Part of Acute Data Alignment Programme (ADAPt) - Piloting private healthcare data in NHS Digital
Executive summary
Purpose
The Acute Data Alignment Programme (ADAPt) is a programme intended to establish the feasibility of flowing private healthcare Admitted Patient Care (APC) data via NHS Digital.
Findings
Three piloting activities have established that a number of customer use cases can be met via an NHS Digital collection of APC data from private healthcare providers and that it is feasible for private providers to submit data directly to NHS Digital.
It has also been established that the Private Healthcare Information Network (PHIN) could meet its statutory duties via a feed of data from NHS Digital (rather than by receiving data directly from private providers as at present).
Pilot 1
Pilot 1 successfully tested use cases for combining NHS and private data via feed of private data from PHIN to NHS Digital.
Pilot 2
Pilot 2 aimed to test flowing private healthcare data as currently submitted by NHS Private Patient Units (PPUs) to NHS Digital to PHIN via a Secondary Uses Services (SUS) extract requested via the Data Access Request Service (DARS). Coronavirus (COVID-19) related pressure on the DARS service has delayed this work, however with successful completion of pilot 1 and pilot 3 no significant variation is expected.
Pilot 3
Pilot 3 successfully tested collecting data from independent healthcare providers via NHS Digital’s SUS and then supplying that data to PHIN.
Recommendations
1. The Programme should now seek to acquire senior sponsorship from both NHS England and the Department of Health and Social Care (DHSC).
2. DHSC should issue a Direction to NHS Digital to require the collection of all private Admitted Patient Care and Outpatient data.
3. The Direction in respect of the collection of private Admitted Patient Care and Outpatient data should take effect from 1 April 2024.
4. The sharing of private Admitted Patient Care data between NHS Digital and PHIN should continue on an interim basis until at least 31 March 2024.
5. The legal basis for this interim processing should be defined in collaboration with independent healthcare providers.
6. Private healthcare providers should begin to collect NHS Number, date of birth, postcode and gender1 as soon as practicable.
7. NHS organisations should continue to make secondary submissions of their private activity data to PHIN pending a data sharing agreement between PHIN and NHS Digital.
8. NHS Digital and PHIN should continue to work closely together to ensure consistency of approach with regard to issues such as data specifications, data linkage and case mix adjustment.
1Currently 'person stated gender' is used in datasets more often than 'person phenotypic sex'.
Next steps
The next steps further to acceptance of this report should be:
- engagement with the private provider sector re plans for adoption
- public consultation on the plan for NHS Digital to hold, link and analyse private healthcare data
Background
The ADAPt programme was initiated at a meeting between the Secretary of State for Health and Social Care and representatives from NHS Digital and PHIN on 9 January 2018. This took place in the light of the conviction in April 2017 of breast surgeon Ian Paterson for harming his patients. He practiced at the Heart of England Foundation Trust and Spire Healthcare.
The Secretary of State asked NHS Digital to work with PHIN to ensure that private healthcare data could be properly captured and analysed within NHS systems. PHIN is appointed as the Information Organisation under the 2014 Competition and Markets Authority’s (CMA) Private Healthcare Market Investigation Order 2014 (as amended in 2017) and therefore has legal powers to collect and process data. It is an independent non-profit organisation that publishes performance data on private consultants and hospitals.
PHIN is funded via a CMA-developed model under which private providers are required to pay it a small fee in respect of every patient treated.
A public consultation ran from 19 February 2020 to 22 May 2020, seeking feedback on proposals to change the way in which private healthcare data is collected, processed, reported and disseminated. Thirty responses were received including from private providers, PPUs, national bodies, professional bodies, consultants and representative organisations. The vision for a standardised single source of healthcare information, with common standards across the two sectors, was widely endorsed.
The ADAPt programme has been running since May 2020 with an initial phase of co-operation seeking system alignment for the direction of change and ensuring readiness for the next phases. This report marks the conclusion of the second phase (piloting).
Last edited: 30 November 2022 9:50 am