CHIA Highlight Report June 2018 Recent highlights and planned/ongoing work: Although we currently have no new CHIA requests in progress, we have a number of regular reports being produced for the CCGs and a number of requests currently in the early discussion stages or under development for completion in the next couple of months. The CHIA analysts are working closely with other areas, for example, becoming involved in producing University of Southampton requests due to their analysts no longer working on CHIA. In addition, CHIA analysts are working with other CSU teams to improve the reporting of GP data. Integrated Population Analytics team are using the CHIA analytical expertise to identify GP attendances and the Digital Transformation team are being supported on the development of a diabetes dashboard. It was recently reported in the CHIE newsletter that the Wessex area has been chosen to become one of the Local Health and Care Record Exemplars (LHCRE). This is fantastic news and will no doubt have a positive impact on the analytical side of the data collected and what can be reported. o https://mailchi.mp/115bf4f9eb5f/chie-bulletin-may-2018?e=179075aa0c South, Central and West
Statistics for the last twelve months: Requests by Month, by Analyst Organisation NHS SCW CSU UoS Total Jun-17 5 1 6 Jul-17 5 1 6 Aug-17 2 2 Sep-17 1 1 2 Oct-17 2 2 Nov-17 5 5 Dec-17 2 1 3 Jan-18 3 3 Feb-18 5 5 Mar-18 3 3 Apr-18 5 5 May-18 2 2 Total 40 4 44 Requests by Clinical Area Delivered Under Development On Hold Closed Total Care Plans 2 2 Children 2 1 3 COPD 1 1 Dementia 1 1 Diabetes 1 1 End of Life 2 2 Long-Term Conditions 7 1 8 Mental Health 7 1 8 Older People 1 1 Paediatrics 2 2 Prescribing 1 1 Primary Care 13 13 Renal 1 1 Total 38 3 1 2 44 Requests by Organisation, by Analyst Organisation Requests by Month, by Type of Request NHS SCW CSU UoS Total Hampshire County Council 1 1 North East Hampshire and Farnham CCG 1 1 Portmouth CCG 2 2 Portsmouth CCG 6 6 Portsmouth City Council 1 1 Portsmouth ICS 1 1 Southampton CCG 5 5 University of Southampton 1 4 5 Wessex End of Life Data and epaccs Group 2 2 West Hampshire CCG 20 20 Total 40 4 44 Adhoc Total Jun-17 3 3 6 Jul-17 4 2 6 Aug-17 1 1 2 Sep-17 1 1 2 Oct-17 2 2 Nov-17 2 3 5 Dec-17 1 2 3 Jan-18 3 3 Feb-18 1 4 5 Mar-18 1 2 3 Apr-18 1 4 5 May-18 1 1 2 Total 16 28 44 South, Central and West Page 2
CHIA Requests In Progress (including CHIA internal developments and maintenance): Currently no requests in progress South, Central and West Page 3
CHIA Requests Under Development (includes requests waiting for Data Sharing Agreements): Request Type of Requestor Clinical Received Request (Organisation) Area Month Details of brief May-18 Diabetes Type 1 Adhoc Southampton CCG Long-Term Conditions There are approximately 1200 people within Southampton City with type 1 diabetes. We know from high level summative data that their outcomes are poor. We wish to gather data which will allow us to map their care and outcomes in more detail such that we can make changes to the local care pathway with a view to improving care. In general terms, we wish to know the detailed demographics of this population, to map their outcomes and to understand how they currently access their care. Mar-18 PCC IAPT Pilot Adhoc Portmouth CCG Mental Health The request will evaluate the impact of a pilot which is expanding access to psychological therapies to include patients who also have comorbid long term conditions, by measuring the impact of the pilot on usage of primary care services. Jan-18 Genomic epidemiology of carried and disease-causing pneumococci during pneumococcal conjugate vaccine implementation University of Southampton Prescribing To undertake anonymised record linkage to confirm the vaccination status and recent antibiotic useage of study participants. South, Central and West Page 4
Completed CHIA Requests (last six months, by completed date): Month Completed May-18 May-18 May-18 May-18 Case-Managed Patients within Southampton CCG (V3) Basket of Procedures (Y2) Leg Ulcers & Complex Wounds Service IPC Children's Personal Budget Pilot Evaluation (Phase 2 data) Type of Requestor Request (Organisation) Clinical Area Details of brief Southampton Care Plans Patient activity for Southampton CCG where a patient has been recorded as being casemanaged CCG or having a care plan in place, over the last year. The same data will be required on a quarterly basis, once each quarter s data becomes available. West Primary Care Breakdown of activity by specific Read Code for the following procedures conducted within Hampshire CCG Primary Care for WHCCG. Post-operative wound management Doppler Assessments 24hr Blood Pressure Monitoring Spirometry West Primary Care Breakdown of activity by specific Read Code for the following procedures conducted within Hampshire CCG Primary Care for WHCCG. First Appointment: Leg Ulcer First Appointment: Chronic Venous Leg Ulcer First Appointment: Complex Wounds Follow up Appointment: Leg Ulcer Follow up Appointment: Chronic Venous Leg Ulcer Follow up Appointment: Complex Wounds Portmouth CCG Children Refresh of previously requested data. To discover the impact on usage of the wider NHS (if any) of the provision of a personal budget facility to 5 children with complex health and social care needs. South, Central and West Page 5
Month Type of Requestor Completed Request (Organisation) May-18 HCC Falls Adhoc Hampshire County Council Apr-18 WH Parity of West Esteem Hampshire CCG Apr-18 Basket of West Procedures Hampshire CCG () Apr-18 Portsmouth Portsmouth Signposting CCG Project Apr-18 Future Wessex End of Planning Life Data and Project - year 2 epaccs Group Clinical Area Details of brief Older People To understand the extent to which falls are recorded in primary care data: - Numbers of individuals experiencing a fall in 2016/17 for those aged 65 and over in Hampshire, by age bands, sex, district (identified by patient residence postcode). - Number of frequent fallers in 2016/17 for those aged 65 and over in Hampshire, by age bands, sex, district (frequent fallers are those who have fallen 3 or more times within a month). - Whether any referrals any falls prevention services were made as a result. Mental Quarterly Update of Dashboard of LTC/MH measures Health Primary Care Breakdown of activity by specific Read Code for the following procedures conducted within Primary Care for WHCCG. Leg Ulcer treatment(s) Post-operative wound management Doppler Assessments 24hr Blood Pressure Monitoring Spirometry Long-Term Evaluation of Signposting project Conditions End of Life The reports requested will provide a record of the codes available in GPs systems that can be uploaded to the Summary Care Record. (The ECR Reports of codes uploading to the SCR from particular practices, CCGs or areas are not available from the National SCR team.) The XaX6Z (CTV3) and 9Ndn (READ2) codes if present in individual patient records will also indicate that FT template codes have transferred to the Summary Care Record. South, Central and West Page 6
Month Completed Type of Request Requestor (Organisation) Clinical Area Details of brief Reports will be forwarded to CCG End of Life and Frailty leads so that they can monitor the uptake of the Future Planning Templates. If uptake is poor or slow then the reports will provide the evidence upon which to base incentive schemes for April 2017 onwards. Apr-18 Ring Pessary West Primary Care To identify the activity that was performed in in 2016/17, 2017/18 and ongoing monitoring of Update Hampshire CCG provision in 2018/19 for in GP practice for Ring Pessary procedures, based upon specific Read Codes. These include codes for the Insertion of Ring Pessaries and the Removal of these devices too. This investigation into ring pessary activity across primary care is to ensure that the provision developed via a local commissioned service is equitable across West Hampshire. Apr-18 UoS Adhoc University of COPD We request data from HHRA to support an MSc project examining GP referral patterns for Pulmonary Southampton patients with Chronic Obstructive Pulmonary Disease (COPD) to pulmonary rehabilitation (PR) rehabilitation in Hampshire. We request data indicative of COPD severity (MRC score, spirometry etc.), and referrals other demographic factors and biomarkers that may in other ways influence a PR referral. We also request an anonymised GP practice identifier to allow for comparisons within and between different GP practices. Mar-18 Child Health North East Children The Children s STP programme has requested a quarterly dashboard to be developed that will Urgent Hampshire and include data from a number of data sources, including data from CHIA. Two of the dashboard Dashboard Farnham CCG items will be taken from the GP practice data: 1. Number of GP consultations 2. Number of Antibiotic prescriptions South, Central and West Page 7
Month Completed Feb-18 Basket of Procedures () Feb-18 Ring Pessary Update Feb-18 WH Leg Ulcer and Doppler by GP Practice Jan-18 WH Parity of Esteem Jan-18 Case-Managed Patients within Southampton CCG (V3) Jan-18 IPC PHB Pilot - Part 2 Type of Request Adhoc Adhoc Requestor (Organisation) Clinical Area Details of brief West Primary Care Breakdown of activity by specific Read Code for the following procedures conducted within Hampshire CCG Primary Care for WHCCG. Leg Ulcer treatment(s) Post-operative wound management Doppler Assessments 24hr Blood Pressure Monitoring Spirometry West Primary Care To identify the activity that was performed in in 2016/17, 2017/18 and ongoing monitoring of Hampshire CCG provision in 2018/19 for in GP practice for Ring Pessary procedures, based upon specific Read Codes. These include codes for the Insertion of Ring Pessaries and the Removal of these devices too. This investigation into ring pessary activity across primary care is to ensure that the provision developed via a local commissioned service is equitable across West Hampshire. West Primary Care To identify the number of doppler assessments and leg ulcer interventions/ treatments for Hampshire CCG individual practices across West Hampshire CCG. Split by patients over and under 65 years old. West Mental Quarterly Update of Dashboard of LTC/MH measures Hampshire CCG Health Southampton Care Plans Patient activity for Southampton CCG where a patient has been recorded as being casemanaged CCG or having a care plan in place, over the last year. The same data will be required on a quarterly basis, once each quarter s data becomes available. Portsmouth ICS Long-Term To discover the impact on usage of the wider NHS (if any) of the provision of a personal Conditions budget facility to 5 children (with explicit consent) with complex health and social care needs. South, Central and West Page 8
Month Completed Type of Request Requestor (Organisation) Clinical Area Details of brief Dec-17 Basket of West Primary Care Breakdown of activity by specific Read Code for the following procedures conducted within Procedures Hampshire CCG Primary Care for WHCCG. () Leg Ulcer treatment(s) Post-operative wound management Doppler Assessments 24hr Blood Pressure Monitoring Spirometry Dec-17 Living Well/IPC Portsmouth Long-Term The information required is data regarding patients who are part of the cohort for year 1 of evaluation CCG Conditions the Integrated Personal Commissioning project. These patients have been identified using the ACG tool by GPs and referred to the Portsmouth Living Well Project managed by Age UK. The cohort is continuing to be added to on a monthly basis as referrals are being sent by GPs, therefore we would like to be able to monitor this change on a monthly basis and to monitor the their use of Primary, Secondary, Community and Mental Health Services until August 2016 in order to refine the finance model. Dec-17 Future Wessex End of End of Life The reports requested will provide a record of the codes available in GPs systems that can be Planning Life Data and uploaded to the Summary Care Record. (The ECR Reports of codes uploading to the SCR from Project - year 2 epaccs Group particular practices, CCGs or areas are not available from the National SCR team.) The XaX6Z (CTV3) and 9Ndn (READ2) codes if present in individual patient records will also indicate that FT template codes have transferred to the Summary Care Record. Reports will be forwarded to CCG End of Life and Frailty leads so that they can monitor the uptake of the Future Planning Templates. If uptake is poor or slow then the reports will provide the evidence upon which to base incentive schemes for April 2017 onwards. South, Central and West Page 9
Month Completed Type of Request Requestor (Organisation) Clinical Area Details of brief Dec-17 WH Liver Adhoc West Long-Term West Hampshire CCG commissioners are requesting a combination of key data indicators that Disease Hampshire CCG Conditions relate to liver disease including non-alcohol related fatty liver disease, alcohol related liver disease and viral hepatitis. This project proposes the development and investment in a community fibroscan clinic which aims to identify patients earlier who are high risk/medium risk/ at risk in the future of developing liver disease. Dec-17 Ring Pessary West Primary Care To identify the activity that was performed in in 2016/17, 2017/18 and ongoing monitoring of Update Hampshire CCG provision in 2018/19 for in GP practice for Ring Pessary procedures, based upon specific Read Codes. These include codes for the Insertion of Ring Pessaries and the Removal of these devices too. This investigation into ring pessary activity across primary care is to ensure that the provision developed via a local commissioned service is equitable across West Hampshire. South, Central and West Page 10
Approved CHIA Publications (last 6 months): Id Publication Request Type Title Audience Request Date 12568 UoS - Presentation - AKI Study 12700 UoS - Abstract - COPD & AFO 12982 UoS - Abstract - Identifying Consultations in Primary Care 13121 UoS - Presentation - Data for Epidemiological Research 13360 UoS - Presentation - COPD & AFO 13589 UoS - Abstract - Dementia in Wessex Presentation Characterising acute kidney injury using a linked clinical database Wessex CLAHRC Away Day 31st Jan 2018 21/12/2017 Abstract COPD Diagnosis in Primary Care: A UK Attendees at IPCRG 12/01/2018 Observational Database Study Comparing conference, May 2018, Patients With and Without Confirmed Airflow Porto, Portugal. Obstruction Publication in conference abstract book. Abstract A Data-Driven Approach to Identifying ADRN Conference 2018 21/02/2018 Patient/Clinician Consultations in Primary Care Presentation Using routine data for epidemiological research ACB Southern Region 15/03/2018 possibilities, practicalities and pitfalls Spring Meeting Presentation COPD Diagnosis in Primary Care: A UK Attendees at IPCRG 18/04/2018 Observational Database Study Comparing conference, May 2018, Patients With and Without Confirmed Airflow Porto, Portugal. Obstruction Publication in conference abstract book. Abstract Modelling the Future of Dementia Care in Wessex PhD Thesis public via the 22/05/2018 thesis depository South, Central and West Page 11