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Anonymised hospital activity data
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Hospital activity data (inpatient, outpatient and A&E) would be used to contribute towards the Joint Strategic Needs Assessments and would be a key component in informing the Public Health advice to Clinical Commissioning Groups.
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HSCIC / Commissioning Support Units
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PHE have sourced Hospital Episode Statistics (HES) on behalf of Local Authorities from the HSCIC. However, this was done with little consultation with local teams who generally do not have the resources to warehouse and manage the dataset as it covers the whole of England. A web-based national system, similar to the Primary Care Mortality Database (PCMD) would be a more efficient solution and reduce duplication across the country.
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This information was readily available to PH teams in Primary Care Trusts.
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Anonymised cancer incidence data
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To identify hotspots of cancer incidence within the local authority. This information would contribute towards the Joint Strategic Needs Assessments and would help inform targeted interventions.
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Public Health England
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PHE will not provide access to anonymised data at record level, which means Local Authorities have to submit individual requests each time we need to data in a slightly different way & PHE have to calculate the rates themselves, which they have limited capacity to do.
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The information was much easier to access prior to 2013.
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Vaccination and Immunisation uptake data
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To identify uptake of vaccination and immunisation across the borough, and assist with fulfilling the Public Health role around assurance for various aspects of health protection. Some data is available at CCG or GP Practice level, but this is insufficient for population monitoring, targeting areas of low uptake and preventing outbreaks.
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NHS England
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Direct access to the information has not been agreed and standard data flow has not been established.
Vague ‘IG’ concerns have been cited as reason data cannot be provided.
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The information was much easier to access prior to 2013.
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Anonymised cancer survival data
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Hospital activity data (inpatient, outpatient and A&E) would be used to contribute towards the Joint Strategic Needs Assessments and would be a key component in informing the Public Health advice to Clinical Commissioning Groups.
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NWCIS/NCIN
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NWCIS are currently undertaking a piece of work looking at cancer survival at a national and local level, but this may take some time to come to fruition and we using relatively old data when discussing how well our residents are doing post diagnosis. We have received data on request (takes some time) from NWCIS since 2013, but it is limited due to the confidentiality issues that arise in allowing access to personal data.
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This information was much easier to access prior to 2013.
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Demographic information available via an extract from the NHS Patient Register
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The data provides a postcode level population denominator, based on GP registrations; essential for calculating rates for non-standard geographies, it assists with the production of local level (ward, SOA) population estimates, and apportion data as appropriate. It also enables us to calculate GP Practice level rates, deprivation scores, etc. and has in the past strengthened responses to ONS consultations on national population estimate methodologies. The GP Patient Register has also been used in the past (with appropriate ethical approval) to undertake population wide epidemiological surveys of health-related behaviour and risk factors. Results of which have been used locally to set priorities and target resource. In addition, information held on the Patient Register could potentially help with specific pieces of work; a recent example being identifying new entrants to the UK to assist with latent TB screening.
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NHS England
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Public Health has not been allowed access to a full non-anonymised version of the GP Register. Individual or postcode level information has not been agreed
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This information was readily available to PH teams in Primary Care Trusts.
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Access to patient postcode across all datasets
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As a general point that applies to all datasets, the absence of patient postcode on data that LAPH teams can access impedes local analysis. Without a postcode, many data records/local data cannot be allocated to defined local areas or new electoral ward boundaries, meaning rates for local areas cannot accurately be calculated.
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Various
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Full postcode is classed as person identifiable data and has not been made available to LAPH teams since transition
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This information was readily available to PH teams in Primary Care Trusts.
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Anonymised mental health services data
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Mental health service data (MHSDS/MHLDDS, IAPT) would be used to contribute towards the Joint Strategic Needs Assessments and would be a key component in informing the Public Health advice to Clinical Commissioning Groups.
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HSCIC / Commissioning Support Units
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The CSU have advised that only commissioners with Accredited Safe Haven status (ASH stage 1) are able to receive data and that although MHMDS is pseudo data they have to treat it as though it is ‘clear’ due to its sensitive nature.
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Data sets have evolved and developed but what information did exist was readily available to PH teams in Primary Care Trusts.
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Breastfeeding initiation data
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Monitor breastfeeding initiation rates across the borough and be used within the Joint Strategic Needs Assessment and Early Years performance data.
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NHS Trusts
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Local data flow – Local hospitals used to supply data to local PCT Business Intelligence Teams. However, when PCTs were abolished this data was no longer available to some Public Health teams. NHS England were publishing the data until Q1 2015/16, but no data has been released since.
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This information was readily available to PH teams in Primary Care Trusts.
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Reporting at administrative scales (county, district and ward). Service provision needs individual level data from the National Drug Treatment Monitoring System (NDTMS).
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To consider the characteristics of people in substance misuse treatment in the county to order to inform needs assessments and commissioning decisions. To assess whether locally commissioned substance misuse treatment services are meeting the needs of service users.
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Public Health England (PHE)
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PHE have concerns over the provision of individual level data because of confidentiality. The only personal information that was ever previously provided was age, gender, ethnic group and partial postcode.
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Yes, via the regional NDTMS team
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Hospital Episode Statistics – Inpatient, Outpatient and Urgent Care
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To monitor patterns of disease and support and improve the local responsiveness, effectiveness and value for money of commissioned public health and NHS services. It is also used to support the statutory ‘core offer’ of public health advice and support to local NHS commissioners, the Joint Strategic Needs Assessment, Joint Health and Wellbeing Strategy and other functions of the Health and Wellbeing Board. It is more specifically used to undertake longitudinal analyses of patterns the incidence and prevalence of health risks and diseases, demand and access to treatment services, health outcomes monitoring, and support the programme of health needs assessments, health equity audits and health impact assessments within local area.
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Health and Social Care Information Centre
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Whilst permission has been granted for local authorities to access this data the process has been problematic. Current arrangements for public health access to pseudonymised HES data are due to close on the 31st of August 2016, with no clarity around a future arrangements for local authority public health access and any associated costs leaving local authority public health teams in limbo and unable to access this information in the longer term. Due to the delays outlined above the short-term access our Council will have will amount to less than three months limiting the ability of the Public Health team to fulfil its statutory obligations or plan for the use of this information to improve health and wellbeing locally in the longer-term.
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Yes – via Secondary Uses Service data feeds within Primary Care Trusts.
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Mortality data (PCMD) including cause of death
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1 Suicide audit
2 Identifying mortality rate for CVD in most and least deprived quintiles
3 Identifying leading causes of death (and compare to England)
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HSCIC
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N3 access no longer available
IGLevel 2 toolkit not in place in our LA
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Yes (public health mortality file). We could link postcodes to IMD data too.
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Cancer stats at a local level e.g. survival rate at 5 years
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Public health surveillance. Continuing to monitor what we have had in past
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National Cancer Intel. Network?
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It is not published at a lower level (e.g. CCG or LA)
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Yes, via H&SCIC Indicator Portal
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HES data for one year free of charge to LA PH teams
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PHE indicated that they would provide access. May or may not be useful
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HSCIC
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Means completing data sharing framework through H&SCIC and a further (different) data sharing agreement which identifies need for N3 or IG Level 2 toolkit.
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PCT Information Team would have had access to secondary care data and we would have been able to put in information request if required. Local CSU is not so accommodating
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Data from STEIS – NHS incident reporting system
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Child health information – that is, all data held within the child health information system, including immunisation
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This would help us to:
I) monitor population health trends
II) enhance support provided to the NHS via the ‘Core Offer’
III) conduct more insightful needs analysis to inform commissioning interventions which promote public health
IV) identify escalating health issues andparticularly for screening programmes, fulfil requirement of the Director of Public Health to provide assurance on screening
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NHS England
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Information governance rules and also the fact that we do not commission these services, this means it is hard to convince partners to share the data, resulting in lengthy bureaucratic processes to try and get data, if at all.
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Yes
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Mental health treatment data
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As above
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MH trust
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As above
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Yes
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GP records
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As above
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GPs/ CCG
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As above
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Yes
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Maternity data
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As above
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NHS Trust
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Information governance makes it almost impossible to share health related identifiable data for so called ‘secondary usage purposes’ and it’s not always straight forward to do this for primary patient care purposes. Even when sharing using pseudonymised data as proposed in our example above it is very difficult to share data. This is despite regulations that suggest using pseuodomymisation for secondary usage sharing purposes is possible
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Yes
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National screening programme data
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As above
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PHE
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Yes
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Ability to link data
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In addition to the previous examples, this enables us to provide a much more detailed analysis. For example, by linking mortality data to maternity data we have been able to demonstrate locally increased risk of infant mortality generated by the following factors; age of mother, smoking, late booking in pregnancy and obesity. We have recently enquired about sharing pseudonymised (non-identifiable) mortality data for the purpose of linking to hospital and social care data, a project which could add tremendous insight into understanding the potential interventions points for health and social care, to improve outcomes for the patients and reduce premature death. However, the current information governance regime makes this almost impossible to do without spending months seeking assurance from ONS to be able to share this data.
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Various including local providers, HSCIC, ONS, CSUs, Councils, other government departments
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Information governance makes it almost impossible to share health related identifiable data for so called ‘secondary usage purposes’ and it’s not always straight forward to do this for primary patient care purposes. Even when sharing using pseudonymised data as proposed in our example above it is very difficult to share data. This is despite regulations that suggest using pseuodomymisation for secondary usage sharing purposes is possible.
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Yes
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Out of Area service recharges
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Only first part of the postcode provided and IG sited for not sharing data.
Not possible to prove that this resident has used the service
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Various providers
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As above
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Yes
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