NHS Digital Data Release Register - reformatted

Cheshire West and Chester Council

Opt outs honoured: N

Basis: Health and Social Care Act 2012

Format: Anonymised - ICO code compliant Non Sensitive

How often: Ongoing

When: unknown — 11/2016

HSCIC Id: DARS-NIC-10994-B8M6V-v0.0

Data: Hospital Episode Statistics Accident and Emergency

Data: Hospital Episode Statistics Admitted Patient Care

Data: Hospital Episode Statistics Outpatients

Data: Access to HES Data Interrogation system

Data: HES Data Interrogation System

Output: HES Data will be used for the purpose of: comparative analysis, both geographical and time related; improving the quality of healthcare management and service delivery; supporting CCGs in the commissioning of health services and for commissioning public health services; health needs assessment; prioritisation and the reduction of inequalities; the development of care pathways; health equity audit; health impact assessment; performance monitoring.

The results of the analyses of the data will be used by the Local Authority to support the discharge of its statutory duties in relation to public health, and wider public health responsibilities. Outputs will include (but not be limited to) the routine and ad hoc production of:

a) Joint Strategic Needs Assessments (JSNA);
b) Joint Health and Wellbeing Strategies;
c) the annual report of the Director of Public Health;
d) reports commissioned by the Health and Wellbeing Board;
e) public health and wider Local Authority health and wellbeing commissioning strategies and plans;
f) public health advice to NHS commissioners;
g) responses to licensing applications and other statutory Local Authority functions requiring public health input;
h) local health profiles;
i) health impact assessments and equity audits; and, among other outputs
j) responses to internal and external requests for information and intelligence on the health and wellbeing of the population.

The JSNA is available on a public facing website and comprises a suite of products that are developed and updated on a rolling programme. JSNA products include local dashboards for children’s centres and council localities, key outcome indicator summaries and thematic reports.
HDIS data will used in the following programmed JSNA products:
• Children Centre dashboards (due 2016): the dashboards are designed to support local understanding of need and outcomes. They are used by senior strategic leads and CC managers to inform service design and monitor impact. Statistics are calculated for bespoke geographical areas based on non-standard groupings of LSOAs. Data used includes child injury admissions to hospital.
• Children’s JSNA summary update (due 2016): topics will include child injury admissions which will use HDIS to investigate geographical variation and analysis of main types of injury. Also to include local analysis of other reasons for emergency admission.
• Mental Health JSNA (due 2016): will include local analysis of geographical variation of self harm a&e attendances and inpatient admissions.
• Falls indicator summary (due 2016): will investigate trends, geographical variation and analysis of main types of injury.
• Community safety (due 2016): an annual partnership assessment of community safety which will include local analysis of alcohol related admissions and assault related a&e attendances.

CCG support:
Liver disease reporting (quarterly update deep dives in 2016/17): support to investigate liver disease as a priority area. HDIS will be used to support local analysis.
Inequalities in service access (due tbc): support to understand inequality, details yet to be defined but expect HDIS would be utilised.

Support for local outcomes target setting and monitoring:
Council forward plans (targets being set 2016): the council is keen to develop targets to reduce inequalities in key priority areas. Falls admissions has been identified as a priority area and HDIS will be used to describe and monitor the inequality gap. HDIS has also been used to support better care fund monitoring of falls admissions.
District committees (tbc): the council plan to introduce District Committees which will have new bespoke geographical boundaries requiring local intelligence to be adapted to help understand local priorities. HDIS data will be used to describe priorities such as falls admissions within the new landscape.

All outputs will be statistics or aggregated data with small numbers suppressed in line with the HES guide.

Activities: Users log onto the HDIS system and are presented with a SAS software application called Enterprise Guide which presents the users with a list of available data sets and available reference data tables so that they can return appropriate descriptions to the coded data. The access and use of the system is fully auditable and all users have to comply with the use of the data as specified in this agreement. The software tool also provides users with the ability to perform full data minimisation and filtering of the HES data as part of processing activities. Users are not permitted to upload data into the system.

Access to the data is provided to the Local Authority only, and will only be used for the health purposes outlined above. The data will only be processed by Local Authority employees in fulfilment of their public health function, and will not be transferred, shared, or otherwise made available to any third party, including any organisations processing data on behalf of the Local Authority or in connection with their legal function. Such organisations may include Commissioning Support Units, Data Services for Commissioners Regional Offices, any organisation for the purposes of health research, or any Business Intelligence company providing analysis and intelligence services (whether under formal contract or not).

No linkage of any record level data from HDIS is permitted to take place with other sources. Linkage is only permitted to other data sources at an aggregated level where this does not increase the risk of re-identification such as geographical databases which are in the public domain.

Access is for public health approved users only and the Director of Public Health will be the IAO for the HES data and be responsible on behalf of the Local Authority to the HSCIC for ensuring that the data supplied is only used in fulfilment of the approved public health purposes set out in this agreement. The Local Authority confirms that the Director of Public Health is a contracted employee to the permanent role within the Local Authority, accountable to the Chief Executive.

The use of HDIS mean that users and organisations have a secure access, remotely hosted software application for the analysis of HES data. The system is hosted and audited by the HSCIC meaning that large transfers of data to on-site servers is reduced and the HSCIC has the ability to audit the use and access to the data. The provision of a tool enables that rapid analysis can be performed to the latest version of the data where speedy analysis is required to react to either local public health, commissioning or research requirements.

Objective: To provide data for the purposes of local public health intelligence in Suffolk, including needs assessment, support to local CCGs and ad hoc requests for analysis of hospital activity data.

The data provided by HDIS will be used by the Local Authorities in fulfilment of its public health function, specifically to support and improve:

1. the local responsiveness, targeting and value for money of commissioned public health services;
2. the statutory ‘core offer’ public health advice and support provided to local NHS commissioners;
3. the local specificity and relevance of the Joint Strategic Needs Assessments and Health and Wellbeing Strategies produced in collaboration with NHS and voluntary sector partners on the Health and Wellbeing Board;
4. the local focus, responsiveness and timeliness of health impact assessments; and, among other benefits
5. the capability of the local public health intelligence service to undertake comparative longitudinal analyses of patterns of and variations in:
a. the incidence and prevalence of disease and risks to public health;
b. demand for and access to treatment and preventative care services;
c. variations in health outcomes between groups in the population;
d. the level of integration between local health and care services; and
e. the local associations between causal risk factors and health status and outcomes.

The main statutory duties and wider public health responsibilities supporting these processing objectives are as follows:

1. Statutory public health duties that the data will be used to support

a) Duty to improve public health: Analyses of the data will be used to support the duty of the Local Authority under Section 12 of the Health and Social Care Act 2012 to take appropriate steps to improve the health of the population, for example by providing information and advice, services and facilities, and incentives and assistance to encourage and enable people to lead healthier lives;
b) Duty to support Health and Wellbeing Boards: Analyses of the data will be used to support the duty of the Local Authority and the Clinical Commissioning Group (CCG)-led Health and Wellbeing Board under Section 194 of the 2012 Act to improve health and wellbeing, reduce health inequalities, and promote the integration of health and care services; the data will also be used to support the statutory duty of Health and Wellbeing Boards under Section 206 of the 2012 Act to undertake Pharmaceutical Needs Assessments;
c) Duty to produce Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWBs): Analyses of the data will be used to support the duty of the Local Authority under Sections 192 and 193 of the 2012 Act to consult on and publish JSNAs and JHWSs that assess the current and future health and wellbeing needs of the local population;
d) Duty to commission specific public health services: Analyses of the data will be used to support the Local Authority to discharge its duty under the Local Authorities Regulations 2013 to plan and provide NHS Health Check assessments, the National Child Measurement Programme, and open access sexual health services;
e) Duty to provide public health advice to NHS commissioners: Analyses of the data will be used by Local Authorities to discharge its duty under the 2013 Regulations to provide a public health advice service to NHS commissioners;
f) Duty to publish an annual public health report: Analyses of the data will be used by Directors of Public Health to support their duty to prepare and publish an annual report on the health of the local population under Section 31 the 2012 Act;
g) Duty to provide a public health response to licensing applications: Analyses of the data will be used by the Director of Public Health to support their duty under Section 30 of the 2012 Act to provide the Local Authority’s public health response (as the responsible authority under the Licensing Act 2003) to licensing applications.

2. Wider public health responsibilities supported by analysis of the data

a) Health impact assessments and equity audits: Analyses of the data will be used to assess the potential impacts on health and the wider social economic and environmental determinants of health of Local Authority strategic plans, policies and services;
b) Local health profiles: Analyses of the data will be used to support the production of locally-commissioned health profiles to improve understand of the health priorities of local areas and guide strategic commissioning plans by focusing, for example, on:
i. bespoke local geographies (based on the non-standard aggregation of LSOAs);
ii. specific demographic, geographic, ethnic and socio-economic groups in the population;
iii. inequalities in health status, access to treatment and treatment outcomes;
c) Surveillance of trends in health status and health outcomes: Analyses of the data will be used for the longitudinal monitoring of trends in the incidence, prevalence, treatment and outcomes for a wide range of diseases and other risks to public health;
d) Responsive and timely local health intelligence service: Analyses of the data will be used to respond to ad hoc internal and external requests for information and intelligence on the health status and outcomes of the local population generated and received by the Director of Public Health and their team.

These lists of the statutory duties and wider public health responsibilities of the Local Authority are not exhaustive but set the broad parameters for how the data will be used by the Local Authority to help improve and protect public health, and reduce health inequalities. All such use would be in fulfilment of the public health function of the Local Authority.

No sensitive data is requested under this application.

Data is only used for Public Health purposes.

Benefits: Access to the data enables the local authority to undertake locally-focused and locally-responsive analyses of health status and health outcomes. For example, the data are used to produce analyses of health inequalities for non-standard geographies and for specific social or ethnic groups in the local population to help ensure that the health challenges facing the local population – particularly the most disadvantaged – have been identified and responded to appropriately by the Local Authority and its partners.

Examples include:

The council is in the process of developing outcome targets for local priorities. One priority is to reduce falls admissions including to reduce the inequality gap. The use of HDIS has been instrumental in providing evidence of inequalities experienced within the local population and will be used to develop and monitor targets designed to encourage targeted work with the most vulnerable communities. HDIS data was recently used to inform a Health and Wellbeing Board workshop where partners discussed local data and supported the development of a local strategy. It is expected that HDIS data will inform the strategy and continue to inform inequality monitoring.

Child injury admissions have been a priority for our local CCG and the HDIS data used in the JSNA has been used to inform local initiatives. Rates have seen a reduction but remain high compared to England. A child injury group has recently been established to further investigate the issue locally and it is expected that HDIS data will be a valuable resource to inform the work of that group and monitor progress.

Source: NHS Digital.