SUS+ essentials Secondary Uses Service user guide

This guidance provides a reference point for new and existing Secondary Uses Service (SUS) users. It introduces general concepts, provides an overview of the submission process and provides details on extracting data from SUS. It also highlights best practice and includes information on data quality, logging system issues and where to find out more about SUS guidance. Users are encouraged to familiarise themselves with all SUS guidance materials for assistance in specific areas, including SUS Payment by Results guidance.

Providers of NHS-funded healthcare in England are required to send Commissioning Data Set (CDS) patient activity data to SUS to support: 

• commissioning
• healthcare development
• improving NHS resource efficiency

SUS processes on average 5 million incoming records and 30 million outgoing records every day. It is therefore important for users to apply the recommendations in this guide to help ensure the provision of consistent and reliable data

It is critical that high quality information for management and clinical decision making continues to be provided for the NHS to keep improving the quality and safety of its services. High quality data is not an ‘option’. It is a fundamental basis for the business of each organisation. It should always be considered at the centre of any future developments for any organisations providing NHS-funded care and should be constantly under review.

The Department of Health mandates the collection and submission of all NHS commissioned activity (Acute and Mental Health), including services provided for the NHS by the Independent Sector. This represents a wide range of organisations of varying sizes.

SUS is managed and developed by NHS Digital. It receives, processes and reports information for purposes other than direct clinical care, hence the title “secondary uses”. Activity data in SUS is submitted using patient-based Commissioning Data Sets (CDS).

Overview of the SUS Data Warehouse

SUS was originally introduced in order to provide a single consistent and authoritative system to process data flows and replace the historical NHS wide clearing service (NWCS). It was then identified as an enabler to support the Department of Health Payment by Results (PbR) national tariff policy initiative. SUS continues to be developed to support the ongoing functionality of national tariff policy by NHS England and NHS Improvement

Since April 2012, the use of SUS has been mandated in the NHS Operating Framework for performance monitoring, contract reconciliation and payment.

The NHS Standard Contract requires that all NHS-funded care activity is reported to SUS using Commissioning Data Sets (CDS)

SUS has been designed to support government objectives and reduce the use of Person Confidential Data (PCD) for purposes other than direct patient care. SUS has significantly improved the security and confidentiality of data management through a combination of:

• comprehensive access controls
• anonymisation and pseudonymisation of data to replace information that could be used to identify individuals 
• enabling the linkage of data from different sources relating to the same care pathway

Providers of NHS care should regularly review data collected on local systems and ensure that all CDS data is submitted to SUS.