With specialised commissioning growing at a rapid pace and requiring some of the most costly interventions, the reliance on advanced data analysis to understand, monitor and manage care is increasing.
In the last four years alone, the budget for specialised commissioning services has grown by 5.2%, from £14 billion in 2014/15, to £17.6 billion in 2018/19. This level of growth puts greater responsibility on the NHS to monitor and manage the impact of services and treatments which can benefit patients. This is where Business Intelligence (BI) has an important role to play – not just in understanding activity and its financial implications, but in supporting the commissioning and delivery of care.
Providing commissioners with the data and analysis to enable them to manage complex contracts and identify QIPP savings is a core BI service. This requires significant number crunching – processing large volumes of data to show what treatments are being applied where, to whom and with what outcomes.
That need was the rationale behind the creation of the National Commissioning Data Repository (NCDR) which NHS England commissioned in 2014/15 financial year.
The NCDR, built and hosted by NHS Arden & GEM CSU, provides comprehensive information on a wide range of commissioning and clinical data which is used across the country to support specialised commissioning. The system enables commissioners to:
- Explain potentially unwanted variation
- Explore clinical pathways
- Flag non-contracted services
- Improve data quality
- Identify QIPP opportunities
- Manage healthcare provider contracts.
To date, the NCDR has been used to identify and deliver millions of pounds in savings within specialised commissioning and is a vital tool in managing contracts against budgets and intended outcomes.
Using analytics to understand specialist conditions
As data science becomes more advanced, we are now able to apply analytics beyond the numbers, to assess clinical data and develop a deeper understanding of specialist conditions, to improve patient outcomes and deliver more cost-effective treatments.
This is already having a positive impact on NHS England’s programme to eliminate viral hepatitis C by 2025. By drawing together a range of tools and techniques, we have been able to provide accurate information about patients with chronic hepatitis C and the effectiveness of treatments. The quality of the data and the advanced analysis we are able to apply has not only enabled NHS England to monitor and assess the effectiveness of treatments, but has informed a strategic procurement with pharmaceutical companies to expand available treatments and assist in case finding within the community.
By working with clinicians to build a more detailed understanding of how BI can validate commissioning decisions, support specialist procurement and quantify treatment success, the value of these purpose-built registries is becoming clearer, helping to break down barriers to sharing information.
From number crunching to better patient care
The Long Term Plan sets out ambitious targets for the NHS covering a wide range of service areas. One of its key principles is to move care towards prevention, with support from population health analysis. Policy makers have recognised that the separation between local and national commissioning has, in some areas, impacted opportunities to intervene at an earlier stage in certain conditions, reducing opportunities to avoid the need for specialist care. However, there is now a move to enable integration of Specialised Commissioning into place-based care planning, with local Sustainability and Transformation Partnerships and Integrated Care Systems sharing responsibility for patient outcomes with NHS England.
As the NHS becomes more skilled at data analysis, so the opportunities to improve specialised commissioning increase. Population health analysis allows us to combine complex sets of data to accurately predict likely outcomes and plan services accordingly. This is particularly important for services where patient outcomes may not be straightforward.
With the move towards place-based care and shared commissioning for specialised services, we need to make best use of the advanced data collection and analysis tools that combine financial and operational reporting together with clinical and patient reported outcomes. While crunching the numbers to manage contract performance and overall spend remains a priority, there are exciting developments in advanced BI which can help shift the focus of specialised commissioning towards prevention and improved service planning, in line with the NHS Long Term Plan.
This is a summary of an article written for Specialised Commissioning Journal by Ceri Townley, Head of Information and Intelligence, Specialised Services National Support team at NHS England, and Ayub Bhayat, Chief Data Officer at NHS Arden & GEM Commissioning Support Unit. Read the full article here.