NHS Digital Data Release Register - reformatted

Adelphi Group Limited projects

45 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).

Incidence, healthcare resource utilisation and mortality of invasive fungal infections (IFI) in hospitalised paediatric patients with and without ever having had an IFI-related hospitalisation in England: a retrospective cohort study using HES data — DARS-NIC-736273-V5T6V

Opt outs honoured: (Excuses: Does not include the flow of confidential data)

Legal basis: Health and Social Care Act 2012 – s261(2)(a)

Purposes: Yes (Consultancy)

Sensitive: Sensitive, and Non-Sensitive

When:DSA runs 2024-12 – 2027-11

Access method: One-Off

Data-controller type: ADELPHI GROUP LIMITED, PFIZER LIMITED

Sublicensing allowed: No

Datasets:

  1. Civil Registrations of Death
  2. Hospital Episode Statistics Admitted Patient Care (HES APC)
  3. Hospital Episode Statistics Critical Care (HES Critical Care)

Type of data: Anonymised - ICO Code Compliant

Expected Benefits:

The services provided to Pfizer Limited are expected to identify improvement opportunities which Pfizer may then exploit by making changes to systems, processes, resources or infrastructure in order to improve patient experience and patient care. For example, outputs might indicate there is scope for further research into development of innovative treatments and/or preventative care.

The use of the data could:
• Help the system to better understand the health and care needs of populations.
• Lead to the identification or improvement of treatments or interventions, or health and care system design to improve health and care outcomes or experience.
• Identify gaps in knowledge and areas for future research.
• Advance understanding of the need for, or effectiveness of, preventative health and care measures for particular populations or conditions such as IFI’s.
• Inform planning health services and programmes, for example to improve equity of access, experience and outcomes.
• Support knowledge creation or exploratory research (and the innovations and developments that might result from that exploratory work).

While the primary aim of the study is to generate new knowledge and insights into the incidence of and possible factors related to IFI-related hospitalisations, there are still some expected direct benefits to patients that could contribute to improved patient outcomes and healthcare quality; these may include:

• Improved knowledge about IFI-related hospitalisations: Patients may benefit from improved knowledge about the incidence and risk factors of IFI-related hospitalisations among paediatric patients. This could help patients to better understand their risk of IFI-related hospitalisations and take steps to prevent or manage these events.
• Improved awareness among healthcare staff, leading to improved diagnosis and treatment: By identifying factors that could contribute to the risk of IFI-related mortality, healthcare providers may be able to improve the diagnosis and treatment of IFI-related hospitalisations. This could lead to improved patient outcomes and reduced morbidity and mortality.
• Improved prevention strategies: By identifying subgroups of patients who are at higher risk of IFI-related hospitalisations, future research can focus on developing and testing IFI prevention strategies which healthcare providers could use to reduce the incidence of these events among paediatric patients. This could help to prevent unnecessary hospitalisations and reduce the burden on patients and healthcare systems.
• Improved communication with healthcare providers: Patients may benefit from improved communication with their healthcare providers about the risk of IFI-related hospitalisations, and patients at increased risk of death. This could help to improve patient engagement and involvement in their own care.

It is hoped that through publication of findings in appropriate media, the findings of this research will add to the body of evidence that is considered by the bodies, organisations and individual care practitioners charged with making policy decisions for or within the NHS or treatment decisions in relation to specific patients.

Pfizer will need to take action based on the information provided to them in order to realise the potential improvement opportunities. For example, where there is an identified need for improved treatment or prevention of IFI’s, Pfizer Limited might commit resources to development of a new treatment or repurpose an existing treatment.
It should be noted that Pfizer might decide not to commit resources to development of improved treatment, or an innovate treatment might not be made available to patients or health & social care practitioners in England & Wales.

The study team plan to reach out to patient advocacy groups, patient advisory committees, or other patient organisations to identify potential patient partners who are interested in collaborating on the dissemination of research findings.

Outputs:

The expected outputs of the processing will be:
• Reports of findings to Pfizer Limited. Regular descriptive preliminary summary snapshots throughout the analysis phase. A final results summary will be provided to Pfizer by December 2025.
• Submissions to peer reviewed journals by mid- 2026. Examples of journals to be targeted are BMJ Open and the Pediatric Infectious Disease Journal.
• Presentations at appropriate conferences such as the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the European Society for Paediatric Infectious Diseases (ESPID) conferences.

The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.

The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Posters displayed at conferences such as the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the European Society for Paediatric Infectious Diseases (ESPID) conferences.
• Reports aimed at the study sponsor Pfizer Limited.
• Direct bilateral engagement with patient advocacy groups, patient advisory committees, or other patient organisations.

The target date for publication of outputs is December 2026.

Processing:

No data will flow to NHS England for the purposes of this Data Sharing Agreement (DSA).

NHS England will provide the relevant records from the HES APC, HES CC, and Civil Registrations of Death datasets to Adelphi Group Limited. The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient.

The Data will not be transferred to any other location.

The Data will be stored on servers at Box.com. Box.com do not have access to the NHS England patient level data.

Adelphi Group Limited stores and accesses Data on the Cloud provided by Box.com.

The Data will be accessed by authorised personnel via remote access.

The Controller(s) must confirm and provide evidence upon audit by NHS England that access via any remote device complies with the data security obligations within this DSA and the Data Sharing Framework Contract.

For remote access:
• Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA;
• Access controls granting users the minimum level of access required are in place;
• Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data;
• Multifactor authentication (MFA) is required for remote access;
• Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access;
• All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this DSA) and complies with the organisation’s remote access policy.

The above applies in addition to any condition set out elsewhere within the DSA (e.g. who may carry out processing, and for what purpose).

The Data will not leave England/Wales at any time.

Access is restricted to individuals within the study team at Adelphi Group Limited who have authorisation from the Principal Investigator. All such individuals are substantive employees of Adelphi Group Limited.

Employees of Pfizer Limited are only permitted to access anonymised data including information derived from NHS England Data. Such datasets will adhere to the relevant small number suppression rules to minimise the risk of individuals being identified.

Pfizer Limited is not permitted to access the NHS England Data.

All personnel accessing the Data have been appropriately trained in data protection and confidentiality.

A Paediatric Infectious Diseases Specialist who is a Professor from the MRC Centre for Medical Mycology at Great Ormond Street Hospital London, will provide expert clinical and scientific opinion, and supporting the data controllers in interpreting the findings of the study. The individual will not have access to NHSE Data but will assist with analysis of aggregated outputs derived using the Data.

The Data will not be linked with any other data.

There will be no requirement and no attempt to reidentify individuals when using the Data.

Analysts from Adelphi Group Limited will process the Data for the purposes described above.

Patient characteristics, treatment patterns and healthcare resource utilization of newly diagnosed Triple Negative Breast Cancer Patients: an observational retrospective cohort analysis of real-world data in England (ODR2021_259) — DARS-NIC-656887-Q7M1C

Opt outs honoured: (Excuses: Does not include the flow of confidential data)

Legal basis: Health and Social Care Act 2012 – s261(2)(a)

Purposes: Yes (Consultancy)

Sensitive: Non-Sensitive, and Sensitive

When:DSA runs 2023-08 – 2024-02

Access method: One-Off

Data-controller type: ADELPHI GROUP LIMITED, MERCK SHARP & DOHME LIMITED (MSD)

Sublicensing allowed: No

Datasets:

  1. NDRS Cancer Pathway
  2. NDRS Cancer Registrations
  3. NDRS Linked Cancer Waiting Times (Treatments only)
  4. NDRS Linked DIDs
  5. NDRS Linked HES AE
  6. NDRS Linked HES APC
  7. NDRS Linked HES Outpatient
  8. NDRS National Radiotherapy Dataset (RTDS)
  9. NDRS Systemic Anti-Cancer Therapy Dataset (SACT)

Type of data: Anonymised - ICO Code Compliant

Objectives:

The aim of this study is to harness real-world data using cancer registration and secondary care data in England, to characterize the treatment patterns, clinical outcomes and HCRU of locally advanced non-metastatic TNBC patients, in the adult
population.
2.1 Primary Objective(s) & Hypothesis(es)
The specific primary research objectives for the study are:
1. To describe the demographics and clinical characteristics of patients with
newly diagnosed, locally advanced non-metastatic TNBC.
2. To describe the pharmacological and other interventional (i.e. surgery, radiotherapy) treatment utilization patterns of patients with newly
diagnosed locally
advanced non-metastatic TNBC, including:
o Place in therapy,
o Number of planned & actual cycles,
o Dosing,
o Real-world time on treatment, (rwToT),
o Reasons for discontinuation.
3. To evaluate real-world effectiveness outcomes of patients with newly diagnosed locally advanced non-metastatic TNBC including event-free survival
(EFS) and OS, for all patients within this study population and by stage at
TNBC diagnosis.
4. To describe the all-cause and TNBC-related HCRU and direct medical costs, prior to and following a new diagnosis of locally advanced, non-metastatic TNBC.

2.2 Exploratory Objective(s) & Hypothesis(es)
1. To evaluate disease progression following a diagnosis of locally advanced non-metastatic TNBC, including pCR, time to locoregional progression (LR/P) and time to recurrent/distant metastases (R/DM).
2. To describe the treatment landscape, including pharmacological and other interventional (i.e. surgery, radiotherapy) treatments by stage of TNBC proregression (PCR, LR/P and R/DM).
3. To describe the all-cause and TNBC-related HCRU and direct medical costs by stage of TNBC progression (pCR, LR/P and R/DM).

Yielded Benefits:

N/A

Expected Benefits:

Triple negative breast cancer (TNBC) is an aggressive form of breast cancer that is typically associated with a poorer prognosis. Around 15% of breast cancer cases are diagnosed as TNBC; approximately 7500 cases of TNBC are diagnosed within England and Wales each year. The prognosis of TNBC is considered poor due to the lack of effective therapies and its clinical aggressiveness, specifically its ability to metastasize and recur. These facts highlight that the study results could help highlight gaps in the care of TNBC patients and improve the lives of these patients.

The data collected within this study will contribute to the improvement of health and social care planning, as the objectives will provide:
- A better understanding of the clinical characteristics of patients with locally advanced [LA] (stage II-IIIB) TNBC
- Treatment patterns and observed pathways for patients diagnosed with LA TNBC
- An understanding of gaps in the treatment of LA TNBC, and highlight where the introduction of immunotherapy and other medical strategies may benefit patient outcomes and improve survival rates
- An understanding of the burden of LA TNBC on both patients and the NHS by assessing the real-world effectiveness outcomes (e.g. survival and progression rates), as well as healthcare resource use and costs incurred to the NHS

The dissemination strategy will provide evidence to support clinicians in the treatment of LA TNBC, inform ongoing standard of care improvement strategies in the use of new and emerging treatments, and appraise the implementation of future clinical trials in line with the overall aim to improve patient outcomes.

This study is not in support of a PhD/post-graduate research study. Data will not be used for sales and marketing purposes.

Outputs:

A final study report is in development, describing the methods, results, and interpretation of results. A manuscript will be developed and submitted to a relevant peer-reviewed journal (such as the Journal of Clinical Oncology, Frontiers in Oncology or Annals of Oncology (to be decided) as well as an abstract and poster to be submitted to an appropriate congress (such as the European Society for Medical Oncology [ESMO] or American Society of Clinical Oncology [ASCO], (to be decided). Manuscript development, submission and review is planned to be completed by the end of 2023. These outputs will enable both the scientific community and general public to be informed of and benefit from the results of this study, with the aim of encouraging discussion between academics and clinicians on potential areas for improvement within the patient treatment pathway. The outputs will only be aggregated data with small number suppression applied where necessary (both primary and secondary suppression). The study is not looking at specific treatments and direct outcomes and no safety data will be generated as a result of this study.

Results to the public domain in the form of abstracts, posters, presentations and/or manuscripts for submission to scientific congresses and journals will be aggregated outputs of the results only, with both primary and secondary small number suppression where required. Additionally, published findings of this study will be disseminated to the public and patient community to improve patient information / understanding and patient engagement.
HRGs derived for secondary care activity.oThe HRG4+ Local Payment Grouper will be used to derive HRGs for care provided in the inpatient, outpatient and A&E settings. The monetary amount a provider is reimbursed for a particular HRG code will be taken from the national prices and national tariff workbook compiled and provided by NHS Improvement and NHS England [48]. The workbook outlines national prices for each HRG code, which are dependent upon the care setting (inpatient or outpatient), method of admission (elective, non-elective, day case etc.) and length of stay.For all sources of unit cost data, the most recent source document available at the time of analysis will be used with the version noted and detailed in the final study report. If the most current documentation is one or more years outdated at the time of analysis, inflation adjustments for costs will be applied with full details to be documented in the SAP.Previous unit cost data may be used ifdata from recentsource documents lacks costing information for specific HRG costs.

Patient characteristics, treatment patterns and healthcare resource utilization of newly diagnosed locally advanced head and neck squamous cell carcinoma: an observational retrospective cohort analysis of real-world data in England (ODR2021_255) — DARS-NIC-656886-D8H1H

Opt outs honoured: (Excuses: Does not include the flow of confidential data)

Legal basis: Health and Social Care Act 2012 – s261(2)(a)

Purposes: Yes (Consultancy)

Sensitive: Non-Sensitive

When:DSA runs 2023-08 – 2024-02

Access method: One-Off

Data-controller type: ADELPHI GROUP LIMITED, MERCK SHARP & DOHME LIMITED (MSD)

Sublicensing allowed: No

Datasets:

  1. NDRS Cancer Pathway
  2. NDRS Cancer Registrations
  3. NDRS Linked Cancer Waiting Times (Treatments only)
  4. NDRS Linked DIDs
  5. NDRS Linked HES AE
  6. NDRS Linked HES APC
  7. NDRS Linked HES Outpatient
  8. NDRS National Radiotherapy Dataset (RTDS)
  9. NDRS Systemic Anti-Cancer Therapy Dataset (SACT)

Type of data: Anonymised - ICO Code Compliant

Objectives:

The aim of this study is to harness real world data from a nationwide registry to describe the characteristics of patients newly diagnosed with LA HNSCC in England, including treatment patterns, clinical outcomes and healthcare resource utilization (HCRU).

2.1 Primary Objective(s) & Hypothesis(es)
The specific primary research objectives for this study are:
1. To describe the demographics and clinical characteristics of patients with newly diagnosed LA HNSCC.
2. To describe the treatment landscape, including pharmacological and other interventional (i.e. surgery, radiotherapy) treatments for patients newly diagnosed with LA HNSCC.
3. To describe the all-cause and HNSCC-related HCRU and direct medical costs, prior to and following a new diagnosis of LA HNSCC.
4. To evaluate real world effectiveness outcomes of patients with newly diagnosed

LA HNSCC including event-free survival (EFS) and overall survival (OS).
2.2 Exploratory Objective(s) & Hypothesis(es)
1. To estimate the prevalence of LA HNSCC and describe changes in the epidemiology over time.
2. To evaluate disease progression following a diagnosis of LA HNSCC, including time to locoregional progression (LR/P) and time to recurrent/distant metastases (R/DM).
3. To describe the treatment landscape, including pharmacological and other interventional (i.e. surgery, radiotherapy) treatments by stage of HNSCC progression (LR/P and R/DM).
4. To describe the all-cause and HNSCC-related HCRU and direct medical costs by stage of HNSCC progression (LR/P and R/DM).

Yielded Benefits:

N/A

Expected Benefits:

Worldwide, there were 890,100 new cases of head and neck squamous cell carcinoma (HNSCC) and 450,000 deaths in 2018. The incidence of HNSCC is predicted to rise to 1.08 million new cases annually by 2030, with around 60% of patients being diagnosed with locally advanced (LA) HNSCC (stage III to IVb). Survival rates have only modestly improved over the past 30 years. Patients surviving HNSCC also have the second highest suicide rates (63.4 per 100,000 individuals) compared with survivors of other cancers. As a result, there is a clear psychological and clinical burden on patients with HNSCC, where better treatments and outcomes are required. These statistics highlight that the study results could help highlight gaps in the care of LA HNSCC patients, improve the lives of these patients.

The data collected within this study will contribute to the improvement of health and social care planning, as the objectives will provide:
- A better understanding of the clinical characteristics of patients with LA HNSCC
- Treatment patterns and observed pathways for patients diagnosed with LA HNSCC
- An understanding of gaps in the treatment of LA HNSCC, and highlight where the introduction of immunotherapy and other medical strategies may benefit patient outcomes and improve survival rates
- An understanding of the burden of LA HNSCC on both patients and the NHS by assessing the real-world effectiveness outcomes (e.g. survival and progression rates), as well as healthcare resource use and costs incurred to the NHS

The dissemination strategy will provide evidence to support clinicians in the treatment of LA HNSCC, inform ongoing standard of care improvement strategies in the use of new and emerging treatments, and appraise the implementation of future clinical trials in line with the overall aim to improve patient outcomes.

This study is not in support of a PhD/post-graduate research study. Data will not be used for sales and marketing purposes.

Outputs:

A final study report is in development, describing the methods, results, and interpretation of results. A manuscript will be developed and submitted to a relevant peer-reviewed journal (such as the Journal of Clinical Oncology, Frontiers in Oncology or Annals of Oncology (to be decided) as well as an abstract and poster to be submitted to an appropriate congress (American Society of Clinical Oncology [ASCO] – others to be decided. One abstract was submitted and accepted for presentation at ESMO 2022. Manuscript development, submission and review is planned to be completed by the end of 2023. These outputs will enable both the scientific community and general public to be informed of and benefit from the results of this study, with the aim of encouraging discussion between academics and clinicians on potential areas for improvement within the patient treatment pathway. The outputs will only be aggregated data with small number suppression applied where necessary (both primary and secondary suppression). The study is not looking at specific treatments and direct outcomes and no safety data will be generated as a result of this study.

Results to the public domain in the form of abstracts, posters, presentations and/or manuscripts for submission to scientific congresses and journals will be aggregated outputs of the results only, with both primary and secondary small number suppression where required. Additionally, published findings of this study will be disseminated to the public and patient community to improve patient information / understanding and patient engagement.

A retrospective observational study of patient characteristics, treatment patterns and healthcare resource utilisation for stage II melanoma in England — DARS-NIC-655446-P9K9Q

Opt outs honoured: No (Excuses: Does not include the flow of confidential data)

Legal basis: Health and Social Care Act 2012 – s261(2)(a)

Purposes: Yes (Consultancy)

Sensitive: Sensitive

When:DSA runs 2023-11 – 2025-11 2024.04 — 2024.04.

Access method: One-Off

Data-controller type: ADELPHI GROUP LIMITED, MERCK SHARP & DOHME LIMITED (MSD)

Sublicensing allowed: No

Datasets:

  1. NDRS Cancer Registrations
  2. NDRS Linked Cancer Waiting Times (Treatments only)
  3. NDRS Linked DIDs
  4. NDRS Linked HES AE
  5. NDRS Linked HES APC
  6. NDRS Linked HES Outpatient
  7. NDRS National Radiotherapy Dataset (RTDS)
  8. NDRS Systemic Anti-Cancer Therapy Dataset (SACT)

Type of data: Anonymised - ICO Code Compliant

Objectives:

Adelphi Group Limited and Merck Sharp & Dohme (MSD) Medical Affairs UK require access to National Disease Registration Service (NDRS) National Cancer Registration and Analysis Service (NCRAS) data for the purposes of the following project:
A retrospective observational study of Patient Characteristics, treatment patterns and healthcare resource utilisation for Stage II Melanoma in England

The following is a summary of the aims of the research project:
• To gain a better understanding of the disease characteristics of patients diagnosed with stage II Melanoma.
• To gain a better understanding of the treatments patients with stage II Melanoma receive, and how effective these treatments are.
• To better understand the cost of the healthcare provided to stage II melanoma patients.
• Aid in categorising key sub-groups within the stage II melanoma patient population that could benefit from the use of new treatments to improve treatment outcomes.

In support of these aims the following NDRS data will be accessed by Adelphi Group Limited:
• NDRS Cancer Registrations- necessary to identify patients who have been diagnosed with stage II melanoma, as well as report demographics and disease characteristics
• NDRS Linked Diagnostics Imaging Dataset (DIDS)- necessary for providing details on imaging tests (such as x-ray or ultrasound) a patient received to confirm their diagnosis
• NDRS Linked Radiotherapy Dataset (RTDS)- necessary for our aim to gain a better understanding of treatments patients receive. RTDS will be used to identify any radiotherapy treatments received.
• NDRS Linked Cancer Waiting Times- necessary to assess the timing of treatment patterns (surgery, chemotherapy and radiotherapy), as well as identifying whether patients experienced disease progression (recurrence and metastases)
• NDRS Linked Hospital Episode Statistics (HES) Admitted Patient Care (APC)- necessary to access information on hospital stays, including surgeries and procedures, assess disease progression events and understand the cost of healthcare provided to patients
• NDRS Linked HES Accident & Emergency (A&E)- necessary to access information on A&E attendances and on treatments including surgeries or procedures occurring at this point-of-care, as well as understand the cost of healthcare provided to patients
• NDRS Linked HES Outpatients- necessary to access information on outpatient appointments and on treatments including surgeries or procedures occurring at this point-of-care, assess disease progression events and understand the cost of healthcare provided to patients
• NDRS Systemic Anti-Cancer Therapy (SACT) Dataset- necessary for the aim to gain a better understanding of treatments patients receive. SACT will be used to identify any chemotherapy treatments received

The level of the data will be pseudonymised.

The data will be minimised as follows:
• Limited to a study cohort identified by NHS England as meeting the following criteria: All adult patients (aged 18 or above) that have a diagnosis of stage II melanoma (as defined by specific diagnosis codes) between 01/01/2015 to 31/03/2018.
• The NDRS Cancer Registry will be limited between 01/01/2015 and 31/03/2018 plus any event data (as per selected variables) held in the cancer registry from date of diagnosis up to 31/07/2022 (or death if earlier)
• CWT, SACT and RTDS will be limited to the time from diagnosis to 31/07/2022 (or death if earlier)
• HES subsets and DIDS will be limited to 12 months prior to diagnosis to 31/07/2022 (or death if earlier)

MSD Medical Affairs UK has commissioned Adelphi Group Limited to undertake this work and has determined the purpose of processing. Adelphi Group Limited, in the form of their subsidiary Adelphi Real World, make decisions about the means of processing and is therefore considered a joint controller.

Merck Sharp & Dohme Limited do manufacture pembrolizumab (Keytruda) and it is approved for use in the UK for several indications, including advanced melanoma. While pembrolizumab has been approved for use in stage II melanoma patients, the indexing period and end of the study period has been limited to ensure treatment patterns and outcome data around pembrolizumab are not included. The study will not evaluate or capture the outcomes of any specific treatments (including MSD’s treatments). However, this study will provide analysis of a care pathway in which Merck Sharp & Dohme have a commercial interest as they produce a drug that is used in this area. The potential commercial benefit to Merck Sharp & Dohme Limited of better understanding this care pathway is proportionate to the potential public benefits of increased understanding of this area of care and appropriate use of drugs approved for patients with stage II melanoma. Results from the study will not be used in any submissions for reimbursement or licensing but will be used to inform wider medical plans on activities that should be prioritised, such as further data generation studies. The primary rationale for carrying out this study is that there is limited data on the patient pathway and outcomes for these patients. As such, Adelphi Group Limited will evaluate the real-world clinical characteristics, treatment patterns, patient outcomes and HCRU for patients with stage II melanoma to increase general understanding and increase awareness for multiple scientific and public groups including clinicians, researchers, the patient community, and the general public. The insights could lead to better clinical outcomes for a significant number of patients and ultimately improve survival outcomes.

There is the potential for direct commercial gain in the understanding of the care pathways for stage II melanoma patients for MSD Medical Affairs UK as they have a drug that is used in this area; however, the outcomes of specific treatments (including MSD’s treatments) will not be explored. Adelphi Group Limited have been commissioned to undertake the work, which may be considered to result in a direct commercial gain. Additionally, intangible commercial gain from this study may arise from publishing the outcomes of the study to provide information for the clinical community because Adelphi Group Limited and MSD Medical Affairs UK employees will be listed as the authors. For example, the research will evaluate the clinical characteristics, treatment patterns, healthcare resource utilisation and survival for all patients within the defined cohort. As such, all treatments patients receive will be assessed. Adelphi Group Limited will not be investigating the effectiveness of any specific treatments (including Merck Sharp & Dohme Limited treatments).

Adelphi Group Limited and MSD Medical Affairs UK both rely on Article 6 (1) (f) of the General Data Protection Regulation (GDPR) as the lawful basis of processing - "processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party”. It is in Adelphi Groups Limited legitimate interest to add value to data through the application of epidemiological methods and expertise. Adelphi Group Limited will provide MSD Medical Affairs UK with aggregated data, with small numbers suppressed and will help them to interpret these outputs for wider dissemination to the scientific and public community as outlined in the study outputs. MSD Medical Affairs UK has determined the processing is necessary for its legitimate interests in being able to inform and raise awareness of the care pathway for patients.

The lawful basis for processing special category data under the UK GDPR cited by Adelphi Group Limited and MSD Medical Affairs UK is:
Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.

The funding is provided by MSD Medical Affairs UK. The funding is specifically for the project described.

The funder will have no ability to suppress or otherwise limit the publication of findings.

Adelphi Group Limited processes the data for the purposes described within this Agreement. No other subsidiary of Adelphi Group Limited will have access to the data disseminated under this Agreement.

Box.com Limited provides IT support and hosting services to Adelphi Group Limited and is therefore listed as a processor. They supply support to the system but do not access data.

With the exception of data that is aggregated with small numbers suppressed, MSD Medical Affairs UK does not process or have access to data released under this Agreement.

Adelphi Group Limited has been commissioned by MSD Medical Affairs UK to run the project, therefore, has received service/consultancy fees for the time spent on the project.

In line with the national data opt-out policy, opt-outs are not applied because the data is not Confidential Patient Information as defined in section 251(10) and section 251(11) of the National Health Service Act 2006.

Where individuals have opted out of disease registration by the National Disease Registration Service (NDRS), their data has been permanently removed from the registry and therefore will not be disseminated under this Data Sharing Agreement (DSA). https://digital.nhs.uk/ndrs/patients/opting-out

Expected Benefits:

The findings of this research study are expected to contribute to evidence-based decision-making for policy-makers, local decision-makers such as doctors, and patients to inform best practices to improve the care, treatment and experience of health care users relevant to the subject matter of the study.

Early identification of melanoma is crucial for successful treatment outcomes. Although there have been several studies relating to the improvement of melanoma treatment and management, there is a crucial data gap in the UK looking at the patient pathway of stage II melanoma patients. A comprehensive investigation of the real-world patient pathway, treatment landscape and outcomes of stage II melanoma patients is therefore needed.

The findings of this work have the potential to contribute to the improvement of health and social care planning in England as the study aims to provide:
- A better understanding of the clinical characteristics of patients with stage II melanoma
- Treatment patterns and observed pathways for patients diagnosed with stage II melanoma
- An understanding of the burden of stage II melanoma on both patients and the NHS by assessing the real-world effectiveness outcomes (e.g. survival and progression rates), as well as healthcare resource use and costs incurred to the NHS

The dissemination strategy will provide evidence to support clinicians in the treatment of stage II melanoma, inform the ongoing standard of care improvement strategies in the use of new and emerging treatments, and appraise the implementation of future clinical trials in line with the overall aim to improve patient outcomes.

It is hoped that through the publication of findings in appropriate media, the results of this research will add to the body of evidence that is considered by the bodies, organisations and individual care practitioners charged with making policy decisions for or within the NHS or treatment decisions in relation to specific patients.

Outputs:

The expected outputs of the processing will be:
• A report of findings to MSD Medical Affairs UK anticipated Q2 2024. The report will detail the study rationale, design, methods, aggregated results (in the form of graphs and tables, with small number suppressed) and conclusions. This is an internal document that Adelphi Group Limited develop for MSD Medical Affairs UK. The report is used as a basis for manuscript development for submission to peer reviewed journals, as well as abstracts/posters submitted to international conferences.
• Submissions to peer-reviewed journals (including but not limited to the Journal of Clinical Oncology, Frontiers in Oncology and Annals of Oncology). Submission is anticipated within one year of receiving the requested data.
• Presentations at appropriate conferences.

The outputs, including any data shared with MSD Medical Affairs UK, will not contain NHS England data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the datasets from which the information was derived.

The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Conferences

Outputs are expected to be produced within one year of receiving the data, however, data will be retained one year beyond this to respond to any queries resulting from the publication of results.

Processing:

No data will flow to NHS England for the purposes of this Agreement. Analysts from Adelphi Group Limited will analyse the data for the purposes described above.

NHS England will provide the relevant records from the NDRS Cancer Registrations, NDRS Linked Diagnostics Imaging Dataset (DIDS), NDRS Linked Radiotherapy Dataset (RTDS), NDRS Linked Cancer Waiting Times, NDRS Linked Hospital Episode Statistics (HES) Admitted Patient Care (APC), NDRS Linked HES Accident & Emergency (AE), NDRS Linked HES Outpatients and NDRS Systemic Anti-Cancer Therapy (SACT) Dataset. The data will contain no direct identifying data items. The data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient.

The data will be stored on the Cloud servers owned and managed by Box.Com Ltd.

The data will be accessed by authorised personnel via remote access. The data will remain on the server owned and managed by Box.Com Ltd at all times.

- Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA;
- Access controls granting users the minimum level of access required are in place;
- Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data;
- Multifactor authentication (MFA) is required for remote access;
- Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access;
- All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this agreement) and complies with the organisation’s remote access policy.

The data will not be accessed outside of England/Wales at any time.

Access is restricted to employees of Adelphi Group Limited who have authorisation from the project lead. All personnel accessing the data have been appropriately trained in data protection and confidentiality.

MSD Medical Affairs UK and other subsidiaries that fall under Adelphi Group Limited are not permitted to access or view any data released under this Agreement that is not aggregated with small numbers suppressed.

The data will not be linked with any other data.

There will be no requirement or attempt to reidentify individuals when using the data.