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03.10.18

The Kent Integrated Dataset

Source: NHE Sept/Oct 2018

Dr Abraham George, consultant in public health at Kent County Council, tell us about the Kent Integrated Dataset, undertaken as part of national integration programmes.

A successful population health system depends on system leadership underpinning a shared vision, strategy, and governance to pool analytical, data management, infrastructure skills, and capacity across local organisations. These systems will face the key challenge of addressing complexity of service and workforce planning using finite resources across multiple programme areas for a heterogenous or diverse population.

The Kent Health and Wellbeing Board first described the vision for ‘integrated intelligence’ and the need to create a ‘research-ready real-world’ dataset out of linked person-level administrative datasets from local health and care organisations. This can offer considerable benefits ranging from population health analytics, better surveillance and reporting systems of patient journeys, improved data quality, and patient direct care through better risk stratification.

The Kent Integrated Dataset (KID) is one of a growing number of linked datasets across England based on a unique local data partnership between Kent County Council Public Health and Kent & Medway CCGs over the last five years. This innovative work has been undertaken as a result of Kent’s participation in national integration programmes. The dataset is assembled by a local data warehouse team  hosted by one of the local acute trusts in Kent based on data-sharing and processing arrangements with hundreds of local health and care providers – mostly GP practices. At the moment, use of the KID is limited to planning purposes only and contains three types of data:

  • Demographics. This is a dynamic list of Kent & Medway’s registered patient population from NHS Digital, comprising of NHS numbers, age, gender, LSOA (Lower Super Output Area) and UPRN (Unique Property Reference Number) starting from April 2014. This represents the ‘hub’ of the KID in which all other local datasets are linked to each other;
  • Service activity and costs based on data flows from approximately 220 local organisations across primary care, acute, community and mental health, social care, fire & rescue, etc;
  • At least five population segmentation tools, e.g. MOSAIC, ACORN & Electronic Frailty Index.

The KID is currently 900 million rows long and 1,000 columns wide. De-identified data is made available through 40 data tables accessible only to the Kent & Medway councils’ public health teams. Special access arrangements have also been given to NHS England, which is using the KID for analysis of frailty, resource allocation and population segmentation to strengthen the national evidence base.

The KID is still on a path to maturity, beset by data quality and data completeness issues. For example, roughly only half the costs of health and social care (an estimated total of £3.5bn) are reflected on the dataset itself. Nevertheless, numerous analytical projects have been carried out supporting public health commissioning, Kent & Medway STP and Joint Strategic Needs Assessment.

Examples include designing capitated budgets for multimorbid patients, matched control impact evaluation of Kent Fire & Rescue Safe & Well Visits for the frail elderly, health profiling of population at risk of fuel poverty, levels of social isolation across different risk groups, and equity audit of NHS health checks programme.

More recently, the KID-related analysis is supporting local efforts in promoting systems thinking skills in STP-led service design and planning for commissioners and other professional groups. A Health Foundation-funded Community of Practice has been set up to impart technical skills in the use of simulation methods known as systems dynamics. Alongside this is the transformation of the Kent JSNA to become a forward-planning and dynamic tool for commissioners.

 

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