Meeting the information needs of clinical

commissioning groups

Ailsa Claire OBE

Transition Programme Lead Patients & Intelligence

NHS Commissioning Board Design Team

“Information, combined with the right support, is the key to better care, better outcomes and reduced

costs.” Equity & Excellence: Liberating the NHS

The vision: Government White Paper

• No decision without me − fundamental change in the relationship with patients

• Health service that is open, transparent responsive

• Clinical evidence − effectiveness

• Safety

• Transforming patient experience

• Outcomes

Context

• Patients access to information to make choices about their care.

• People should be able to share their records with third parties eg, patient support groups, who can help patients manage their condition better.

• Patients increased control over their own care records.

• People should have access to information for self care and self-directed support.

• Patients information on health care to enable them to share in decisions made about their care and available services.

• ‘NHS like the internet for info and access.’

Patient choice and control

• Patient and public voice

• Insight

• Trustworthy open data intelligence

• Consumer choice − channels

• Technology to transform relationships

Intelligence context

• Clinical commissioning

• Based on clinical practice

• Focus on a patient, groups of patients and populations

• Focus on self care, self-directed support

• Care pathways not described in current PbR language

• Procurement, contracting back room functions

The CCG narrative

• Devolved down to practices

• Not real time

• Not connected to individual patient info

• Not connected to finance

• Often inaccurate or incomplete

• Difficult to engage with

• Focus on contract validation

Traditional information

Why do we think it will be different this time?

• Clinical commissioning will fail if things do not change.

• The information revolution’s obligations to patients will not be achieved.

• Unique role of the NHS Commissioning Board.

• Unique role of GP commissioners.

• Information Centre has greater powers.

• New support for commissioning arrangements.

Intelligence requirements of CCGs

• One shared, virtual patient-level care record visible at primary care that supports clinical practice and care pathway-based commissioning

• Data and intelligence aggregated from the care record

• Patients access to their care record

• Risk stratification tools

Intelligence needs of CCGs – continued • Systems should be inter-operable between care settings to

allow commissioners to track patients through a pathway

• Integrated finance and activity data (inc. ‘forward order book’)

• Information must be timely

• Data quality must be improved and be consistent across the country

• National information standards must be set and adhered to.

NHS Commissioning Flows - GPCCPotential Future State

• Commissioning Information• Performance Information

Activity information for:• Annual Planning• Contract Monitoring

Information for:• Patient risk stratification• Benchmarking

Ability to share information across consortium

Information for:• Health Care• Patient Choice• Decision support• Patient empowerment

Secondary data maps to primary care;Captured close to point of care;Ability to track patients

NHS Commissioning

Board

PCT Cluster

GP Consortium / Commissioning

Support Unit

GP / Primary Care

Governance/AccessOther organisations may require access to care records e.g. Information Centre; Social Care; Public Health; Local Authority; Healthwatch; CQC; NICE and Economic Regulator

PatientGreater control over care record:• Access to electronic or otherwise

• Ability to comment/challenge

Denotes : NHS Commissioners/Groups of commissioners

Healthcare ‘Any Willing Provider’

Activity data

• Ambulance• Community• Acute• Mental Health• General

Practice• Other non-

NHS providers e.g. Third Sector, Local Authority etc

Patient level care record

• Single authoritative source of patient level data

• Data captured at point of care

Denotes : Providers

Aggregated Primary Care Information

• A culture of open information, active responsibility and challenge to ensure patient safety is priority.

• To make aggregate data available in a standard format to allow intermediaries to analyse and present it to patients.

Information sharing

• Providers would have clear contractual obligations, with sanctions, in relation to accuracy and timeliness of data.

• Commissioners and providers would have to use agreed technical and data standards to promote compatibility between different systems.

• More information about commissioning of health care will also improve public accountability. Information about services will be published on a commissioner basis where possible.

Commissioning

Government White Paper – Information Revolution

The role of the NHS Commissioning Board • Commissioning for quality improvement:

- making information on commissioner performance available

• Promoting public and patient involvement and choice:

- commissioning information requirements for choice and for accountability, including through patient-reported measures

• NHS CB will need access to robust data to hold providers to account for quality and outcomes

• The NHS CB would be responsible for setting and maintaining national information standards for the NHS

The future

• Intelligence to enable patients carers, public and those who support them to make the best decisions and choices they can.

• Transform patient experience with information and technology.