Results

“It has led to considerable benefits to public health. The data is used to identify patterns and trends in mortality rates, life expectancy and premature death, highlighting differences between geographic areas, age, sex and other socio-economic characteristics. It is also used specifically to identify health inequalities and differences between areas which is critical for the planning, distribution and targeting of health, care and public health services. It is used to set recommendations in the Annual Public Health Report, which inform the commissioning and coordination of public health services.”

Bristol City Council

“Metrics based on the analysis of HES data:

• provides objective evidence of the current major strengths and challenges for the North East and North Cumbria AHSN in terms of population health and healthcare 
• enables the AHSN to objectively monitor changes (improvements) in the region’s population health and healthcare processes/outcomes
• enables the AHSN to monitor and evaluate the impact of its initiatives (measure success).”

Northumberland Tyne and Wear NHS Foundation Trust, NHS England Academic Health Science Networks (AHSN) programme

“An improved patient experience with faster recovery is one of the benefits that results from the use of the NEQOS hip and knee dashboard. This product, which utilises HES data, enables Trusts to monitor enhanced recovery pathways as it includes metrics measuring length of stay and emergency readmissions within 30 days of discharge.”

Northumberland Tyne and Wear NHS Foundation Trust, North East Quality Observatory Service (NEQOS)

“Patients with APL [acute promyelocytic leukaemia], a sub-set of AML have benefited significantly from the emergence of a chemotherapy-free regimen. Further advances have been made in refining the identification of patients suitable (or not) for stem cell transplant.”

Cardiff University, Acute Myeloid Leukaemia (AML) trials

“Assisting a CCG in the South of England implement improvements in the area of diabetes and respiratory disease. The improvements will involve the health system – GPs, hospitals, community services – working more effectively together (or in the jargon working in a more 'integrated' way). HES data has been used to identify variation in 'outcomes' to identify potential areas to target.”

NHS North and East London Commissioning Support Unit

“In South Tees the Parkinson's team has been using data to help make the case for ongoing service investment and development. The team realised that they were failing to meet the needs of patients with complications such as motor fluctuations, dementia and psychosis and realised that 15-minute review appointments, every six months, was no way to deal with complex issues.”

Wilmington Healthcare working with Parkinson’s UK on data dashboard

1. “Identifying a higher than normal failure rate of hip resurfacing procedures in women over the age of 50, leading to an immediate change in clinical practice.
2. Identification of the DePuy ASR hip replacement system as an outlier leading to its immediate withdrawal from the market
3. The identification of a higher than normal failure rate of large head, metal on metal, stemmed hip replacements
4. Research, using NJR and HES data, looking at the risk of cancer following a metal on metal hip replacement compared to other bearing surfaces and the general population” 

Northgate Public Services (UK) Limited, National Joint Registry (NJR) clinical audit

“Readmissions issues relating to specific surgeons were highlighted. i5 Health went beyond problem identification and evaluation and made detailed and well considered recommendations – not just for the CCG but also its providers and colleagues across primary and community care.”

i5 Health, Report for NHS England on digital initiatives

“The yielded benefits so far (of this wider piece of work) include providing a report to the SM commissioning team, and meeting with the CCG to discuss the findings. Further anticipated benefits are to hold a joint meeting with the CCG with the local MH trust, and depending on the result of further investigations, identify what steps might need to be taken to improve the health of this client group.”

London Borough of Greenwich Council, Joint Strategic Needs Assessment, substance misuse

“We have both fed back evaluations of service innovations locally and disseminated findings at national conferences and workshops (innovations include advice and guidance referrals, location of care, barriers to discharge, hospital delivery of health promotion advice). Some of our work and future programmes impact on mental health and we will therefore collaborate with the Centre for Public Mental Health and Applied Healthcare Research described under the next theme.”

Birmingham University, NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) Maternity and Child Health Theme

“Increasingly, the work of the public health information team in Bristol City Council is focussed on sharing detailed and more relevant health profiling data with a greater number of our colleagues; within the public health team, the wider local authority (including the elected politicians responsible for much of the decision and policy agenda) and the wider community with the potential to influence the health environment across the city in many settings, [such as] schools.”

Bristol City Council

“As part of the public and stakeholder engagement work for this project, the study have developed various visualization tools and public-facing dissemination materials, which are collected together at this website: http://www.york.ac.uk/che/research/equity/monitoring/” 

University of York, Centre for Health Economics (CHE), working with NHS England equality and health inequalities team

“The Lancet has published a paper which, to the University's knowledge, is the first study in a national health system to quantify specialist involvement in the care of emergency admissions at weekends and weekdays, and to analyse this with weekend and weekday admission mortality rates.”

University of Birmingham, High-Intensity Specialist-Led Acute Care (HiSLAC) Study

“The audit has also produced close to 20 primary research articles using the NACR dataset. The NACR data is quickly becoming known, internationally, as a leading source of data for real-world Cardiac Rehabilitation research. This is the culmination of over 10 years of work and the essential part that the HES data plays in the produce from the yearly annual report.”

University of York, British Heart Foundation (BHF) National Audit of Cardiac Rehabilitation (NACR)

“The previous data has highlighted that the population incidence of both AKI and AKI-D has increased more than 12-fold in England. This research has led to further projects by UK Renal Registry to collect dialysis data for AKI prospectively.”

University Hospitals of Derby and Burton NHS Foundation Trust, ‘National trends in acute kidney injury (AKI) requiring dialysis in England between 1998 and 2013’

“This study utilized a cross-sectional survey of ENT consultants and analysis of HES data to provide, for the first time, an estimate for the prevalence of recurrent respiratory papillomatosis in the UK. This prevalence informed the sample size for an NIHR Research for Patient Benefit grant application - three year award granted.”

The Newcastle upon Tyne Hospitals NHS Foundation Trust, ‘Prevalence and management of recurrent respiratory papillomatosis (RRP) in the UK’

“This project focuses on A&E attendances for the whole population of England, and will cover the time period 2007 to the present. In addition to A&E data, The Health Foundation has used inpatient and outpatient data at episode level to characterise patients in terms of their demographics, diagnoses, number of previous attendances, and missed appointments. This information has been used within a series of panel data models to investigate how the performance of an A&E department varies with factors related to demand and supply of health care, and the characteristics of patients.”

Health Foundation, ‘Analysis of factors associated with the performance of A&E departments in England’

“Diabetes incidence in older British South Asians and African Caribbeans remains at least two-fold even at age 80 years compared with British Europeans. The ethnic differentials in women were largely explained by midlife truncal obesity and insulin resistance, but the study was unable to explain the ethnic difference in men. The study showed that obesity cut-points of 24 and 27 kg/m2 in South Asians and African Caribbeans respectively were equivalent to a body mass index of 30kg/m2 in Europeans in terms of diabetes risk.”

University College London, Southall And Brent REvisited Study (SABRE)

“The CRIS linkage to Hospital Episode Statistics (HES) has been used to investigate health inequalities at the level of hospitalised disorders, including a recently published demonstration of the high risk of respiratory disease admissions in patients with learning difficulties, as well as longer durations of hospitalisation and higher risk of readmission.”

South London and Maudsley NHS Foundation Trust, Clinical Record Interactive Search (CRIS) platform)

“The trust profiles are publicly available, providing transparency and enabling patient choice. Publishing 90-day post-operative mortality outcomes at individual consultant level provides transparency and enables patient choice.”

Health and Social Care Information Centre

“The re-design of the national back pain pathway has been informed by robust data on the whole population of England using hospital services for back pain. It has been possible to quantify the extent to which treatments are being given which do not comply with best practice (such as NICE guidance) and this information has been used to design new pathways to ensure that appropriate treatments are available.”

Northumberland Tyne and Wear NHS Foundation Trust, NEQOS

“NATCANSAT [National Clinical Analysis and Specialised Applications Team] provides to NHS and DH [Department of Health] organisations a range of analyses associated with service reconfiguration on a local or national basis. Analyses range from calculation of the resources required at a new facility and the potential reduction in activity at those facilities currently providing a service, to assessment of the most appropriate locations for a new national service, including the projected activity at each location.”

The Clatterbridge Cancer Centre NHS Foundation Trust

“The use of HDIS allows DHSC analysts to have a secure access to a remotely hosted software application for the analysis of HES data. This provides the flexibility to access and use data when policy priorities and Secretary of State requests require us to do so. It is a key requirement for analytical capability within the department. We would not be able to support policy profession in their use of evidence and analysis for decision making as effectively if we did not have it.”

Department of Health and Social Care

“The study will inform the Welsh government regarding aspects of social exclusion and the relationship between social exclusion and mortality will be a key part of these findings. Service planning will benefit from more accurate estimates of morbidity and disability, and will allow resources to be targeted where they can be most effective.”

University of Cambridge, Cognitive Function and Ageing Studies (CFAS)

“Improved planning by better understanding patient flows through the healthcare system, thus allowing commissioners to design appropriate pathways to improve patient flow and allowing commissioners to identify priorities and identify plans to address these.”

NHS North East Hampshire and Farnham CCG

“Reports have been used to inform both Commissioning and Provider organisations to support discussions on service need and potential areas for investment/development. This benefits patients by ensuring scarce resources are targeted most effectively and support the decisions on projects which demonstrate the most benefit to patients and the healthcare economy as a whole. It is difficult to quantify the effect of improved analysis in financial terms or on the outcome of decisions, as reports are used to enable informed decision making. This is why there is an insistence on capturing the link between the reports provided and the intended patient/service benefit which will be delivered by use of the information during the project scoping process.”

Nottingham University Hospitals NHS Trust, East Midlands AHSN

“These reports influenced JNC7 Guidelines on the Detection and Treatment of Hypertension in the USA and NICE [National Institute for Health and Care Excellence] guidelines for the management of hypertension and blood lipids in the UK, in addition to the European Society of Cardiology reports on prevention of heart disease (Piepolo 2016) and detection and management of blood lipids (Capetano, 2016) and American Heart Association reports for prevention of heart disease over the last 15 years.”

University of Oxford, Prospective Studies Collaboration meta-analysis

“The pre-inspection data packs/evidence tables help the planning and review stages of an inspection that seeks to highlight areas of poor care requiring improvement while also seeking to promote good practice.

In addition, the data will also be used in the CQC’s remit to investigate serious concerns about the quality of public services. These data will be a vital pillar in both a national system of monitoring registered organisations, and the development and publication of reliable performance indicators.”

Care Quality Commission (CQC) insight products

“Considerable benchmarking work across the North East to look for QIPP [quality, innovation, productivity and prevention] savings, and the ability to drill down into the data sets provided by HES to understand variation at low levels of granularity. However, NECS has noted that even if they managed to bring every CCG down to the level of the best in the North East they would still be outliers nationally, as the North East is a national outlier. To this end, HES allows the CSU [commissioning support unit] to place the North East into context with other sub-regions from across the country, using identical queries, to help to explain some of the limitations of QIPP schemes, but also some of the true opportunities.”

NHS North of England Commissioning Support Unit (NECS)

“The evidence-based clinical indicators derived in the audit are used by maternity units to assess their performance and compare it with others. Information is made publicly available, including key results at both individual maternity unit-level and at regional levels reflecting the various commissioning structures in England.”

Royal College of Obstetricians and Gynaecologists, National Maternity and Perinatal Audit (NMPA)

“Use of HES data has also included a complex piece of modelling work looking at admissions related to drugs and alcohol, and this has informed future commissioning intentions for local drug and alcohol services. As Drug and Alcohol services are Wirral Council’s Public Health Departments biggest area of spend, this is an extremely important area on which to have robust information about the impact drug and alcohol related admissions have locally.”

Wirral Metropolitan Borough Council

“NECS have utilised HES data to inform baseline capacity and demand positions for the acute sector in STPs [sustainability and transformation partnerships] in their footprint. In particular, one of their STPs which is well progressed is utilising HES data to inform a capacity planning model to forecast future demand and produce scenarios for future hospital configuration. This STP includes a CCG that is outwith their traditional CCG footprint, therefore the HES data provides a consistent baseline from which this modelling can be carried out.”

NHS North of England Commissioning Support Unit

“Analysis of HES data is an important element of service evaluations. For example, HES data has been an important data source enabling initiatives aimed at keeping people out of hospital to be evaluated. The analysis of HES data helps to answer the question as to whether hospital admissions/A&E attendances have reduced since a specific initiative (such as falls reduction initiative) was put in place.”

Northumberland Tyne and Wear NHS Foundation Trust

“The Nuffield Trust evaluation will provide an independent assessment of the impact of RVS’s [Royal Voluntary Service] Home from Hospital Scheme. This scheme aims to use volunteers and voluntary sector staff to help support older people’s timely discharge from hospital wards. It is one of a number of similar schemes increasingly being commissioned by local authorities, CCGs and acute trusts in England.”

The Nuffield Trust for Research and Policy Studies in the Health Services

“Using the information reported in the NEQOS Hip and Knee Dashboard, four out of the five subscribing trusts in the North East have reduced the mean length of stay in hospital following elective knee surgery, and two out of the five have reduced the length of stay following hip surgery. In relation to emergency readmissions within 30 days of discharge, three trusts have reduced their readmission rate following knee replacements and four following hip replacements.”

Northumberland Tyne and Wear NHS Foundation Trust

“For all of London, there is now an on-line process that allows each of the 32 CCGs and five STPs to establish the value of introducing of social prescribing within their areas. Likewise for each area of London, the value of introducing 48 digital initiatives has been made available online. Current estimates indicate a circa £800m annual value will accrue in five years time and over £3 billion in ten years time.”

i5 Health

"The main benefits associated with the data requested from NHSD are the ability of the NJR to undertake a broader range and type of analyses, and improved monitoring of clinical, patient, and implant-related outcomes by being able to risk-adjust analyses using additional data."

Northgate Public Health Services (UK) Limited, National Joint Registry (NJR) audit

“The local authority now have a data warehouse containing HES Accident and Emergency and Admitted Patient Care data. The HES data has been decoded using look-up tables and the NHS Data Dictionary. This allows the data to be aggregated by a range of different geographies and by arrange of key demographics in order to understand the health of the local population. The aim is for a timely annual refresh of the data in order to provide responsive local data analysis."

Bracknell Forest Borough Council

“Better management of data. Avoiding the unnecessary processing, movement and management of data – by utilising one existing source, rather than seeking data from multiple organisations for each project, significantly reduces the transmission and processing of data and allows for consistent processing. It also avoids the delay in producing the evidence for service improvement/effectiveness. Standardised, validated data leads to more accurate results enabling comparison between organisations and safe, region-wide aggregation.”

Nottingham University Hospitals NHS Trust, East Midlands AHSN reports

“NEQOS is also using HES to highlight issues with data quality and completeness which may be putting the long-term safety of patients at risk. One area of focus for NEQOS Shoulder Surgery dashboard has been in highlighting low levels of reporting to the National Joint Registry (NJR)."

Northumberland Tyne and Wear NHS Foundation Trust

“Data-driven dashboard – Working with Parkinson’s UK

By building on work undertaken in the previous year, a Parkinson’s data dashboard has been developed to enable individual CCGs to understand their performance in Parkinson’s management. Updating the admission data has shown once more the common reasons for hospital admission in Parkinson’s which has enabled the charity Parkinson’s UK to structure its research agenda around addressing the issues that precipitate admission.”

Wilmington Healthcare

“Alongside the reports and peer-reviewed papers, key outputs will be tools that can be applied locally for looking at changes over time which will be supported by web-based materials. These tools will enable decision makers use their own data to monitor key outcome measures over time to identify, for example, whether new care initiatives are improving outcomes or quickly spot sudden deteriorations so that they can be acted upon in a timely fashion.”

Nuffield Trust for Research and Policy Studies in Health Services, Comprehensive Geriatric Assessment (CGA) evaluation)

“Specific analysis supporting implementation and roll out, such as showing which long-term conditions have the highest burden on the population, will allow teams to refine practical details of implementation of New Models of Care to maximise benefits in terms of quality of care and financial efficiencies.”

Oliver Wyman Limited, Vanguard

“Working with national associations such as the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) and the British Heart Foundation (BHF) the University has, through data reporting, helped increase uptake to rehab services across England."

University of York, National Audit of Cardiac Rehabilitation