c are.data

1. care.data A modern data service for the NHS Geraint Lewis

2. care.data Purpose: to supply timely, accurate information to citizens, clinicians and commissioners about NHS care (i.e., a modern data service) care.data

3. care.data Which consultant has the lowest complication rates for gastrectomy? Where are duplications and gaps-in-care occurring? Purpose: to supply timely, accurate information to citizens, clinicians and commissioners about NHS care (i.e., a modern data service) Which GP practice in my town is best for patients with diabetes? One patient, one record… but multiple media and multiple channels How much is my CCG spending on depression? England becomes the default study site for health services research care.data

4. From HES Inpatient Demographics Dates Diagnoses Procedures Outpatient Demographics Dates Speciality A&E Demographics Arrival/Disposal (Diagnosis) (Treatment) Care.data To CES Inpatient Demographics Dates Diagnoses Procedures Symptoms Medications Observations Investigations Outpatient Demographics Dates Speciality Symptoms Procedures Diagnoses A&E Demographics Dates Diagnoses Procedures Symptoms Medications Observations Investigations GP Community Social care Audit Mental Health etc. NHS | Presentation to [XXXX Company] | [Type Date]

5. Examples of research based on HES – counting events

6. Predictive Risk Modelling

7. Underlying data – one individual

8. Underlying data – another individual

9. Propensity-matched cohort studies Start of intervention

11. Start of intervention

12. Start of intervention

13. Start of intervention • Steventon et al. An evaluation of the impact of community-based interventions on hospital use. A case study of eight Partnership for Older People Projects (POPP) . Nuffield Trust March 2011

14. Protecting Confidentiality • The entire care.data service will comply with letter and the spirit of: • Data Protection Act • Common law duty of confidentiality wherever it applies • Human rights legislation • Caldicott2 review • NHS Constitution • (i.e., a “quintuple lock”) UNCLASSIFIED

15. Internet care.data Identifiable data Potentially identifiable data Aggregate data NHS Commissioner, Providers, and Public Health England Health and Social Care Information Centre NHS provider Health Service Researchers S251 Communicable Disease etc. Patient

16. Aggregated data Internet care.data Identifiable data Sophisticated commissioning Potentially identifiable data Aggregate data NHS Commissioner, Providers, and Public Health England Health and Social Care Information Centre NHS provider Nuffield Trust etc. Legally mandated Big Blue Button Health Service Researchers S251 Communicable Disease etc. Patient

17. 3x Publications • Technical Specification for GP extract • Good Datasets (CCG strategy by 30 September) • Consultation on additional hospital data

18. Care.Data Linked interoperable data infrastructure which protects patients’ information and respects confidentiality Move to event triggered updates Health and Care Providers Hospital care Knowledge for All Clinical Data Safe Haven Prescribing Data Data Feed Validation NHSCB Commissioning Intelligence Tool Primary care Data Linkage Clinical Data Processing and derivations Prescribing Data Community care De-identification Publication and Access Mental health Clinicians / Research Social care Information for patients and the public Information for patients and the public Health and Social Care Information Centre Data flows where standards and systems exist

19. Care.DataPlanned accelerators to progress developing areas Current position: Local initiatives and national registers operate largely in isolation Potential benefits from prescribing in care homes and home monitoring. Some leading hospital sites capture detailed data Patients with LTCs in active participation. Leading hospital sites’ prescribing results. Work with social care data pioneers. Patients with access e.g. to path results. Phase 3 (TBC) Phase 2 (TBC) • Patient access to real-time hospital data Phase 1 • LTCs • Hospital prescribing and administration • Coded discharge messages • Social care Current • Hospital pharmacy data • Care Home prescribing • Detailed hospital data collection 2012/13 2013/14 2014/15 2015/16