Transcript Cohort management in Secondary User Services (SUS)

Cohort management and the
Secondary Uses Service (SUS)
Nirupa Dattani
Office for National Statistics
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Cohort management using National
Health Service Central Register (NHSCR)
• NHSCR computerised in 1991 and the database is
known as Central Health Register Inquiry System
(CHRIS)
• Contains details of all patients registered with a GP
since 1 January 1991
• New entries are created with new births from the
Registrars and for new registrations with GPs (eg
immigrants)
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Cohort management using NHSCR (2)
Updates on CHRIS
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Deaths
Name changes
Immigrations
Enlistments to armed forces
Adoptions
Entry into Service Medical Officer Care
Cancer registrations
Cohort management using NHSCR (3)
CHRIS record contents
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Surname and forename(s)
Sex
Date of birth
Health authority and date of registration
Date and place of death
NHS number
Cohort management using NHSCR (4)
Medical research studies
• ONS provides medical research service by ‘flagging’
or ‘tracing’ study members on the NHSCR
• Other services provided include ‘list cleaning’, vital
events outputs and mail out services
• www.statistics.gov.uk/about/services/medicalresearch
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NHS Strategic Tracing Service
(NSTS)
• It’s a national (England and Wales) database of
people, places and NHS organisations
• NHS staff can access patient information such as
names, address, date of birth, GP name and address
details and patient’s NHS number
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NHS Care Records Service
A single electronic health care record for every registered NHS
patient in England:
• Life-long history of patients’ health and care information
regardless of where, when and by whom they were treated
• Provide healthcare professionals with immediate access to
medical records and care notes
• Supporting the NHS to collect and analyse information
• Secure access and audit trails
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Services supported
• Personnel Demographic Service (PDS) will include
basic demographic information such as name,
address, date of birth, date of death, sex, GP details.
• The PDS exists to support direct patient care in real
time, enabling access to and linkage of care records
• Secondary Uses Service (SUS) exists to support
uses of care record data for purposes other than
direct patient care
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Secondary Uses Service
• The central repository of health data for secondary
uses
• Copy of PDS will be held on SUS
• Most data collected or derived from clinical systems
• SUS will have all NHS related activity and other nonpatient record based data
• Concentrating on coded, textual data
• Provide the tools and services for an effective and
secure working environment for analysis and
reporting
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Applications
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Payment by results
Benchmarking and performance assessment
Public health activities
Patient safety activities
Research and development
Benefits of SUS
• Consistent data collection across the country
• Comprehensive coverage of all NHS-commissioned
care
• Cohesive information collection enabling linkage of
patient data from different sources
• A secure environment in which patient confidentiality
is maintained
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Cohort management in SUS (1)
The following systems will be decommissioned and their
functions incorporated in SUS :
• The National Strategic Tracing Service (NSTS)
• The Central Health Register Inquiry System (CHRIS)
operated by the NHS Central Registry (NHSCR)
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Cohort management in SUS (2)
Back office functions:
• Duplicates – where 2 records are present for the same person
• Confusions – where 2 patients are using the same record
• Changes of identity – for example adoptions, witness protection,
gender reassignment.
• De-registrations from the NHS – emigration from England or exit
to MoD
• Resolution of unmatched civil registrations – births and deaths
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Cohort management in SUS (3)
Issues:
• NHSCR covers England and Wales while SUS is for
England only
• Cross boundary flows to Scotland
• Prisoners or psychiatric patients not registered with a
GP
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Summary
• Study population can be traced at NHSCR on the
CHRIS through medical research
• CHRIS and NSTS will be decommissioned when the
current systems are migrated to PDS
• Issues with Welsh residents currently covered in
medical research studies as SUS is for England only.
• Issues with cross border flows with Scotland
• SUS will be a comprehensive database of all NHS
activities for patients in England
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