NHS providers and commissioners have long been using data to communicate with each other – from monthly performance reports that offer insights on service delivery, to quality, innovation, productivity and prevention (QIPP) and quality outcomes framework (QOF) schemes and annual quality accounts that drive forward standards.
Data is also used for forward planning and budgeting, with annual plans and service level agreements based on the activity carried out in previous years. For example, provider trusts plan for winter pressures together with commissioners by looking at the previous year’s demands on services to support and inform their strategic plans for the forthcoming year.
In these ways, data on performance and quality plays a significant role in monitoring the success of NHS services, but it doesn’t necessarily indicate how those services mirror the needs of the local population.
For that kind of insight, clinical commissioning groups (CCGs) and integrated care systems (ICSs) can look to joint strategic needs assessments, pulled together by the local authority for each area, which look not only at the state of public health but also at its wider determinants such as levels of employment, housing and the environment. National commissioning intentions are also available to show the latest thinking on how services should be designed and delivered.
The challenge for CCGs and ICSs comes in pulling all this information together to form a coherent narrative on whether the services in their area are running efficiently and making a difference, and what more they could do within their allocated resources to influence the future health of the population.
Using data to improve care
CCGs will have differing levels of experience in data analysis and how they work to get the most from the available data; there are however now national tools available to support this work.
For example, NHS RightCare has been introduced to help local health systems identify opportunities to reduce unwarranted variation and improve population healthcare. NHS RightCare teams work locally with systems to present a diagnosis of data and evidence across that population, identifying the greatest potential improvements in spend and outcomes.
NHS RightCare data packs cover a range of programme areas including cardiovascular, respiratory and musculoskeletal, and NHS England have advised that all systems are expected to work with the programme to implement national priority initiatives for cardiovascular and respiratory conditions in 2019/20, as well as addressing variation and improving care in at least one additional pathway outside of the national priority initiatives.
Recognising that most health conditions are linked to demographic factors such as deprivation and age, NHS RightCare also compares systems to their closest demographically similar geographies, giving realistic comparisons.
The expertise to ‘crack’ the data open
Here at ICHP we’re at the forefront of work using integrated data for evaluation of new technologies and models of care, thanks to our access to North West London’s Whole Systems Integrated Care dataset (WSIC). WSIC provides a de-identified, linked primary care, acute, mental health, community health and social care record for over 2.4 million patients who live and are registered with a GP in North West London (NWL). WSIC is fed by data from over 400 provider organisations including 360 GP practices, two mental health trusts, two community trusts and all acute providers attended by NWL patients making it one of the most powerful health and social care datasets in the UK.
We’re also working on a new type of STAR (socio-technical allocation of resources) analysis, which involves measuring the allocative efficiency or the effectiveness of spend across a whole pathway and enables CCGs and ICSs to consider whether a reallocation of resources could lead to better patient outcomes. To create a STAR analysis we not only look at integrated data across a whole health system, we also bring together experts and patients from those pathways to look at how they value and measure the outcomes and experiences along the way, to give a holistic view of the benefits any changes will bring.
Whatever data a CCG or other organisation uses which needs evaluating, an intervention whose success needs measuring, or a public health issue that needs quantifying, the chances are ICHP can help – it’s just a case of having access to the right data, experience and expertise to crack it open and find the answers.