Emergency Care Data Set Conformance Indicators

Due to increasing demand for emergency care, we need to better understand how and why people attend Emergency Departments (ED).

In December 2014 the Royal College of Emergency Medicine, Department of Health, NHS England, NHS Digital (previously the Health and Social Care Information Centre), Public Health England, NHS Improvement (previously Monitor), NHS Providers and other parties came together to deliver a collaborative project to develop and implement a new data set for the capture of emergency department activity information across England; the Emergency Care Data Set (ECDS).

ECDS is particularly important in understanding how and why people access urgent and emergency care. To help improve our planning to reduce pressure in the system, the aim is to:

• improve patient care through better and more consistent information;
• allow better planning of healthcare services; and 
• improve communication between health professionals

ECDS is better equipped to keep pace with the increasing complexity of delivering emergency care than its predecessor. This means that the improved quality of data collected in emergency departments provides better support to healthcare planning and better informed decision making on improvements to services. This improved data helps the understanding of

• the complexity and acuity of attending patients;
• the causes of rising demand
• the value added by emergency departments

ECDS also allows

• the capture of better diagnostic data to ensure an enhanced understanding of need, activity and outcomes;
• consistent monitoring of data across local and national initiatives
• support for injury surveillance, such that it will be possible to identify patterns that may be amenable to targeted interventions and improved public health

Which in turn informs more effective and efficient resource management.

ECDS was approved as an Information Standard on the 19 April 2017 and was subsequently updated on 07 November 2018.

Following publication of the ECDS as a Standard, the project has now transitioned to business as usual and is managed by NHS England and Improvement.

Every acute trust in England has deployed ECDS, however there are residual issues around data quality, frequency and timeliness of data submission. This impacts on the ability to fully utilise the data set to its full potential and to replace the majority of the daily Sitrep and all the monthly aggregate data collection.

The aim for ECDS in the NHS Long Term Plan is to record 100% of patient activity in EDs, UTCs and SDEC via ECDS by March 2020, this deadline has been impacted by the COVID19 pandemic and new deadlines set.

The overall aim for ECDS to become the single source of ED data from 1 April 2021, replacing the majority of the daily Sitrep and all the monthly aggregate data collection.

To enable this aim to be achieved, we need to ensure that

1. data is flowing daily from all type 1 and type 2 EDs

2. ensure data is flowing daily from each type 3 (UTC)

4. introduce new data items (ECDS ISN v3 09 September 2020)

a. ready to proceed

b. NEWS2 and CFS

c. 111 booking into UTC time

4.. Enable trusts to submit new data items

5. Ensure new data items flow from all providers.

To support this aim, there are a number of task and finish groups within the ECDS workstream which are:

• supporting early movers and Clinical Review of Standards (CRS) pilot sites to comply with ECDS v3 from as early as November 2020
• developing a regional framework to enable local teams to build BI dashboards, and local reports to drive clinical and operational efficiencies using ECDS
• national communications strategy to promote ECDS across Urgent and Emergency Care (UEC)
• monthly publishing of ECDS data 
• ongoing development of the data set to ensure it keeps up with the pace of ED demands

In readiness for the aggregate ED data to cease and ECDS to be the single source of data, all acute providers need to be flowing data on a daily basis and completing all data fields in ECDS that are currently reported in the daily SitRep.

A key set of indicators have been developed which will enable the national team to monitor conformance, analyse the data and assess for readiness. This will be a significant burden reduction on providers submitting daily ED data for the daily SitRep and will be reported on a monthly basis.

In a high-functioning health system, data is collected at the point of care, which means that the data items submitted should not require validation or updating following initial submission.

We are looking at ways to capture a data item that will summarise the change of healthcare data between the initial and final data submission.

Expectation is that the final ECDS data must be submitted within 24 hours of the first data submission.

This would then measure the amount of change between the first ECDS data submission and the final data submission of the headline data quality data items listed above.

This will not be collected in the short term.

Aiming to incorporate this in ECDS v4 by April 2022.