1. Kent Integrated Dataset
Produced by
Emily Weitzel, Senior Analyst
Rachel Kennard, Senior Analyst
Version: 1
Last updated: 13th July 2018

2. Contents The KID Analyses Limitations of the KID Developments
Conception & datasets
Analyses
Self harm
Limitations of the KID
Developments
Hisbi
Optum

3. The KID
Person level dataset linking routinely collected administrative activity and cost data
National pilot in 2012
Initially NHS England funded
Co-funded by Health & Social Care
KCC oversight with Hisbi data warehouse

4. The KID: datasets April 2014 1.8 million
~900 million rows of data vs ~1000 columns, spread across 40 data tables
Pseudonymised dataset

5. The KID: datasets GP
210 practices flowing as of June 2018
Community health
Mental health
Out of hours
Acute hospital
Public health
Adult social care
Hospice
HISBI data warehouse (Trusted Third Party Data Processor)
KID minimum dataset: data on activity, cost, service/treatment received, staffing, commissioning and providing organisation, patient diagnosis, demographics and location.
Datasets linked on a common patient identifier (NHS number) and pseudonymised derived from Patient Master Index (Household level data is linked via pseudonymised UPRN)
Pseudo at source
KENT INTEGRATED DATASET
Accessed securely by
Kent County Council Public Health

6. Data quality Provider responsibility DQ matrix Data receipt
Data quantity
Data accuracy and completeness
All participating organisations have provided data for each of their service areas
Data received is stable over time (i.e. within expected stochastic tolerances for month-to-month changes)
Data volumes are comparable with external reference data, such as published numbers of hospital admissions
All data items are complete
Coding of events (such as Read Codes) appears consistent across data providers
Data includes costs for all contacts
Data is free of duplicates (to acceptable levels)

7. Questions?

8. Self harm KID analysis Background Kent Public Health Observatory

9. Admission rates have remained stable over time
In 2016/17 alone, there were 1,018 admissions to hospital for self-harm amongst year olds resident in Kent, involving 823 individuals
Admission rates have remained stable over time
From HSCM. Shows large number of admissions, although a stable trend
Analysis of hospital admissions for self-harm

10. Gender
Girls account for almost three-quarters of the admissions for self-harm amongst year olds in Kent
Relates to all admissions (not individuals)
Analysis of hospital admissions for self-harm

11. Age distribution
Around half of these admissions involve young people aged between 14 and 18
48% of total admissions involve a young person aged between 14 and 18
Analysis of hospital admissions for self-harm

12. Deprivation
A third of the admissions for self-harm involve children & young people living in the 20% most deprived areas
Alternatively you could say that children living in deprived areas are twice as likely to end up in hospital for self-harm than those living in the most affluent areas.
Analysis of hospital admissions for self-harm

13. The KID: Self harm
This analysis focusses on year olds admitted for self-harm in 2015/16 or 2016/17
This then allows before-and-after analysis of service usage for a cohort of children & young people admitted to hospital for self-harm
Usage of acute, out of hours, community and (adult) secondary mental health services have been explored using data contained within the KID
Kent Public Health Observatory

14. Service usage Since their registration with a Maidstone GP…
DEVELOPMENTAL STATISTICS
Since their registration with a Maidstone GP…
IN THE YEAR PRIOR
TO THE FIRST SELF-HARM ADMISSION
IN THE YEAR AFTER
THE FIRST SELF-HARM ADMISSION
Including the admission day
Community contacts are a variety of needs – but top two: 25% are HV, 15% LAC.
Source: MBC, KID, prepared by KPHO (RK)
ADULT ONLY
Images from Noun Project
Analysis of hospital admissions for self-harm
*includes telephone consultations
Analysis restricted to individuals registered with a GP flowing data to the KID

15. Service usage Since their registration with a Maidstone GP…
DEVELOPMENTAL STATISTICS
Since their registration with a Maidstone GP…
IN THE YEAR PRIOR
TO THE FIRST SELF-HARM ADMISSION
IN THE YEAR AFTER
THE FIRST SELF-HARM ADMISSION
IN THE 3-12 MONTHS AFTER
THE FIRST SELF-HARM ADMISSION
Including the admission day
Community contacts are a variety of needs – but top two: 25% are HV, 15% LAC.
Source: MBC, KID, prepared by KPHO (RK)
ADULT ONLY
Images from Noun Project
Analysis of hospital admissions for self-harm
*includes telephone consultations
Analysis restricted to individuals registered with a GP flowing data to the KID

16. Service usage: Prior usage of A&E
DEVELOPMENTAL STATISTICS
FREQUENCY OF USAGE
A&E in the 12 months prior to first self-harm admission
TIMING OF USAGE
Timing of latest A&E in relation to first self-harm admission
6+ months before
1 day before
2-7 days before
4-6
months before
1 week –
1 month before
1-3 months before
Were discharged with no follow-up required
44%
Were discharged to GP follow-up
Left before being seen or refused treatment
18% 9%
Analysis of hospital admissions for self-harm
Source: MBC, KID, prepared by KPHO (RK)
Analysis restricted to individuals registered with a GP flowing data to the KID

17. Service Usage: findings
Around 25% of persons were already known to Adult MH services prior to admission for self harm.
This increases to around 60% in the 12 months following admission (including day of admission)
However, in the 3-12 months following admission contact with MH services ‘normalises’ to around 30%
Around 30% of persons had been seen in A&E one month before admission for self harm

18. Questions?

19. KID: Finnamore review
review of the KID 2016
“The achievement in overcoming Information Governance hurdles to establish this dataset and the permissions to use it is considerable. This is an invaluable resource”
“The KID has known issues with data flow and data quality and is undergoing ongoing improvement and development to address these”
“No children's Mental Health data”
“No children's Social Care activity”

20. Linkage of routinely collected data from public services has the potential to improve how local health, education and social care are delivered to children and young people1.
1https://

21. Context
Care dot data

22. KID: Challenges CYP MH data: SPFT / NELFT
Education & Specialist Children’s services – NHS number
KCC restructure
Data quality?
Local providers
Public consultation
Data warehouse: Hisbi / Optum

23. KID: Optum SUS MHMDS MHLDDS MHSDS IAPT CCG managed MSDS
CYPHS
DIDS
CCG managed
Contract management rather than research?
NHS number linkage
MHSDS
IAPT

24. KID: Developments Optum Hisbi NHS D datasets inc. MHSDS
NHS number linkage
Broader role-based access
DARS application
Hisbi
Local datasets
NHS number linkage
Limited access
Deterministic matching possibility

25. KID: DARS application Optum KID MHSDS in the Optum KID (Autumn?)
Data batching service to add NHS number to KCC SCS & education
Pseudonymisation of NHS number
Secondary research

26. KID: Deterministic matching
Hisbi KID
Use deterministic matching to link CSC & education data to the CYP MH data
First name, surname, DOB, postcode
CYP MH has NHS number in
Link matched CYP MH / education / CSC data to the KID
Would only be possible to link CYP with a MH record (NHS organisation) into the KID

27. Conclusions KID Optum / Hisbi Children’s data
Great resource, limitations, potential
Optum / Hisbi
Building on existing KID
Children’s data
MHSDS
Education & Specialist Children’s Service

28. Questions?
Type 2 – if person objects to sharing they can tell their GP and come out of the PMI for sharing
To what extent would analysis of linked data be useful within your organisation?
Which additional data would you want to see linked?
How could linked data inform practice within your organisation?
Examples of linked datasets and outcomes that you’ve heard of?