Quality data can reflect what is happening in community health services, identify the gaps, and take an informed, system-wide approach to improving patient outcomes.
The pandemic brought community providers into sharp focus, as clinical leaders stepped up community services in support of the overall NHS response to help prevent the service from being overwhelmed. The value of community services, with its workforce of around 120,000 whole-time-equivalent staff, undertaking 75 million care contacts in 800 provider organisations, with a total annual spend of £6.2 billion, was made visible.
The rich diversity of services in the sector is amazing and is supporting people to live their best lives in, or very close to, the place they call home.
As a physiotherapist working many years in the community, I have seen the benefits the sector provides day in day out, and throughout my career I have worked with data to improve services. I moved into NHS England to transform community healthcare.
Identifying the gaps
To achieve this, we need to be confident that we know where the gaps are, especially with health inequalities. Where are some people not getting what they need? Where are the backlogs and why are they happening? Where’s the quality practice? How do we know if a service is effective or not? Where is the risk?
We need a data architecture that minimises burden on providers and which can be used to visualise data that reflects what is truly happening in community health services
To answer these questions fully we need data, and good data. We need a data architecture that minimises burden on providers and which can be used to visualise data that reflects what is truly happening in community health services in near real time.
We need national data to support the sector to achieve its fair share of funding and understand variation.
Linking data to show the patient journey
Most importantly, we need to link data to understand the patient journey through the whole system. This allows us to work as a system rather than a group of disparate parts.
Acute trusts and primary care have a much better understanding of their sector because the national data is better, and this puts them at an advantage when it comes to demonstrating their impact.
In NHS England, the community transformation team is working to better understand community services, so we can clearly demonstrate what we do and the outcomes for our patients and wider system.
System-wide ‘data lakes’ are popping up that draw data from providers across the system to show a system-wide picture of health activity
The essential part of this goal is to work closely with providers, commissioners and other stakeholders with an interest in community (of which there are lots!). Some systems have incredibly impressive access to data, which they build into their improvement plans. System-wide ‘data lakes’ are popping up that draw data from providers across the system to show a system-wide picture of health activity, and demonstrating it is possible to map individuals’ journeys through healthcare. Others may not yet have that capability, but we see and hear about the appetite to change this all the time and we’re working with systems to change the landscape.
We now have an extremely useful baseline for the sector, which for the first time ever gives us an excellent understanding of what community services are made up of nationally. We have also been working to significantly improve the community services data set to extend its reach across all large providers.
Exploring new approaches
We are exploring new data approaches, one being data extraction from community provider systems to lower the burden of data collections while delivering daily, useful, accurate and linkable data. Several providers are involved. Already we have shown that daily patient-level data can flow and be available to us nationally as well as locally for providers.. Feedback from providers is positive, as they are seeing the potential to use this data to improve patient care.
We continue to work at pace to level up community health data and ensure the sector gets the support it needs to make further progress.
Another key priority this year is the national expansion of virtual wards and we’re looking at what data is required to support these important developments.
To further test and scale up data solutions, we’ll be talking to community providers and systems more and more about this work. We need to develop these solutions together in our respective organisations at system, regional and national level. If you’re a system or provider who’d like to be involved in this work, please get in touch: firstname.lastname@example.org
Alex Thompson is assistant director for community health service data transformation at NHS England. You can follow the NHS England Community Health Services on Twitter @NHSEnglandCHS