NHS Digital Data Release Register - reformatted

Havering London Borough 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-387346-G3H3J-v0.2

Data: Hospital Episode Statistics Accident and Emergency

Data: Hospital Episode Statistics Admitted Patient Care

Data: Hospital Episode Statistics Outpatients

Data: Personal Demographics Service (PDS) data

Output: The PDS will return a single matched NHS Number and associated patient demographics or an error code and description. The returned NHS Number will be used to update the Social Care client record held on the case management system. The recording of this unique identifier will enable the coordinated care of individuals across health and social care as described above.
In the Social Care case management system the NHS Number will be used to ensure that information exchanges with healthcare colleagues (by whatever method) who are dealing with the same individual are indeed about the same individual, the NHS Number being an unambiguous identifier.
The current planned implementation date is 1/10/2017.

Activities: The System Process
PDS Access Method
The NHS Number will be accessed from the Personal Demographics Service (PDS) via Spine Mini Services Provider (SMSP). The NHS Number will be requested regularly, for individual service users at the start of a care episode as well as by regular data downloads for groups of service users at the start of their care episodes. at a particular point in time, this will ensure maximum accuracy when matching a social care client to their NHS number. It is anticipated that the volume of traces will be about 100 per month.
There are four processes that will be implemented in the Social Care case management system in order to match and validate NHS Numbers:
• Get NHS Number - this is an automated process that matches NHS Numbers from the PDS with case management system Client details. Only clients that meet the Legitimate Relationship criteria described in the Objective for Processing section above are selected for matching. The process is designed to operate to a pre-defined schedule at a frequency of 30 minutes or less.
• System Administration Screens - System Administration screens will be available to manage the PDS process and to identify where errors in NHS Number matching need to be corrected.
• SMSP search - this process allows for a search of the PDS to take place based on specified search criteria. The screen will form part of the System Administration screens and therefore will only be accessible by Systems Administrators. The screen will be used to help rectify errors and mismatches in the case management system.
Each process will send Date of Birth, Surname, Forename, Gender, Address and Postcode to the PDS via a Spine Mini Service Provider. The PDS will return a single matched NHS Number and associated patient demographics or an error code and description.
PDS tracing within the case management system is through an automated process that selects records for matching that meet the Legitimate Relationship criteria. Records that already contain an NHS Number traced by SMSP will not be selected for matching. A SMSP web client is available but its use is limited to a small number of system administrators and data quality staff who use this screen to ensure accurate matching and the maintenance of data quality. This SMSP web has an easy to use graphical interface which validates data upon entry and allows a basic trace to be easily executed.
System administrators and data quality staff will work in conjunction with front line social care colleagues to try to resolve any discrepancies in NHS Number matching. Where this is not possible health colleagues will be contacted (GP etc.) to try to confirm details. The PDS National Back Office (NBO) is available to try to resolve difficult data quality cases.
In some circumstances Social Care will hold more up to date information than the PDS. PDS data is taken from GP records. The involvement of the GP practice when PDS errors cannot be reconciled by Social Care staff will have an overall benefit on the quality of PDS data.
Once retrieved from the PDS the NHS Number will be stored on the client’s record within the case management system, which is a secure system that implements a local standard for Role Based Access Control (RBAC). The RBAC process is administered by the system administration team with system functions being allocated dependent upon job role and team. Social Care staff have access to client records only where they are involved with the case, and thus have a legitimate relationship with the client, eg, the social worker, team manager, occupational therapist, etc. Strong passwords for access to the case management system are enforced and must be changed every 90 days.
System suppliers will not have routine access to the data in the case management system. However, occasional access may be required for maintenance and fault resolution purposes; this is covered in confidentiality clauses in supplier contracts.
Training for new users of the case management system specifically covers the use of the NHS Number. The training explains what the NHS Number is, who has an NHS Number and how it is used by Social Care in the authority.
The Business Process
Once stored in the case management system the NHS Number will be accessible by social work colleagues working with health colleagues in order to assess need, review existing service or support a client who is being jointly cared for by health and social care. In these circumstances the NHS Number will be used as an identifier to ensure all parties are using the correct information. Without the NHS Number the identification process relies on name, address, date of birth which are not always the most accurate and up to date pieces of information. The NHS Number will also be printed on all correspondence that flows from Social Care to health, again this acts as a means of ensuring accuracy of information.
In summary the process is as follows:
• Person presents to Social Care
• Person’s details are recorded as a contact in the case management system
• Person is either signposted to non-adult social care services or is allocated to a social worker for assessment and created as a client in case management system
• If allocated to a social worker the clients details are sent to the PDS for NHS Number matching
• The returned NHS Number is stored on the clients record
• The social work colleagues then use the NHS Number when contacting health colleagues in partner health organisations in order to carry out an holistic assessment of need, a review of current services or provide ongoing support and provision of service to the person
• The NHS Number is printed on correspondence to health organisations
Legal Basis
As detailed previously the NHS Number will be used in support of the delivery of specific statutory functions within Social Care.

Objective: The Authority wishes to access the NHS Number and basic demographic details (ie, name, address, date of birth, date of death, registered GP practice) in order to meet its statutory functions within Social Care in terms of:
• Ensuring integrated care
• Cooperating with partners
• Sharing of support plans
• Review of care provision
• Movement of people
• Discharge of patients from hospital
• Discharge of patients who have received treatment for a mental disorder

Social Care Operational Context
Social care professionals directly involved in a patient’s care need to access the most up-to-date information about the patient, using the social care case management system. They also need to be able to engage with local healthcare colleagues who are also caring for the patient. The means of ensuring that social care and healthcare colleagues are referring to the same individual is through the use of the NHS Number, together with basic demographic information, such as name, address and date of birth. Therefore social care departments need to access the PDS to get or confirm the NHS Number, and, crucially, to determine if there is a date of death recorded.
The case management system is subject to its own information governance arrangements, and data sharing agreements have been established across the health and social care partners in the Authority’s area.
The types of participating healthcare organisations are:
Acute Trusts
• Community Healthcare Trusts
• Mental Health Trusts
• GP Practices
• CCGs - for users involved in direct patient care, and not in the commissioning functions of CCGs

The method of accessing the PDS determines the type of user accessing the PDS. For case management systems with an online real-time tracing capability, it will usually be the social care professionals themselves. For the Demographics Batch Service (DBS) offline method it will be the administrators who support the social care professionals. System administrators will also need access in order to resolve data quality issues, for example where there are discrepancies between the data in the case management system and that in the PDS.
The following types of social care record held by the authority are included in the scope of this submission.
-Adult Case files; Residential Care (looked after in care); Home Care
-Blind / Partially Sighted or Deaf Adult files
-Physically disabled client / Disability Services file
-Deprivation of Liberties
-Learning Disability client Case file
-Mental Health client case file
-Transitions (the transition from child social care provision to adult social care provision)
-Review File
-Safeguarding: any adult case file that contains a Safeguarding Adults activity

. We will be using 2 methods of access.
1. Will be SMSP integrated with the current swift case management system to trace NHS numbers at the start of a care episode without any user intervention.
2. SMSP web client will be used by staff for data quality checking and other back office processes.

System administrators may also need access in order to resolve data quality issues.
High Level Use Case
For people receiving support from Social Care then the NHS may share their NHS Numbers with Social Care. This is so that the NHS and Social Care are using the same number to identify clients whilst providing care. By using the same number the NHS and Social Care can work together more closely to improve care and support.
The NHS Number is accessed through an NHS service called the Personal Demographics Service (PDS). Social Care sends basic information such as client name, address and date of birth to the PDS so it can find the NHS Number. Once retrieved from the PDS the NHS Number is stored on the Authority’s Social Care case management system.
It should be noted that the NHS Number is not shared with any other organisation directly. It is used within the case management system and to link health and social care information together.
The NHS Number will only be requested for social care cases where its use will contribute to the direct care of the person. The rules by which a person’s NHS Number will be requested are as follows:
• Recorded on the Social Care case management system with at least one allocated worker. This shows that the case has been allocated to a social worker either for assessment, review or ongoing support. It is at this point that the social worker will need to contact health partners in order to provide a holistic assessment of need and to ensure that any support provided is aligned to current health interventions.
• The allocation has no end date recorded, the case is currently with a social worker
• The person does not have a date of death recorded
The NHS Number then has two uses, the first being a unique identifier to allow social care information to be displayed, the second being the inclusion of the NHS Number on printed material that is used by health and social care colleagues in the provision of direct care.
The NHS Number will also be printed on a subset of social care printed documentation that is specifically used to communicate between health and social care organisations, currently around 100 documents have been identified. This brings the benefit of better co-ordinated and safer care across health and social care through the use of the unique identifier rather than a reliance on name and date of birth to identify a patient.
These printed forms relate to:
• referral
• assessment
• support and care planning
• reablement and rehabilitation
• medical consent
• GP consent
• transitional beds
• deprivation of liberty
• case review

Benefits: Most of the benefits detailed in this section relate to patient or practitioner benefits and not individual organisation benefits. The NHS Number is used to facilitate greater joining up of care across the whole Health and Social Care System, as such it is impossible to say that health realise the benefit here and social care realise the benefit there. In the integrated world the patient and those delivering care and support are the ones that directly see the benefit.
The use of joined up information across health and social care brings many benefits. One specific example where this will be the case is the discharge of patients into Social Care. At the moment delays in discharge (commonly known as bed blocking) can occur because details of Social Care involvement are not readily available to the staff on the hospital ward. The hospital simply does not know who to contact to discuss the ongoing care of the patient. The linking of social care and health information via the NHS Number will quickly help hospital staff identify if social care support is already in place and who the most appropriate contact is. Ongoing care can be planned earlier in the process because hospital staff will know who to talk to.
The addition of Social Care data, enabled via the storage of the NHS Number, will bring additional benefits:
• better coordinated and safer care across health and social care enabled through the sharing of real-time information
• better co-ordination of discharges from hospital into social care, as explained above
• more time to spend on planning and coordinating social care because health staff can identify and involve social care staff earlier in the process
• earlier intervention to maximize the opportunities of reablement services leading to greater independence for patients
• less paperwork and more efficient use of social care resources

Source: NHS Digital.