Emergency Care Data Set (ECDS) Healthcare Provider Show and Tell, 28 March 2017 Aaron Haile, ECDS engagement lead (Royal College of Emergency Medicine) Peter Sherratt, ECDS implementation lead (NHS Digital) Stuart Blake, Head of Information Utilisation (NHS Digital) Version: v2.1 The ECDS project is a collaborative project between the Department of Health, the Royal College of Emergency Medicine, NHS England, NHS Digital, NHS Improvement, NHS Providers and Public Health England. This document has been produced on behalf of the ECDS Project Board in collaboration with the organisations listed above.

Before we start Next webinar focused on Providers is 25th April @ 2pm. We’ve enabled “PC audio” so you can listen on your PC speakers as well as phone We are recording the webinar for the benefit of others The previous webinar links are available through the transcript document We’ll be going through some things in more detail on this call The benefits of timely and more frequent data The CQUIN scheme Most people will be muted – please send your comments and questions via the WebEx chat function We’ll be running a simple poll towards the end We’ll share the following after the meeting: The slides The links to the recordings The transcript of the QA session along with written answers Next webinar focused on Providers is 25th April @ 2pm. Send your comments to : ECDS@nhs.net

Quick progress update The SCCI process is on track for ISN publication – mid-April 2017 The XSD file has now been assured and will be published this week We will release ECDS spec v6.3 as the final version of the data set spec this week

Information and technology for better care NHS Digital strategy 2015-2020 Vision Statement By 2020, we will have revolutionised the way technology, data and information are used to transform the delivery of England’s health and social care services. Our priorities Ensure that every citizen’s data is protected Assure the quality, safety and security of data and information flows across health and social care. Citizens will share their data with confidence knowing that it will be kept confidential and shared only when appropriate and for their benefit. Establish shared architecture and standards for the benefit of everyone Implement services to meet national and local needs Support organisations to get the best from technology, data and information Make better use of health and care information NHS Digital strategy.

Moving from historic reporting to operational and strategic analyses moving from current bottom left to top right

Faster data - principles We will seek to reduce our turnaround times, aggregating and producing data faster and more frequently We will seek to reduce the number of aggregate returns (e.g., QMAE) that providers will be asked to submit; the emphasis will be on record-level data The higher-frequency data will be used for operational management purposes: providers will still have time to code the data and sign it off for financial purposes We will rationalise data requests across CQC, NHSI, NHSE & NHSD, to reduce overlap One of CQC’s top 4 priorities one is to be an intelligence-led organisation – this needs greater frequency data.

What this means for Providers Requirement to flow data at greater frequency Requirement to improve Data Quality in underlying systems, as opposed to separate data cleansing processes Integration and rationalisation of systems and data flows, to enable higher frequency and faster turnaround

Interactivity We will make the data available to Providers in a more interactive form (example above), and also data-driven, generating alerts when certain thresholds are reached.

Overview Rationalisation: fewer datasets, as we rationalise across CQC NHSI, NHSE, NHS Digital Methodology: improving what we do with the data, applying better methods Timeliness: monthly data monthly to weekly data weekly, or daily data daily Depth: as trusts deploy EPRs, the datasets include prescribing data, observation data, clinical risk assessment, laboratory data Burden: reduced as more data flows automatically at record-level

The ECDS part of the 2017-19 CQUIN Intro Incentivisation for the ECDS is provided by the 2017/2019 CQUIN scheme (see target 8a). High level overview The CQUIN calculator Principles and Things to note CQUIN Part 1 (Q1 17/18) (demonstrable & credible plans) CQUIN Part 2 (Q3 17/18) Worked example for CQUIN Part 2 (Q3 17/18) CQUIN Parts 3 – 6 (Q1 18/19 to Q4 18/19) Achieving high quality data

The ECDS part of the 2017-19 CQUIN High level overview Part 1: Q1 17/18 – Providers submit demonstrable and credible planning for a 1 October 2017 Go-live. Parts 2-6: Q3 17/18 to Q4 18/19 – Providers are assessed on data quality and submission frequency in incrementally more challenging ways. Reports will be generated from the SUS+ system which will provide reliable metrics to both providers and commissioners. We can only issue guidance and advice to commissioners on how to administer the scheme.

The ECDS part of the 2017-19 CQUIN The CQUIN Calculator This is provided without warranty, feel free to get your CQUIN team to check it.

The ECDS part of the 2017-19 CQUIN Principles and things to note No “cliff edge” Data quality is more important than submission frequency – weightings reflect this The CQUIN is based on sites being live on 1 October 2017. However, the main focus of reward is for December 2017 (start of winter pressures) A report(s) will be made available in SUS+ to enable monitoring against this recommended approach General data quality – all items are important Specific item data quality – later SUS downtime etc. Arbitration / dispute resolution Reports should be run about a week after the end of the quarter

The ECDS part of the 2017-19 CQUIN CQUIN Part 1 (Q1 17/18) (demonstrable & credible plans) Plans to be submitted to commissioners by 30th June 2017 We recommend you share your plans with ECDS@nhs.net Plans should be sufficiently detailed to give credibility – we’ll produce a template “model plan” Evidence of support and engagement should be sought from: Senior management inc. Directors of finance, IT EDIS supplier, XML broker etc. ED staff (management, clinical, nursing, clerical) Informatics staff

The ECDS part of the 2017-19 CQUIN CQUIN Part 2 (Q3 17/18) If there’s £50,000 available for this part of the CQUIN… Priority 1: Going live with ECDS from 1 December 2017 (50%) (£25000 – data for the whole of Dec) Priority 2: Data Quality (40%) (£20,000 available – Chief complaint and Diagnosis) • Greater than 95% (Good) attracts 40% £20,000 of payment • 90-95% (Medium) attracts 20% £10,000 of payment • <90% (Poor) 0% No payment Priority 3: Frequency and timeliness (10%) (£5000 available) There are 13 weeks in this quarter – so you get 1/13th of £5000 (£385) for each weekly submission More worked examples coming up….

The ECDS part of the 2017-19 CQUIN Worked example for CQUIN Part 2 (Q3 17/18) Scenario Go Live Date Data Quality (Diagnosis & Chief Complaint) No. of weekly submissions (out of 13) A 1 October 2017 96% (Good) 13 B 20 November 2017 94% (Medium) 6 C 1 December 2017 95% (Good) 1 D 2 December 2017 90% (Medium) 4 If there’s £50,000 available for this part of the CQUIN… Scenario Go Live Date Data Quality Weekly submissions Total A £25000 £20000 £5000 £50000 B £10000 £2308 £37308 C £385 £45385 D £0 £1538 £11538

The ECDS part of the 2017-19 CQUIN CQUIN Parts 3 – 6 (Q1 18/19 to Q4 18/19) Split data quality and daily submissions 60/40 Chief complaint, Diagnosis, Acuity, Discharging Clinician, Referral Source and Discharge Status

The ECDS part of the 2017-19 CQUIN Achieving high quality data Discharge status - Must be completed for every patient Chief Complaint, Acuity and Referral Source - Not needed if EMERGENCY CARE DISCHARGE STATUS is: Diagnosis and Discharging Clinician - Not needed if EMERGENCY CARE DISCHARGE STATUS is: ECDS_Group ECDS_Description SNOMED_Code Left before treatment complete Left before initial assessment 1066301000000103 ECDS_Group ECDS_Description SNOMED_Code Streamed at assessment Streamed to primary care service / GP 1077021000000100 Streamed to Urgent Care Centre 1077031000000103 Streamed to Emergency Department 1077781000000101 Streamed to Ambulatory Emergency Care service 1077081000000104 Streamed to falls service 1077091000000102 Streamed to frailty service 1077101000000105 Streamed to mental health service 1077041000000107 Streamed to pharmacy service 1077071000000101 Streamed to dental service 1077051000000105 Streamed to ophthalmology service 1077061000000108 Left before treatment complete Left before initial assessment 1066301000000103 Left after assessment with intent to attend other healthcare provider 1066311000000101 Left after assessment but before treatment complete (destination unknown) 1066321000000107

ECDS Q&A Feedback A reminder: “Mandated”, “Required” and “Optional” data items Local XML validation: More on this next session

Send your comments to : ECDS@nhs.net Your feedback – survey How many of your ED’s do you think you could have up and running for October 2017? Assume for now that your IT suppliers are ready, willing and able On the next call we expect to have more detail about the early adopters scheme Consider: how much can be done with configuration Tell us what’s driving your timescales and what could potentially be done to help if necessary 2. We are looking to identify early adopter sites which would start collecting ECDS locally from early August 2017, and make first submissions during September. Come back to us if you’re interested in the ECDS early adopters scheme 3. Are there any particularly difficult parts of the spec you’re struggling with? 4. Do you see any differing issues for Type 3 and 4 departments? 5. Have you been discussing this with your suppliers already? Send your comments to : ECDS@nhs.net

Future webinars…. We plan to hold a webinar roughly every 3 weeks They’re totally open – invite anyone Future topics will include: A focus on the early adopters scheme The transition period from CDS010 to CDS011 (next session) Local XML validation Implementation support – materials that will be available Benefits case studies performance management / SitRep / 4 hour A focus for ED staff / managers CCG webinars Let us know anything particular you’d like us to cover again or in more detail Next webinar focused on Providers is 25th April @ 2pm Send your comments to : ECDS@nhs.net