NHS Digital Data Release Register - reformatted

Suffolk County 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: HDIS_SuffolkCountyCouncil

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.

Ongoing production of tables and graphs, mainly of in-patient activity, including comparisons of Suffolk with East of England and England as a whole and statistical neighbours.

A recent example of an analysis of data from HDIS was the production of in-patient activity data, grouped by method of admission and specialty, to support development of five-year plans for CCGs in Suffolk and also Norfolk (completed September 2014).

Another example was the use of data from HDIS to calculate hospital admission rates, standardised for age and sex, for a study of variations in hospital admission rates in Suffolk in colder and warmer winters (initial study completed August 2014). This study covers the financial years 2003/04-2012/13.

Another example was analysis of HES data for inclusion in the Suffolk hidden harm needs assessment, including data on hospital admissions for mental disorders in pregnant women and for foetal alcohol syndrome (analysis completed September 2015). These outputs were pooled data for financial years 2009/10-2014/15 with small numbers (<6) suppressed.

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.

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 where this does not increase the risk of re-identification such as geographical databases which are in the public domain and is done so on an aggregated basis.

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).

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.

Suffolk County Council currently have 1 licence.

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 fulfillment 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: In general, data produced from HDIS in Suffolk will contribute to the planning of local public health initiatives to prevent ill health and improve health services in Suffolk.

Regarding the example of comparative in-patient activity data to support development of five-year plans of CCGs in Norfolk and Suffolk, the hospital activity data described will inform the planning and commissioning of hospital services for the local populations of Norfolk and Suffolk over the next five years. A range of factors contribute to this process, but HDIS in Suffolk County Council was the only local source of comparative hospital activity data from which the request could be answered in a timely manner.

Regarding the example of research to inform the Warm Homes, Healthy People initiative in Suffolk and the subsequent preparation of the research report for publication, it is suggested that the main finding of the study, namely that warmer winters had a statistically significant protective effect on hospital admission rates, could be used to inform the planning of hospital services, including early warning systems and winter plans.

Presently, no information is held on the findings of the report have been adopted locally. However, if the report is published in a medical journal, it will reach a wider readership and possibly have a positive impact on the planning of hospital services as a result.

Regarding the examples of hospital activity data produced for the Suffolk hidden harm needs assessment, these data contributed to this needs assessment, which has been published and will inform planning of local services in an area for which local information was difficult to obtain until now.

The Suffolk hidden harm needs assessment can be found at this link: http://www.healthysuffolk.org.uk/assets/JSNA/PH-reports/FINAL-HH-Report-April-2016.pdf.

Source: NHS Digital.