Presented to: AHSN We have the technology......we need the projects Routine data + Health Outcomes Group Simon de Lusignan St. George’s – University of London

Opportunity  We have the most complete health data in the world  We have the capacity & capability – To measure health outcomes along complex care pathways – Link data without knowing patients’ identities  Growth in A&E use provides an opportunity – Pilots so far of interventions: –Before –In A&E –After... – Maybe a need for more robust evaluation?

Readily available routine health data  Among the best primary care data in the world! – CONDUIT study internationally recognised output  Secondary care data – Standard format available through “SUS” – Most cases and major outcomes managed within NHS  “Ad hoc” clinic data – Other non-SUS clinical data (e.g. Diabetic clinic)

Capacity & capability:  Capacity: – Current largest study: QICKD trial – Cluster randomised trial of quality improvement interventions in chronic kidney disease (CKD) –1.3 million patients – 137 practices in a 3 year study –Over 6,000 variables –Largest ever study 2.4 million patients  Capability: – Evaluation of impact of introducing IAPT in pilot sites – Pseudonymise & link data from hospital – GPs – IAPT clinic –(IAPT clinics have no NHS number) – Case-control study: IAPT less hospital utilisation

Data linkage capability:

Health outcomes group – general approach to evaluation Health Care Problem Intervention Outcome

Workshop No1: Pilot interventions to control admissions Growth in A+E admission Intervention -Pre- -During -Post Outcome Relentless rise??? Do we know if they work?

Summary  Excellent local data...  Unique population & potential collaborators  Capacity and capability to harness that data to measure the impact of new interventions  A&E may be the right place to start?

for listening Simon de Lusignan