2. Purpose
• Overview of Comparative Data
• The change that Comparative Data will
realise
• What changes patients and clinicians will
see
• This is an opportunity for you to influence
the course of this work
NHS | Presentation to [XXXX Company] |
[Type Date]
2
4. High quality care for all,
now and for future generations
Open Outcomes
World class data
Transparency
Text Text
Greater voice and
insight for patients
and clinicians
More choice
and control
Participation
5. Our starting point for
world class data: HES
• Hospital Episode Statistics (HES) is a world-class
data service containing details of all NHS hospital
activity in England
• Records every inpatient ‘episode’ (1989 onwards),
outpatient attendance (2003 onwards) and A&E
attendance (2007 onwards)
• Invaluable research tool – tens of thousands of
peer-reviewed articles and audits
Dame Edith Körner (1921-2000)
6. Uses of Comparative Data
Data can be made easier to use or more relevant by
information intermediaries
7. Comparative data supports
participation
• Individuals can choose the treatments that are right for
them
• Shared Decision Making
• Information about treatment options
• Individuals can choose the right service provider for
them
• Location and logistics
• Quality and experience
• Citizens can get involved in local conversations about
the design and quality of local services
• Providers, commissioners and citizens see the same information
• Comparisons can provide context
NHS | Presentation to [XXXX Company] |
[Type Date]
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8. Two years of HES data
for one individual patient
Year 1
Year 2
9. Uses of NHS Data
Describing: to describe
patterns of hospital activity
over time
Predicting: to build models
that help plan services and
reduce the risk of needing
unplanned care
Evaluating: Using modern
scientific methods to find out
the success rate of preventive
care
Comparing: to compare
health needs and the use of
services in different parts of
the country
Auditing: to help assess the
quality and safety of hospital
care
Investigating: exploring what
apparent links in the data are
telling us
10. Problems with HES
1. Variable data quality and completeness
2. Very difficult for patients to access their own data
3. Missing data:
a) No information about in-hospital prescribing,
investigations, observations, etc.
b) No information about care outside hospital
c) No information about social care
11. Questions that cannot yet
be answered using HES
• How many patients in England received chemotherapy last year?
• What proportion of patients in St. Mary’s hospital were reviewed by a
consultant at least once a day?
• For patients in Birmingham versus Bristol, what was the average time
between presenting to their GP with bowel symptoms to being diagnosed
with colon cancer?
• What proportion of patients on Ward 20 who had highly abnormal nursing
observations were reviewed by the intensive care outreach team within an
hour?
14. Level of Care
×
× ×
J F M A M J
Time 2011
×
× ×
J A S O N D J F M A M J
2012
Mental Health
Social Care
Prescribing
Primary Care
Emergency
Out-patient
In-patient
J A S O N D J F M
2013
A M
15. J A S O N D J F M A M J
2012
J A S O N D J F M
2013
A M
Pharmacy
Diagnoses
Results
o oo
Tests
o
o
✪
Level of Event
Level of Care
J F M A M J
Time 2011
★★
✪
★
★ ★
Procedures
Imaging
Observations
★
Symptoms
C
× ×
× ×
✚✚
×
×
Mental Health
Social Care
Prescribing
Primary Care
Emergency
Out-patient
In-patient
21:00
Time
22:00
23:00
0:00
12-Jul-11
1:00
2 3 4 5:00
17. Safeguards
Potentially identifiable
data
Non-identifiable
data
Contains identifiers such as
date of birth and postcode
Contains a unique pseudonym
for each person
Contains aggregated or
anonymous data
Extracted into the secure
environment of the HSCIC
Available only to approved
organisations for approved
purposes under a legal
contract
Published openly
Disclosed by the HSCIC only
where there is a legal basis
(e.g. section 251 approval) or
with patient consent.
Wide range of safeguards as
specified by the information
commissioner’s office (e.g.,
purpose limitation, prohibition
of re-identification, time limits
for destroying data, contractual
penalties)
Safeguards to ensure that
the data are truly
anonymous in line with ICO
advice (e.g., small-number
suppression, perturbation,
rounding)
Identifiable data
18. Hospital, social
care providers
etc.
Patients have
a choice
Health and
Social Care
Information
Centre
GP Practice
Publication
NHS
Commissioners
& Providers,
Public Health
England etc.
Health Service
Researchers &
analysts
Section 251
Patient
Potential patient objection
20. Discussion
1. What benefits could cara.data and better use of comparative data bring
for patients and the public?
2. How could comparative data help citizens to hold organisations to
account?
3. How do we make sure that a wide range of people are able to get
involved in setting the priorities for comparative data/care.data?
Hinweis der Redaktion
Storyline of Emergency episode: Elderly woman has loses balance on the escalator in tube station and has a fall, 999 phoned at 20:14 and underground station first responder attend to her. 20:35 Ambulance staff arrive. Symptoms: no loss of consciousness, acute pain, unable to stand or walk, slight transient slurred speech, disorientation, no known conditions . Paramedics determine no head/neck injuries, and measure blood pressure, blood sugar, and vitals finding BP on low side. They carry patient by foot to ambulance at street level. Medical history taken en route, patient much less disorientated. 20:55: Arrival at St Thomas’s Hospital A&E. Nurse triage upon arrival has patient sat in wheel chair at minor injuries unit awaiting to be seen. Upon patient’s companion request, nurse called as patient is increasingly uncomfortable, dazed and sleepy. BP taken again, reading of 80/50 prompts admission to bed in Majors Unit at Emergency at 21:10. Nurse performs EKG and monitors BP, heart vitals OK, reports to consultant-led team. Consultant orders full blood test panels, at 21:45 performs mobility and neuro exam, no numbness but pain reported, Dr prescribes paracetamol with codeine and orders pelvic/spine x-rays. Nurse draws bloods and sends to lab, awaits radiographer. Blood results have long delay, suspected problem in lab. Nurse unable to locate blood booked in at lab, but courier says they were delivered. 23:00 Bloods drawn again and sent. Nurse continues monitoring and takes patient to x-ray at 23:15, notes patient able to walk better as she accompanies to toilet. When both sets of test results are in, consultant reviews and enters diagnoses of dehydration and fractured coccyx at 23:55, orders 1 L of saline drip and additional pain medications. Nurse cannulates for IV drip. Patients vitals stabiles with BP at 120/75 and discharged shortly after 5:00 AM with codeine dispensed TTA and advised to follow up with GP for any physio and pain-management and cause of low BP. Axis is indicated as flexible hourly scale based on density of events. Dotted lines link tests with their results.
Storyline of Emergency episode: Elderly woman has loses balance on the escalator in tube station and has a fall, 999 phoned at 20:14 and underground station first responder attend to her. 20:35 Ambulance staff arrive. Symptoms: no loss of consciousness, acute pain, unable to stand or walk, slight transient slurred speech, disorientation, no known conditions . Paramedics determine no head/neck injuries, and measure blood pressure, blood sugar, and vitals finding BP on low side. They carry patient by foot to ambulance at street level. Medical history taken en route, patient much less disorientated. 20:55: Arrival at St Thomas’s Hospital A&E. Nurse triage upon arrival has patient sat in wheel chair at minor injuries unit awaiting to be seen. Upon patient’s companion request, nurse called as patient is increasingly uncomfortable, dazed and sleepy. BP taken again, reading of 80/50 prompts admission to bed in Majors Unit at Emergency at 21:10. Nurse performs EKG and monitors BP, heart vitals OK, reports to consultant-led team. Consultant orders full blood test panels, at 21:45 performs mobility and neuro exam, no numbness but pain reported, Dr prescribes paracetamol with codeine and orders pelvic/spine x-rays. Nurse draws bloods and sends to lab, awaits radiographer. Blood results have long delay, suspected problem in lab. Nurse unable to locate blood booked in at lab, but courier says they were delivered. 23:00 Bloods drawn again and sent. Nurse continues monitoring and takes patient to x-ray at 23:15, notes patient able to walk better as she accompanies to toilet. When both sets of test results are in, consultant reviews and enters diagnoses of dehydration and fractured coccyx at 23:55, orders 1 L of saline drip and additional pain medications. Nurse cannulates for IV drip. Patients vitals stabiles with BP at 120/75 and discharged shortly after 5:00 AM with codeine dispensed TTA and advised to follow up with GP for any physio and pain-management and cause of low BP. Axis is indicated as flexible hourly scale based on density of events. Dotted lines link tests with their results.
![Purpose
• Overview of Comparative Data
• The change that Comparative Data will
realise
• What changes patients and clinicians will
see
• This is an opportunity for you to influence
the course of this work
NHS | Presentation to [XXXX Company] |
[Type Date]
2](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)