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SUS+ User GroupAgenda and Minutes

17 January 2018

SUS+ User Group

Table of Contents

Meeting details 3Agenda 3Review of Previous Meeting Actions and Minutes 3Feedback from and to the SUS Programme Board 4SUS+ Service Update 4SUS+ Development Update (inc Training Requirements) 5Hospital Episode Statistics 7Any other business 8Attendance 10Next meeting 11

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SUS+ User Group

Meeting details

Date Wednesday 17 January 2018Time 10:30am - 13:00pm

Location Whitehall 2, Leeds, 6th Floor, W61&2, LS1 4HRRemote access WebEx – Detailed in the calendar entry

Support contact [email protected]

Agenda

Item Agenda Item Presenter Schedul

e1 Welcomes and apologies Chair 10:30

2 Review of previous meeting actions and minutes Chair 10:35

3 Feedback from and to the SUS Programme Board Chair 10:40

4 SUS+ Service Update Mark Stangroom 10:45

5SUS+ Development Update (inc Training Requirements)

Steve Fenner/Graham Spearing

11:15

6 Hospital Episode Statistics Netta Hollings 12:15

7 Any other business All 12:45

8 Meeting close All 13:00

Review of Previous Meeting Actions and Minutes

The notes from the previous meeting were approved.

Actions

Performance report to be distributed to the group prior to the next meeting.The performance report has been received.

GS to arrange workshops with DSCRO’s regarding ECDS To be carried over

PSh to inform the group how the CQUIN data quality report will be accessed and when, as it’s not a native SUS+ report.AB has confirmed that it’s to come through the DQ dashboard. It’s being looked at whether SUS+ should be generating this report. SF to discuss with PSh. Outstanding.

GS to look into providing the additional SNOMED ECDS code list.The additional SNOMED ECDS code list is now on the website.

SF to look at the impact of anonymization on spell numbers for SEM and PbR.To be carried over

SF to check the impact of PCD in the RTP pathway field.To be carried over


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SUS+ User Group

All user group members to consider the 18/19 work stack list and give feedback as to what value it would it bring.This is on the agenda and will be discussed in this meeting.

SF to circulate the correct guidance for backwards compatible codes.To be carried over.

SF to provide a live demo of MESH to show how mesh works in practice.SF will provide a MESH demo at the February meeting.

Feedback from and to the SUS Programme Board

SH provided feedback from the last SUS board. It was emphasised that the development team are under pressure at the moment in time and that getting to a BAU state is a priority. SH noted that it was important to be mindful of what is requested, planned, and developed is actually used. It was agreed that the group will review the development plan and agree on what should be prioritised in the next financial year. The issues with sensitive codes was raised and this was taken on board.

SUS+ Service Update

MS gave an overview of the SUS+ Service Update, please see attached slides, for details.

HighlightsDecember was a quiet month. There was 100% availability across the month, PbR was delivered overnight and completed in the early hours. The extract with the longest extract took twenty-three hours to complete. There was one historic data request and the team successfully launched GP Metrics on the system, with no incidents raised. This gives functionality for GP’s to download data.

LowlightsHES output was delivered successfully, but it was one day late.

Next three monthsA penetration test is planned in for Q1 2018, looking at late February, on the SUS+ infrastructure and something else that hasn’t yet been tested. The team are wanting to widen what is tested from previous penetration tests.

ECDSThere are currently seventy providers who are submitting, with six daily submitters and one who is in the test phase.

There were no HSSI’s in December. There was a total of nineteen incidents and twenty-nine service requests. Regarding interchange errors, there were forty-three in total and four dead letters. These were due to ECDS submissions.

Inbound processing - On the 11 and 13 December an ECDS interchange dead lettered blocking the processing queue until the next day.Outbound processing - There were a few spikes for extracts for inclusion. On the 6 December 107 extracts were requested by one DSCRO, however this did not cause a delay.

The question was asked what happens if there is a blockage in the queue?The DSCRO in question, the DDC will be going to visit them to see if there is a problem and what can be done to help them. From a system point of view, we are asking them to use delta extracts.


SUS+ User Group

SH asked if it is possible to make providers aware of any hot spots? It was flagged that in April there will be a big increase in the number of submissions and there is a risk that submissions will become stuck in a queue,It was confirmed that no extract will take twenty-three hours, with the maximum delay being an hour. Interchanges take around ten minutes per interchange. Submissions need to be made by the latest at 11 o’clock on a night for them to be processed that day.

Presented by: Mark StangroomAccompanying material:

SUS+ Development Update (inc Training Requirements)

SF gave an overview of the forward delivery view, please see attached slides for details.

The forward delivery view shows what is being worked on now and next few months. Next year’s developments now have t-shirt sizing to give a rough idea of what development is involved. SF would like feedback on potential developments and the desired order to be completed.

At the moment in time the team are working on capacity planning and extract performance, including tuning of the system to increase performance.

AN raised concerns on the impact of 3 April and the increase in activity. SF confirmed it may be a case of adding some additional hardware. AN suggested the DSCRO’s could do more to helpAN confirmed that the DSCRO’s uses hashing for databases and Invited SF to ask for help if required.

SH has asked if the developments that have been completed, are they being used as intended? SF confirmed no. SH understand that this sometimes happens, but it would be good and important to see if it is money well spent. GP metrics would be a good example.

SH suggested we should be asking customers if they use what they asked for. SF confirmed that some things that we are asked to do, we don’t have a choice. Question is, is that always a good use of resources. A&E utilisation, not sure who approved it. This may be a question for the board.SF reiterated that if boards from high in NHS Digital and NHS England ask, we must do it. AB made the point that as there is a governance and approval system, should go to the SUS+ board for approval?

SF feels that as we can do developments quickly, it makes it easier for people to come and ask us to do things, however SH made point that we are victims of our own success. This is a matter for the board as some of these requests pushes back other work that is needed.

NEW ACTION: Mandated developments to be raised at the board for approval.

SF asked from a UG point of view, what is the most important work to do? We need a clear view, as it also gives a strong statement elsewhere as to what is required. AN used the example of the DSP board, that if the scope drifts, due to requests from NHS England for example, it can go to the cabinet office who will instruct them to stick to their delivery. Maybe the SUS board needs this, to stop SUS+ drifting.


SUS+ User Group

Developments to be prioritised:

Order of priorityPCD – Important as it affects everyone and could lead to reputational damage.Local pricing and IRLocal IRJSONData qualityIt was noted that these change in order of priority according to different organisations. The key is how to balance priorities between providers and internal developments.

GF noted that the PLICS collection, that takes admission discharge specialty data, adds a price to it and sends it in. As a result, this is almost a parallel collection. It would be better to have one system transferring costs and the other doing all the commissioning.NH commented that it is her team that receives and analyses PLICS data and it is being linked to HES. NH and JF to discuss in more detail.

NEW ACTION: UG to look at, list, and put in ranked order the development they would like, with benefits. Next year SUS will cease to be a programme and have their own money. This will be important.

Training Requirements

It was agreed that training would be beneficial, however, it would be better focusing on how commissioning works and how SUS+ fits into it, or more of a SUS+ user guide. PSh also agreed and felt it would be beneficial from an ECDS point of view. Joanne Field suggested that the secondary use sessions may include the type of audience that we should be asking regarding SUS and the plans for it. It was also asked that there be JSON training sessions.

PCD Security

SF gave an overview of PCD security, please see attached slides for details.

The team are planning to start checking for PCD in unexpected fields shortly. They will also be looking at a floor limit for false positives. They will be looking for NHS numbers and name - pulling through from PCS and looking for last names.

AB has asked this to be documented and providers to be given fair warning. DSCRO’s need to be included in this communication. It is planned that the number checking will be completed in the next month and the name check will be by April. SF confirmed that the worst offenders will be contacted after a full analysis. This will be fed through to the board to gain approval as to when this can be done.

There is the feeling that we should be redacting fields that have incorrect PCD, after informing submitters, and then ultimately rejecting them. This is an IG risk so needs to be addressed. It was agreed that redacting fields would be the best course of action and the providers informed. There should also be consequences as providers will be liable once the new GDPR regulations come into force in May. SF will discuss with Chris Roebuck as he is responsible for data quality at a senior level in the organisation.One thing that would make it secure is if we hash the fields. You would have to hash the linkage to the fields.

NEW ACTION: SF to discuss PCD security and the new GDPR regulations with Chris Roebuck.


SUS+ User Group

NEW ACTION: SF to compile a prioritisation list by provider and commissioner. This will go to the next board. Development to be ordered by preference.

NEW ACTION: SF top provide PCD leakage analysis by next month

Presented by: Steve FennerAccompanying material:

Hospital Episode Statistics

NH gave a brief overview of HES, please see attached slides for more details.

What do NHS Digital do with HES?CDS is in SUS+ then it goes to customers. The HES team produce monthly and annual publications, which are bespoke publications based on the data.The HES team also answer a lot of parliamentary questions (PQ’s), around half of all NHS Digitals PQ’s, an addition to a large volume of media queries and external data requests. HES links to many data sets and audits

There are some specific DQ issues that HES are facingSUS DQ dashboard - There are many future plans, including moving to a new platform, due to it being out of support, improve feedback to providers and ECDS DQ reports.

DQ feedback notes are provided with each HES publication and HES Data Dictionaries contain details of all field definitions contained in the datasets. HES is a significant data source and we do get requests from abroad. HES is important for further analysis to improve evidence-based decisions.

PSh asked how much the monthly publications are used, are there download stats? NH confirmed that the monthly publications do not tend to get used a great deal, however the annual ones are. A lot of the data is requested by DARS.The plan is to move much of current HES processing into SUS+

What will NHS Digital do with HES in the future Align SUS with HES Stop A&E dataset March 2019. Retire various CDS types Add SNOMED- target of 2020. Align APC and MHSDS Link to ERS Link to prescribing Make HES available to providers

What might NHS Digital do with HES? Look at which of these returns can be calculated out of ECDS submissions. Replace MAR and QAR- already in discussion with NHS England Stop calling it HES, SUS and CDS and call it admitted patient care, out patients and

emergency care data set Stop the annual refresh – take the month 13 submission and use that as it’s a year to date

extract.


SUS+ User Group

More frequent data, which will lead to more frequent publications

Presented by: Netta HollingsAccompanying material:

Any other business

ECDS Update

Overall, 58% are collecting and this is rising. It was hoped that it would be in the mid 60% by now. Submission rates are at 46% by volume to SUS+. Those who aren’t submitting have been contacted again. NHS Digital can’t put pressure on providers as NHS England, NHS Improvement and Department of Health have requested we do the collection, it would be up to them and the commissioners to do this.

AN has asked for the ECDS tracker to be supplied to the DSCRO’s, that can then be distributed to the commissioners.

ACTION: PSh to provide the ECDS tracker to the DSCRO’s

It has been noted that the C-QUIN guidance needs clarity as there have been differences in how it has been interpreted between Trusts as there is confusion as to how it should be done. It is intended that providers will get a window of opportunity to check and amend if necessary.

Regarding early adopters, the data will be looked at to make sure it is correct. Once done we will recommend to NHS England that they receive the £20,000 bonus.

SUS DQ Dashboard

AB noted that he has an issue with the SUS DQ dashboard, specifically with the A&E one.There are invalid errors, and incorrect data being presented in the dashboards. NH feels this is due to a mapping issues, however, it will be investigated.

AN asked that there be a SEM/PbR workshop be arranged as the DSCRO’s would like one.

NEW ACTION: SF to arrange a SEM/PBR workshop for the DSCRO’s, ideally for a Thursday.

Streaming Guidance

GH informed the group that on the 11 December his local CCG sent a CCG officer to the A&E dept. and decided to do their own individual validation, tracking patients and how they should be recorded. When informed of the figures they were completely different to the ones that GH had. As such, streaming guidance is required as soon as possible as the commissioner’s interpretation goes against clinical decision making.

PSh confirmed that NHS Improvement have said there should be no adverse consequences for not streaming via ECDS. PSh has suggested making his local CCG aware of this and challenging the CCG.


SUS+ User Group

Implementation of sensitive codes

Chris Cooper noted that the SUS ‘What’s New’ section on the internet doesn’t have the correct impact analysis included for implementation of sensitive codes. There was nothing to state why his PCD records have been nulled and it has come as a shock to their CCG. CC has requested in future that full comms and analysis should be provided.SF apologised and acknowledged that communications could have been better and confirmed that the list is still in consultation and that it closes in January.CC asked why was no formal guidance issued? SF replied that the codes that were in SUS were out of date and there was a legal implication to not doing so. SF apologised and noted that the decision was taken high up and there is an admission more work should have been done to look at the impact. There is an agreement to take the data out on the way out, as opposed to the way in.

GF noted that the sensitive codes should be subject to a standard. Once the standard has been completed a consultation will take place.

ODS

Please se the ODS attached below.

Supplied by Gerry FirkinsAccompanying material:


SUS+ User Group

Attendance

Attendee Organisation Attendance

Andy Banks (AB)Co-Chair NHS West Sussex Foundation Trust In personStuart Howard (SH)Chair Blackpool Teaching Hospitals In personMark Bridges (MB) Central Midlands DSCRO In personGary Hardcastle (GH) York Hospital In personRichard Peasgood Northern Lincolnshire and Goole In personJonathan Bliss NHS Digital In personSteve Thornton NHS Digital In personJames Salt (JS) NHS Digital In personAndy Norman NEL CSU In personGraham Spearing (GS) NHS Digital In personPhil Saville NHS Digital In personGerry Firkins (GF) NHS Digital RemoteSteve Fenner (SF) NHS Digital In personMark Stangroom NHS Digital In personNetta Hollings (NH) NHS Digital In personPeter Sherratt (PSh NHS Digital In personCarl Davies Nottingham CCG Remote Chris Cooper (CC) Yorkshire DSCRO RemoteDerek Alexander North East London DSCRO RemoteDarren Wright NHS Wales RemoteDave Parsons North West Surrey CCG RemoteAndy Norman North East London DSCRO RemoteJoanne Field Newcastle Hospitals RemoteSu Clark University Hospitals Leicester RemoteDean Small Leeds Teaching Hospitals RemoteJohn Lowther Poole NHS Trust RemotePhil Smith Great Western Hospitals RemoteJulian Hamer Optum UK RemoteNancy Springate Medway NHS Foundation Trust RemoteBernard O’Donnel NEL CSU RemoteDarren Wright NHS Wales RemoteCatherine Cockfield Oxford Health RemoteCathy Hendy North West DSCRO RemoteDan Taylor Countess of Chester Hospital NHS Trust RemoteWendy Lee South, Central and West CSU RemoteChris Taylor NHS North of England CSU RemoteDonna Sweeney Anglia Community Healthcare Service In personErica Field Anglia Community Healthcare Service In personCarole Archer Leeds Teaching Hospitals Trust Remote


SUS+ User Group

Next meeting

Date 21 February 2018Time 10:30 - 13:00Location TSQ Bevan, Ground Floor, 1 Trevelyan Square, Boar Lane, Leeds, LS1

6AE

Remote access WebEx - TBC Support contact Phil Saville – [email protected]


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