UEC data TEM dashboards user guide

This document is intended as a guide for users of all the dashboards in the TEM suite of dashboards. 

There are 3 dashboards in the suite:

• NHS 111 provider dashboard
• commissioner dashboard
• streaming and redirection dashboard

Version 1.0

Initial publication of guidance - 8 December 2022

UEC data dashboards are free to all organisations working within or alongside NHS Urgent and Emergency Care services, and all future new releases are also free.

UEC data dashboards involve no burden from user organisations, as the required data flows seamlessly from the various sources into the dashboards.

The dashboards are being continuously improved, and new features are being added as a result of research with stakeholders.

Once you have been given access by the UEC data team you are free to use the dashboard without any need for a licence or payment. However, please ensure that you have read and agreed to the end user agreement before using the dashboard.

The data in the dashboard is a combination of NHS 111 telephony triage cases, hospital admissions, and attendances at emergency care settings.

For the streaming and redirection dashboard, it also includes streaming and redirection cases. 

The data from these sources is linked together using patient NHS numbers, into the linked data asset, which is maintained by the UEC data team.

4.1 NHS 111 telephony data

NHS 111 telephony triage data comes directly from Pathways IDT (Intelligent Data Tool), populated by 111 and 999 service providers. IDT provides business intelligence and data visualization of NHS Pathways data.

111 Online data is not included in the dashboards, as the 111 Online system does not store patient NHS numbers, so it can not be linked to the other data sources. In addition, the UEC data team have not been given permission to use this data, as it has separate disclosure and confidentiality rules.

4.2 Streaming and redirection case data

The data comes directly from Pathways IDT (Intelligent Data Tool), which is populated by services using the S&R triage product. IDT provides business intelligence and data visualization of NHS Pathways data.

4.3 Hospital admissions data

This data comes from the Hospital Episode Statistics (HES) data warehouse. Find out more about HES.

4.4 ETC attendance data

This data comes from the Emergency Care Data Set (ECDS) national data set. Find out more about ECDS.

4.5 Basis of permission to use data

HES provides data for the purpose of healthcare analysis to organisations such as national bodies and regulators, DHSC, NHS England and Improvement, the Care Quality Commission, ICSs, service providers, NICE, patients, service users and carers, and the media.

ECDS is the national data set for urgent and emergency care. It collects information about why people attend emergency departments and the treatment they receive to:

• improve patient care
• allow better planning of healthcare services
• improve communication between health professionals

We have permission for this data to be included in the Linked Data Asset, as the dashboards help stakeholders to fulfil these functions.

4.6 Suppression and rounding of data

Suppression and rounding have been applied to the data in this dashboard, compliant with NHS Digital disclosure control guidance. This ensures that no identifiable patient data or record-level information is presented in the dashboards.

Read the HES analysis guide to see the rules for HES and therefore for all the data that is in the dashboards.

4.7 Data refresh and update cycles

The data in the dashboard is updated every two weeks, as new Pathways data becomes available according to this cycle.

However, as the HES and ECDS data is only published by the NHS once a month, this data is refreshed once a month.

Hospital Episode Statistics (HES) and Emergency Care Data Set (ECDS) are published monthly, on the 2nd Thursday of each month, and include only the data for the month two months previously. So in March we receive the data for January, in April we receive the data for February, and so on.

Because we link secondary care outcomes to Pathways events which occur up to 7 days before or afterwards, we then must wait for the next Pathways data refresh, in case a linked event occurred.  So the earliest that we can display all data for the month of January, is April.

See the diagram below for a visual representation. 

4.8 Reporting period for ED attendance

After consulting with stakeholders, it was decided and agreed that 48 hours was a reasonable maximum time to allow, to make the assumption that the attendance is linked to the preceding call to NHS 111. 

There are many reasons why a patient may attend up to 48 hours after calling 111, and these were taken into account to avoid bias in the dashboard dataset. For example:

In addition, not all ETC services are emergency services (see appendix A).

4.9 Reporting period for hospital admission

Hospital admission data in the HES data source does not provide a timestamped admission, only a date of admission. This means that in order to capture all admissions that occurred in the 48 hours following a call to 111, it is necessary to extend this to 3 days. 

4.10 Definition of age groups

Age groups are defined as:

• infant and neonate – up to 12 months
• toddler – between 1 and 4 years
• child – between 5 and 15 years
• adult – 16 years and up

5.1 Dates

Data updated – when this dashboard was published and the data in it refreshed from the ‘linked data asset’.

Last data refresh date – the last time that the linkage to link Pathways triage data (NHS 111 and Streaming and Redirection cases), HES data, and ECDS date together was run.

Secondary care linkage date - The most recent publication date for the secondary care data (HES data and ECDS data) by NHS Digital.

5.2 NHS number coverage

There are several scenarios which mean that a patient’s NHS number cannot be determined. An NHS number is retrieved when the patient’s demographics are entered in the Tool and a successful match is made to the Personal Demographics Service (PDS) database on the Spine.

However, no attempt is made to collect demographics from the patient or find a match if the patient:

• is a child under 5, or has difficulty interacting with the device
• the patient has self-reported symptoms of coronavirus (COVID-19)

In addition, the ‘Cases without NHS Number’ also includes scenarios where a search for the number was made, but was unsuccessful because the details entered didn’t match precisely with any personal details on the (PDS) database. Find out more about the PDS.

This may be because, for example, the name is spelt differently, the date of birth doesn’t match that held on PDS, or the patient has moved and not informed their GP practice of the move. It may also be because the patient does not have an NHS number; foreign students, foreign workers, and refugees are examples.

Streaming and redirection tool - cases with and without NHS number

5.3 Access to S&R sites

Any sites which the user has been given permission to view are presented in a drop-down list. Users may select from this list. Note that this list may comprise only one entry, and in this case no choice can be made.

5.4 Disposition Group definition

Streamer – Telephony Links page

Amb (Ambulance) group

This includes all disposition codes which include the word ‘ambulance’, other than a few validation codes such as ‘refused ambulance’ and ‘ambulance validation’. It also includes a few other codes such as ‘transport to an ETC within 1 hour’.

This group also includes the disposition codes given for emergency conditions which indicate that the patient needs urgent clinical assessment, and require the patient to go straight to the reception desk rather than complete the triage.

ETC (Emergency Treatment Centre) group

This includes disposition codes which mention a referral to a Treatment Centre, (including Emergency Departments), SDEC, a Dental Treatment Centre, or a Mental Health/Crisis Service. It also includes patients with a booked arrival time, referred by a HCP, or discharged from hospital within the last 3 days. Also included are patients ‘not age appropriate for self-triage’.

PC-E/U and PC-R (Primary Care) groups

These groups include all ‘speak to’ and ‘contact’ a Primary Care Service codes, as well as codes indicating a further assessment by a Primary Care service. The codes are further categorized as either ‘Primary Care Emergency/Urgent’ (less than 2 hours) or ‘Primary Care Routine’.

TelTrg (Telephone Triage) group

This group includes:

• revalidation/assessment/callback by a clinician 
• COVID CAS

OthRef (Other - referred) group

This group includes:

• repeat prescription
• speak to or contact dental, midwife, orthodontist, pharmacist, community HCP
• refer to child protection, other agency or service
• see also appendix C

OthNR (Other - not referred) group

This group includes all disposition codes not included in one of the other groups, including:

• self care, home management, no action, call terminated
• refer to social services
• contact optician (routine appointment)
• see also appendix C

Streamer - DoS page

Immediate assessment group

This group includes the disposition codes given for emergency conditions which indicate that the patient needs urgent clinical assessment.

Ambulance group

This includes all disposition codes which include the word ‘ambulance’, other than a few validation codes such as ‘refused ambulance’ and ‘ambulance validation’. It also includes a few other codes such as ‘transport to an ETC within 1 hour’.

ETC (Emergency Treatment Centre) group

This includes disposition codes which mention a referral to a Treatment Centre (including Emergency Departments), SDEC, a Dental Treatment Centre, or a Mental Health/Crisis Service. It also includes patients with a booked arrival time, referred by a HCP, and discharged within the last 3 days. Also included are patients ‘not age appropriate for self-triage’.

Primary care group

This includes all ‘speak to’ and ‘contact’ a Primary Care Service Dx codes, as well as codes indicating a further assessment by a Primary Care service.

Other group

This group includes all disposition codes not included in one of the other groups, including: 

• COVID CAS
• self care, home management, no action, call terminated
• speak to or contact Optician, Dental, Midwife, Orthodontist, Pharmacist, Community HCP
• revalidation/assessment/callback by a clinician
• repeat prescription, medication enquiry
• refer to social services, child protection, other agency or service

6.1 Dates

Data updated – when this dashboard was published and the data in it refreshed from the ‘linked data asset’

Date range – something here when this is fixed

6.2 Access to NHS 111 provider sites

Any provider sites which the user has been given permission to view are presented in a scrollable list. Users may select from this list. Note that this list may comprise only one entry, and in this case no choice can be made.

6.3 Disposition Group definition

Ambulance group

This includes all disposition codes which include the word ‘ambulance’, other than a few validation codes such as ‘refused ambulance’ and ‘ambulance validation’. It also includes a few other codes such as ‘assistance needed – unable to get off the floor’ and ‘transport to an ETC within 1 hour’.

ETC (Emergency Treatment Centre) group

This includes disposition codes which mention a referral to a Treatment Centre (including Emergency Departments), SDEC, a Dental Treatment Centre, or a Mental Health/Crisis Service. See Appendix A for a definition of the types of ETCs.

Primary care group

This includes all ‘speak to’ and ‘contact’ a primary care service codes, as well as codes indicating a further assessment by a Primary care service.

Other group

This group includes all disposition codes not included in one of the other groups, including: 

• COVID CAS
• self care, home management, no action, call terminated
• speak to or contact optician, dental, midwife, orthodontist, pharmacist, community HCP
• revalidation/assessment/callback by a clinician
• repeat prescription, medication enquiry
• refer to social services, child protection, other agency or service

See appendix C for more details.

7.1 Dates

Data updated – when this dashboard was published and the data in it refreshed from the ‘linked data asset’.

Date range – the range of dates for which data is available in the dashboard.

7.2 Access to ICBs

Any ICBs which the user has been given permission to view are presented in a scrollable list. Users may select from this list. Note that this list may comprise only one entry, and in this case no choice can be made.

7.3 Disposition group definition

Ambulance group

This includes all disposition codes which include the word ‘ambulance’, other than a few validation codes such as ‘refused ambulance’ and ‘ambulance validation’. It also includes a few other codes such as ‘assistance needed – unable to get off the floor’ and ‘transport to an ETC within 1 hour’.

ETC (Emergency Treatment Centre) group

This includes disposition codes which mention a referral to a treatment centre (including emergency departments), SDEC, a dental treatment centre, or a mental health/crisis service. See appendix A for a definition of the types of ETCs.

Primary care group

This includes all ‘speak to’ and ‘contact’ a Primary Care Service codes, as well as codes indicating a further assessment by a primary care service.

Other group

This group includes all disposition codes not included in one of the other groups, including: 

• COVID CAS
• self care, home management, no action, call terminated
• speak to or contact optician, dental, midwife, orthodontist, pharmacist, community HCP
• revalidation/assessment/callback by a clinician
• repeat prescription, medication enquiry
• refer to social services, child protection, other agency or service

See appendix C for more details.

7.4 Disposition and top 5 symptom groups

The filters at the bottom right of the screen can be used to select a cohort of patients in order to see the top 5 symptom groups for that cohort.

7.5 Emergency treatment centre disposition

The chart on the left shows the top 5 DoS services selected, for the final disposition code selected from the bar in the centre of the page.

The orange diamonds represent the percentage of patients who were directed to use that service and who subsequently attended at an ED within 48 hours.

The chart on the right shows the top 5 symptom groups, for the final disposition code selected from the bar in the centre of the page.

The orange diamonds represent the percentage of patients who were given that symptom group and who subsequently attended at an ED within 48 hours.

‘Other’ dispositions fall into 2 types, referred and not referred. These are the main reasons in each category, although this is not an exhaustive list.