Trusted Research Environment service for England

The TRE service provides approved researchers from trusted organisations with timely and secure access to health and care data. Researchers are given access to their approved data (in accordance with their Data Sharing Agreements), enabling them to collaborate, link data, share code and results within the same research projects.

The service provides a secure data platform with the analytical and statistical tools to support researchers in conducting their work. Their findings can then be exported safely, ensuring the formats and analyses are approved and sent to authorised users.

We are developing the service based on user feedback to provide a flexible and scalable solution that supports all our users’ needs in a safe and secure way. The service is currently being used to help guide national decision making and recommend potential interventions to reduce the severity of COVID-19 outcomes.

As part of our TRE process, NHS Digital routinely seeks advice from the Independent Group Advising on the Release of Data (IGARD) to ensure that the highest standards of data stewardship and governance are upheld.

Researchers will only gain access to the data they are permitted to see, and all approved data flows are published on the Data Release Register.

Our transparency notice details our legal basis for processing personal data in the course of this work.

If you are a member of the public and would like further information about how the NHS can use and share patient data and the choices patients can make, please visit the Your NHS data matters patient site.

The TRE service in England uses the five safes framework for safe use of secure data.

We provide researchers with:

• a transparent and secure access management process to make decisions on applications to bring data, tools and code into the environment. This transparency delivers assurance to patients and the public that any information inputs are safe and assessed at the point of entering the environment
• a Safe Output Service to our service users that is robust, effective and transparent to third-party audit. We assess each request using NHS Digital’s Disclosure Control Rules in accordance with the Safe Output Policy where the output is analysis results developed using personal, sensitive and confidential data

We carry out independent audits and where necessary post audit reviews to check that our customers are meeting the obligations in their Data Sharing Framework Contracts and Data Sharing Agreements. This helps to ensure that organisations abide by the terms and conditions set by NHS Digital and data is kept safe and secure. 

A number of data sets are currently available via the TRE service and several others are in development, principally to support COVID-19 related research in the TRE service including those made available through the Data and Connectivity National Core Study

The full list of all data sets available can be found on our Data Access Request Service (DARS) webpage.

Researchers can only access data sets approved under their specific Data Sharing Agreement (DSA) project. They are then provided with their account details and instructions on how to access the secure platform within the TRE service. 

The secure platform puts virtual walls around data under their DSA, to ensure that users can only access data for which they have been approved and cannot download patient-level data which might allow them to carry out unapproved analysis.

All data is de-identified and so does not contain personal information such as names and addresses or NHS Numbers. 

All projects requiring access to the TRE service will first have to apply for their data through the Data Access Request Service. 

TRE service users will be given access to our secure Data Access Environment, which hosts powerful analysis and interrogation tools such as Databricks and RStudio:

• Databricks is a collaborative analytics platform that supports SQL and Python languages for the analysis of big data in the cloud
• RStudio is a data analysis environment for R, a programming language for statistical computing and graphics

Researchers with the same data sharing agreement can work collaboratively with their colleagues in shared project folders, using their preferred tool. The final intended output is checked for compliance with the five safes before exports are approved. 

Working in partnership with Health Data Research UK (HDR UK) and our first client, the British Heart Foundation Data Science Centre (BHF DSC), the NHS Digital TRE service has already created a powerful environment, capable of answering complex research questions.

Using an agile, collaborative approach, the TRE service is delivering the tools and data needed to support teams of researchers from UK universities and other research organisations to perform analyses on a variety of linked, pseudomymised data sources.

BHF Data Science Centre

The BHF Data Science Centre team is currently researching the impact and effects of the COVID-19 pandemic on cardiovascular diseases in terms of diagnosis, management and patient outcomes.

Initial work resulted in the publication of the following BMJ paper, on 7 April 2021, from the CVD-COVID-UK consortium.

A second HDRUK/BHF Data Science Centre paper, using NHS Digital’s Trusted Research Environment (TRE) service for England, was published in PLOS Medicine on 22 February 2022. The studies were carried out independently in the UK and supported by Health Data Research UK and the BHF Data Science Centre.

This research found only a small elevated risk of blood clots and a slight increase in risk of intracranial thromboses in some populations after the AstraZeneca COVID-19 vaccine.

DATA-CAN 

DATA-CAN, the UK’s health data research hub for cancer, recently completed the process necessary to access key cancer data within NHS Digital’s TRE. Our TRE is now providing approved DATA-CAN researchers from trusted organisations with timely and secure access to de-identified cancer data, enabling important COVID-19 related research on rates of cancer referrals, diagnoses and treatment.

DATA-CAN is hosted by UCLPartners and is made up of the following partners - Genomics England, IQVIA, Leeds Teaching Hospitals NHS Trust, Queen’s University Belfast, University of Edinburgh, University of Exeter and University of Leeds.

Visit the DATA CAN TRE webpage to see further details about DATA-CAN and their work using NHS Digital’s TRE.

We continue to carefully onboard new customers to the TRE service in order to support research into the impact and treatment of COVID-19.

If you have enquiries about the TRE service for England, contact [email protected]. 

If you have technical questions about data or working with the data, contact [email protected].