1. 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.

2. 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 2pm.
Send your comments to :

3. 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

4. Information and technology for better care
NHS Digital strategy
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.

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

6. 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.

7. 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

8. 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.

9. 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

10. 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

11. 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.

12. 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.

13. 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

14. 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
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

15. 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….

16. 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

17. 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

18. 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
ECDS_Group
ECDS_Description
SNOMED_Code
Streamed at assessment
Streamed to primary care service / GP
Streamed to Urgent Care Centre
Streamed to Emergency Department
Streamed to Ambulatory Emergency Care service
Streamed to falls service
Streamed to frailty service
Streamed to mental health service
Streamed to pharmacy service
Streamed to dental service
Streamed to ophthalmology service
Left before treatment complete
Left before initial assessment
Left after assessment with intent to attend other healthcare provider
Left after assessment but before treatment complete (destination unknown)

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

20. 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 :

21. 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 2pm
Send your comments to :