CARE
NIGB
NIGB IG Collaborative Workshops
The Reality of Delivering the Information Revolution
Break out Sessions
Consultation
#NIGB #HSCIG
Leeds – Birmingham - London