'Merits of sharing both NHS and private data': a blog by Mr Ken Anson.
When I first saw my NHS data alongside my private practice data, I almost fell off my chair – I was stunned. It has become apparent, very quickly, that transparency is happening in private healthcare and the Private Healthcare Information Network (PHIN) is driving this forward following the CMA ruling. Also, it came as a huge surprise to me that PHIN is able to align their private outcome data with large volumes of NHS data as well. As a result, data quality standards within both healthcare systems are being aligned at the consultant level, allowing individual practitioners visibility of their whole practice on one digital platform for the first time.
The process of reviewing my practice data from PHIN raised some interesting questions for me, such as why is the first time I’m seeing my NHS data alongside my private data, and perhaps more importantly, where is the NHS data coming from? I explore these issues a little later, but I am in no doubt that the provision of whole-practice data on PHIN’s platform represents real progress in driving transparency and improving access to information for patients.
From the outset it is important to note that consultants in everyday practice in the NHS live and breathe transparency; we have a duty of care and a duty of candour and are expected to inform all aspects of healthcare with patients at every opportunity. We are now part of a process of engaging with PHIN to sign-off our private healthcare outcome data for publication to allow private patients access to a similar level of information that NHS patients enjoy.
The idea of whole-practice data isn’t revolutionary to me; I know my numbers, and I love the work that I do, so there were no surprises in the data that I first saw in my activity report. However, it is the first time I have seen this data provided in such a clear and compact format, and what is revolutionary is private practice clinical and outcome information publicly available for patients and outside agencies to monitor and audit in the future. This is a hugely important development.
The importance of publishing health outcomes to provide some measure of quality is likely to have a significant impact on patients and possibly on consultants’ activity. Whilst data alone doesn’t change one’s practice, how the data are interpreted and acted upon can drive changes in behaviour. For example, I was somewhat surprised to see that one of the initial data points (i.e., length of stay) was slightly longer than I had thought. To then be able to analyse and interpret that information down to the individual patient provides a fantastic level of insight and allows me to reflect on my practice and see if I can effect changes to improve my practice. Visibility of whole-practice data will also be very beneficial for consultants for both annual appraisals and re-validation. As PHIN proceeds to explore publication of further surgical outcomes measures over time, the greater the value of this information will prove to be for surgeons and patients alike.
Having said all of the above I predict that this initial sign-off and publication process by PHIN will prove challenging for many of my consultant colleagues. Some will question the validity of their NHS HES data and will no doubt comment on the fact that in most centres around the country individuals do not have the opportunity to check or validate their data before it leaves their Trust. Others will question why PHIN should be the organisation to publish whole practice data. Ultimately, it will be up to individuals whether they want to include their NHS practice alongside their private practice when approving their indicators with PHIN. However, in my opinion, HES data does provide a sufficient indication of NHS practice to justify it being included alongside PHIN’s private practice information. PHIN is working to meet a government mandate and is moving the sector forward quickly. The information published earlier this year will be just a starting point. This will provide consultants with a fantastic opportunity to initiate a virtuous circle – the more we get involved with our data, the more accurate the data will become, and the more time will, therefore, be saved in its validation – all which will ultimately and positively impact on our workload and patient safety.
My experience thus far has been that engaging with PHIN has been an easy and straightforward process. There is a remarkable level of data being made available for sign-off, and I have been pleasantly surprised by the quality of the initial private healthcare practice information being provided. Bringing both NHS and private datasets together into one place is immensely attractive to me for the reasons outlined above. I would encourage all consultants working in private practice to get behind this initiative which may well prove to be the source of all our whole practice data in the future.
Mr Ken Anson is a Consultant Urological Surgeon and Reader in Urology at St. George's Hospital, London. You can find his profile here.