Maternity and Children’s Data SetsMeasure quality and improve performance

Child and Family Health Community Health Professionals Forum: June 2014

2

Agenda

• Introducing the Maternity and Child Health data sets

• What's in the data sets?• How can your organisation get the most out of

the data sets?• How can the HSCIC help you to get the most

from the data sets?• What will the HSCIC produce from the data

and how will it compliment your own analyses?

3

Introducing the Maternity and Child Health data sets

• http://www.hscic.gov.uk/maternityandchildren

• Maternity Services Data Set

• Child and Young Person’s Health Services (CYPHS) Data Set

• Child and Adolescent Mental Health Services (CAMHS) Data Set

4

What's in the Maternity data set?

• The Maternity Services Data Set (MSDS) sets out national definitions for the extraction of data for: – routine booking appointment activities – maternity care plan – dating scan – antenatal screening tests – structural foetal anomaly screening – labour & delivery – newborn screening – maternal or neonatal death

5

What's in the Child Health data set?

• The CYPHS data set describes national definitions for the extraction of data in relation to the following key areas:– personal and demographic – social and personal circumstances – breastfeeding and nutrition – care event and screening activity – observations of BMI – Assessment at age 2-2.5} being– Childhood disability } added

6

What's in the CAMHS data set?

• The CAMHS Data Set sets out national definitions for the extraction of data in relation to:– demographics – background – family history – targeted needs – referrals to CAMH services – care planning – interventions – outcome measures – inpatient stays – presenting problems and diagnoses

Children and Young People’s IAPT being added in next version

7

Getting the most out of the data sets?

• The Maternity and Children's Data Sets (MCDS) have been developed to help achieve better outcomes of care for mothers, babies and children. The data sets will provide comparative, mother and child-centric data that will be used to improve clinical quality and service efficiency; and to commission services in a way that improves health and reduce inequalities.

8

Getting the most out of the data sets?

• Information from the data sets will be made widely available to commissioners, providers, clinicians and service users and will be used to:– record, compare and improve outcomes and safety – improve clinical quality and service efficiency – commission services in a way that improves health and reduces

inequalities – improve accountability by providing comparative information to service

users – provide activity data on which to base mandatory tariffs for payment– support regulation – increase the understanding and dissemination of best practice – underpin improvement of local information systems to meet data set

standards

9

Getting the most out of the data sets?

• Work on the Maternity and Children's Data Sets began with the policy driver of the National Service Framework (NSF) for Children, Young People and Maternity Services in 2004 and remains aligned to the policy direction set out in:– Equity and excellence: Liberating the NHS – Achieving Equity and Excellence for Children – NHS Outcomes Framework 2013-14 – NHS Outcomes Framework 2014-15 – Everyone Counts: Planning for Patients 2013-14

10

Getting the most out of the data sets?

• Try not to see them as a data set for central submission

• Use them locally – build into Board reports• Could be used to implement changes e.g. electronic

red book, digital pen technology• Talk to us about what would be useful for you – we

would much rather do things that were useful to data providers!– What data to collect– What reports would be useful– enquiries@hscic.gov.uk

11

How can the HSCIC help?

• CAMHS Data Set Specification: This document precisely defines the information standard, 'what it is' and 'how it should be implemented'. It is the formal definition of the standard.

• CAMHS data set technical output specification: This is the approved data set for implementation. It fully defines the data items that are in scope for submission.

• (Draft) CAMHS data set user Guidance v1.3: This describes how the information standard should be interpreted by service providers, IT system suppliers and other stakeholders. It helps users understand the scope of the standard and how it should be implemented locally.

– Please note: This document will remain in draft form. This will enable us to address issues in a timely way through updates to the document.

• CAMHS Data Set Technical Guidance: This describes the data submission framework; how service providers should create and submit a data submission file.

• CAMHS Dataset Model: Shows the structure of the dataset and the inter linkages between the different data tables.• CAMHS Data Set Validation Reporting Specification: This describes the validation reporting which is designed to highlight

issues that suggest incomplete or poor data.• CAMHS Intermediate Database (IDB): The IDB is a Microsoft Access database which is used to submit the dataset. Please

request this via enquiries@hscic.gov.uk specifying that you require the CAMHS IDB.• System Conformance Checklist: This is a worksheet tool for service providers to assess how well their local IT systems 'map'

to the data set specification.• CAMHS Implementation Planning Template: You can use this planning template to plan your organisation's activity for

implementing the CAMHS dataset. The resulting plan should give a high level picture of how your organisation intends to tackle this implementation within the anticipated timescales.

• CAMHS Readiness Assessment Tool: You can use this readiness assessment tool to measure your organisation's CAMHS dataset Implementation progress. This spans a baseline assessment, regular reviews and a final review to report successful implementation.

• CAMHS Frequently Asked Questions (FAQs): An FAQ document to help providers further understand the data set submission process by providing guidance for frequently asked questions.

12

Reporting and Analysis

What will the HSCIC produce from the data and how will it compliment your own

analyses?

Maternity examples

Overview

• What are we doing?– Working with internal and external customers– Undertaken pilot submissions– Encouraging feedback for reporting wants/needs– Data due to published around Sept 2015– Maternity Compendium (September 2014)

Data Quality

• Expectation of some data quality issues initially

• Statistical outputs will be dependent upon the data quality

• As this improves, the statistical outputs will evolve

• Bear in mind – Maternity currencies

Current Maternity (HES) Reports

• Monthly collections and publications (headline figures)

• Annual report (more detail)• The number of deliveries (not children) taking place in NHS hospitals is 671,255.• 404,094 (61.7 per cent) of deliveries in NHS hospitals were spontaneous, whilst 25.5 per cent (167,283) were caesarean deliveries.

• Over a third of all deliveries (37.1 per cent, 211,374) required no anaesthetic before or during delivery.

• 44.3 per cent (297,066) of delivery episodes had a total duration of one day or less;

69.9 per cent (468,891) two days or less and only 10.4 per cent (69,861) of delivery episodes lasted five days or more. 

The longest stays were associated with caesarean deliveries.

• http://www.hscic.gov.uk/hes

HES Maternity (National & Provider level)

Age of mother

Unknown Total excl. Unknown

Spontaneous vertex

Spontaneous other

Forceps low

Forceps other

Ventouse Breech Breech extraction

Elective caesarean

Emergency caesarean

Other

Total 671,255 2.4% 655,459 60.9% 0.4% 3.2% 3.6% 6.0% 0.4% 0.0% 10.7% 14.8% 0.0%

14 and under 223 35.9% 143 69.9% 1.4% 4.2% 2.1% 10.5% 0.0% 0.7% 3.5% 7.7% 0.0%

15-19 30,650 3.0% 29,718 71.8% 0.4% 2.9% 3.7% 7.1% 0.3% 0.0% 2.7% 10.9% 0.0%

20-24 120,302 2.6% 117,173 69.0% 0.5% 2.8% 3.5% 6.0% 0.3% 0.0% 5.4% 12.5% 0.0%

25-29 185,856 2.4% 181,394 63.6% 0.4% 3.3% 3.8% 6.0% 0.4% 0.0% 8.4% 14.1% 0.0%

30-34 196,593 2.3% 192,139 58.6% 0.3% 3.4% 3.7% 6.1% 0.4% 0.1% 12.2% 15.2% 0.0%

35-39 102,775 2.1% 100,629 53.4% 0.3% 3.0% 3.2% 5.5% 0.4% 0.0% 17.1% 16.8% 0.0%

40-44 24,342 1.8% 23,900 47.7% 0.2% 2.6% 2.7% 5.1% 0.4% 0.0% 21.7% 19.5% 0.0%

45-49 1,343 2.6% 1,308 37.4% 0.2% 1.9% 2.0% 3.6% 0.2% 0.1% 31.3% 23.4% 0.0%

50 and over 114 11.4% 101 21.8% 0.0% 2.0% 0.0% 5.0% 1.0% 0.0% 48.5% 21.8% 0.0%

unknown 9,057 1.1% 8,954 36.9% 0.3% 4.2% 5.0% 7.3% 0.7% 0.1% 19.6% 26.0% 0.0%

Total deliveries

Method of Delivery

Maternity Compendium

• Linking to existing Mental Health datasets (IAPT & MHMDS)

• Linking within HES (Inpatients, Outpatients, Maternity, A&E)

• Causality of birth weights/lengths – e.g. age of mother, health conditions, ethnicity?

• Examine existing data sources – ONS, Maternity Survey

• Variety of presentation formats

Maternity Services Data Set

• Will be able to report on the whole pregnancy pathway not just the delivery– Ante and Post natal care– Ultrasound Scan results– Tests

Before (Downs Syndrome) After (Blood spot)

– Babies linked to the mother– Breastfeeding initiated – Smoking status

Reporting MSDS

• Interactive online tool• Requirements to include:

– Filtering– Charts– Hierarchies– Maps– Dashboards– Ability to connect to a range of data sources (SQL,

Excel etc.)– Ease of use– Support– Basic statistical capabilities

• Evaluating options

Example (screenshots)

Connect with us

www.hscic.gov.uk@hscicwww.slideshare.net/hscic