1 cohort management and the secondary uses service (sus) nirupa dattani office for national...
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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
• Deaths• Name changes• Immigrations• Enlistments to armed forces• Adoptions• Entry into Service Medical Officer Care• Cancer registrations
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Cohort management using NHSCR (3)
CHRIS record contents
• Surname and forename(s)• Sex• Date of birth• Health authority and date of registration• Date and place of death• NHS number
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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 non-
patient 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
• Payment by results• Benchmarking and performance assessment• Public health activities• Patient safety activities• Research and development
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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