Health and social care: data strategy

Creating Insights from Data

We want to work in partnership with health and social care to adopt a whole-system approach to creating insight from data that allow us to improve services. This includes the creation of insight to: inform communities, inform policy, identify, measure and monitor differential outcomes, experiences and access to services for different population groups, target interventions and support, improve services and improve partnership working.

Background

Improving our use of health and social care data is not only needed to help us provide the best care possible for people, but also on a national and regional basis, to ensure that the decisions made are based on quality, up to date information. Sharing information across organisations in near real-time, such as the number of available hospital beds across regions, social care capacity, rate of infection of emerging diseases, or efficacy of certain treatment options, is key to ensuring the delivery of responsive and fit-for-purpose services.

The analysis of the consultation for the Strategy highlighted that there are acknowledged difficulties in appropriately sharing ‘near real-time’ data for the purposes of timely planning and decision-making. To address this, we must ensure that the data is recorded in a consistent manner to enable the interoperability that allows staff to access the right data at the right time. This includes secondary uses of health and social care data such as official statistics, reasons of public interest such as protection against serious cross-border threats to health, and supporting public bodies to understand and improve services.

Data is often held in multiple places, making it difficult for people providing care and support across health and social care to access the most relevant, up-to-date information. This makes safe and effective delivery of care, and continuity of care across different service providers more challenging, particularly as care needs change over time. It also hampers strategic planning, service improvement and Research and Innovation (R&I).

Where we are now

Strategic Planning and Service Improvement

Our experience during the COVID-19 pandemic has shown us that the public have an increased appetite for accessing insights into health and care data. This is demonstrated clearly by the fact the PHS COVID-19 Daily Dashboard has accrued 51 million views. Deriving insight from our health and social care data is also crucial in achieving our principle of being accountable, transparent, and open to independent scrutiny. That is why the Scottish Government and Public Health Scotland publish official statistics, in line with Code of Practice for Official Statistics, explaining insights from our health and social care sector.

At present there is no ‘single line of sight’ or ‘route of access’ into management information across health and social care in Scotland. This makes visibility of data for service delivery and improvement difficult, with sources being disparate, and limiting us from improving the care we provide by achieving the true potential of the data produced and held. This is exacerbated by the fact that we do not currently have a single data mart for the management of information data. To achieve our goal of greater discoverability, accessibility, interoperability, and reusability of data, planners need to have better access to appropriate and near real-time data, to better analyse, understand and improve processes and services at different levels and better inform strategic planning priorities.

The timeliness of our data for service delivery and improvement also makes it difficult to take data-driven decisions in near real-time on a consistent basis. This is because we face a trade off in the timeliness of data versus the quality and cleanliness of that data. To make timely data available, we need to understand our appetite for using data that has not been fully cleansed.

Where we want to be

A key aspect of our vision is to create a complete system approach that will facilitate the understanding of the issue, the context, and the wider system. This will allow management information data to be utilised in a timely manner to improve services by providing insight to decision makers and the public. Our approach to collecting and supplying data for this purpose will be reviewed, focusing on the following:

• how we provide data as part of an analytical pipeline; removing siloed structures, produced once and used for multiple suitable purposes
• setting clear pathways to commissioning analytical work
• moving towards a whole-system approach to developing intelligence that can be utilised to improve health and social care.

The development of a whole-system intelligence model for health is already in progress. As part of this, we will consider how we can reinvent the way we approach intelligence, including how we can improve our ability to use near real-time data. Data integrity must be balanced with our ability to act on it effectively and efficiently.

Improving the accessibility, connectivity, and visibility of data for service delivery and improvement will also be crucial to deriving the greatest possible insight and improving our service delivery. That is why it is important that we review the data sets that are currently available to us, considering where the greatest gaps lie; and to where we could more routinely link data to give as full a picture as possible. When doing so we will build on work that is already underway, for example:

• The work of the Equality Data Improvement Programme, the actions being taken forward following the recommendations of the Expert Reference Group on Covid-19 and Ethnicity or the current review of the suite of official statistics.
• Work is also under way in the Local Government Digital Office to develop a Blueprint Library that will contain a shared library of blueprints for data analysis, analytics, and visualisations developed by individual local authorities, so that they can be re-used and replicated by other local authorities.
• The e-Rostering programme for the NHS, to improve workforce data and make staffing safer; or theatre optimisation technologies to maximise efficiency and combat waiting times.

Data is collected and stored across several organisations, we recognise that combining insights from across the health and social care sector will allow us to have the greatest impact on care provided. In order to do this, we need to strive towards greater federation of our data infrastructure, allowing third and independent sector data to be used alongside national public sector data.

Having data available for modelling, planning and projections is also crucial to ensuring our health and social care sector is able to provide the best possible services. Modelling is key to workforce planning and supporting the sector to navigate periods of high demand such as Winter or for resilience purposes for developing strategies to deal with ad hoc changes in demand, such as with COVID-19. Completeness of data also supports the identification and monitoring of differential access, experience, outcomes and health needs between different population groups, including equality groups – which is essential to improve our services.

We want data in our health and social care sector to adhere to the principle of collecting once and using many times, reducing the administrative, technological, and environmental burden of siloed data. Key to this will be good data governance and making use of unique identifiers that support linkage and interoperability of data, such as CHI or Unique Property Reference Number (UPRN).

We must also ensure that we support our analysts to deliver the insight required from data. This will mean ensuring that we have the right technology and software, that we are clear on a common language across professions, and that we deliver the right training and upskilling to our analytic community. The Local Government Digital Office and NHS both facilitate communities of practice for the sharing of learning and best practice. Encouraging communities of practise is essential to creating an environment that allows our practitioners to share their experience for the benefit of health and social care.

It is also essential that the information we do create from our health and social care data is translatable and digestible for its intended audience, including, where relevant, the public. That is why we will ensure that analysis includes professional consideration of the ‘so what’ arising from its results, helping users to understand what actions must be taken based on the intelligence being presented to them.

We must also ensure that data is being captured and used effectively to plan the workforce needed to deliver services. We are already gathering data that helps us identify the demographics and geographical spread of our workforce. However, we must strive to continually improve the quality and granularity of the data we collect, especially on the unregistered workforce, and adapt our planning accordingly.

Case Study – Cancer Medicines Outcomes Programme (CMOP)

Scotland has introduced many new cancer medicines in recent years. It is safe and effective to prescribe medicines after they have undergone clinical trials. Patients in clinical trials may differ from patients receiving these medicines in routine care (or ‘real world patients’).

As proof of concept, CMOP focused on immunotherapy which is a new treatment used for several cancer types.

Collaboration and clinical engagement across the health boards enabled these data to be reported ‘once for Scotland’. CMOP were able to link nationally-held datasets with prescribing data and were able to describe some patient characteristics of the Scottish population who received immunotherapy treatments, including: age, gender, diagnosis, and fitness for treatment. CMOP reported outcomes that supported healthcare professionals to provide more personalised care.

This example shows how the CMOP links health data to report and understand the outcomes of cancer medicines, enhancing the information available for patients and for the clinicians making treatment decisions.

Our Commitments

We will use modern technology to support the timely analysis and understanding of Scotland’s Health & Social Care system.

Who is it for?

Professionals

Our Commitments

We will take a more joined-up approach to funding and commissioning, ensuring analytic communities are joined-up. This includes encouraging communities of practice for the sharing of learning and ways of working.

Who is it for?

Professionals

Our Commitments

We will invest in the people we need to help deliver the data, growing our workforce to use timely analysis to deliver the intelligence and insight that is needed to improve health and wellbeing in Scotland.

Who is it for?

Public
Professionals

Our Commitments

When publishing analysis, we will always ensure we help readers to understand the key insights being derived from the analysis of data.

Who is it for?

Public
Professionals

Our Commitments

We will support the sharing of data analysis and insights across the public, independent and third sector organisations to deliver improved services.

Who is it for?

Public
Professionals

Our Commitments

We will be smart in our approach to creating insight from data, making the most of the data already available. We will take a collaborative approach to learning, sharing, and developing our data and insights.

Who is it for?

Professionals