How data analysts began a culture change for the NHS

Adam Millican-Slater, Population Health Management (PHM) programme manager at NHS England, explains the crucial role analysts have in spreading culture change by bringing Population Health Management to the front line.

With more than 100 data analysts from across local Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) now working on the Population Health Management programme it’s a great moment to reflect on how these skills and enthusiasm are improving patient care.

At its heart Population Health Management (PHM) is about using data and analysis to drive change in the way health and care services are delivered so the people we serve receive better care and better health outcomes and the system can remain sustainable.

We often say PHM is 10% data and 90% culture to capture the importance of seeing data as a catalyst for improvement rather than an end in itself, but let’s be clear, that 10% is essential – if you’re not using data and analytics you’re not doing PHM.

We are at a particular moment right now, with a general move towards increased integration of the health and care system and an on-ongoing digitisation of the NHS.

This is leading to the development of linked data sets that have the potential to revolutionise the way care is planned and delivered, moving the focus from treating disease, to treating people and learning to intervene earlier to reduce the risk of worsening health.

The data and analytics are essential to PHM but not, on their own, sufficient to drive the integration we hope to achieve. This is where the 90% culture change comes in – if you’re not trying to improve the way care is delivered, you’re also not doing PHM.

We should be careful though not to fall into the trap of thinking analysts do the 10% and other groups the 90%. Taking full advantage of this new resource will not be possible without analysts working shoulder to shoulder with care professionals and managers to work out how to use the data to create new insights that drive action.

I’ll be running a webinar on actuarial analysis on Thursday December 5 (12.30pm – 2.00pm) which we’d encourage you to join– it’s a key tool for analysts, commissioners and financial planners to help us move from managing patients and resources in a single organisation to how we can manage and mitigate risk across a system.

It’s helping us to understand what’s driving health risk in different population groups and predict demand and financial risk in different care settings – and importantly how local primary, community, secondary care providers and local councils can work together to integrate care and develop new proactive anticipatory care models for these population groups which tackles these risks and addresses some of underlying causes (the wider determinants of health).

When I worked as an analyst, one of my biggest frustrations was producing regular reports which were mandatory but often seemed to disappear without trace giving me very little satisfaction for how I could have any real impact on people’s lives with my skillset.

PHM asks everyone in the system to stop thinking about data as something that needs to be reported upwards and to start thinking about it as resource for identifying opportunities to minimise the risk of people becoming ill in the first place.

This needs that change of culture to happen both within the analytical community and in other staff groups of the NHS.

For analysts this is not just about using new techniques, but also finding new ways to work with care professionals and managers to understand how data and analysis can inform decision making.

This means listening to the needs of those who use our analysis and being ambassadors to others within our organisations for how PHM works, what it can do and the impact it can bring to people’s lives. It means finding the others in the system who are interested in using this approach and developing networks across organisational and professional boundaries.

One great way to find out more about PHM and potentially connect with other people in your system is to join the PHM Academy to see the updates, case studies and the discussions that take place.

Just having linked data starts to change the conversations in Primary Care Networks and systems – instead of talking about organisations they’re talking about patients and they need us as data analysts to be the catalysts.

We couldn’t be more crucial for that culture change and the challenge for STPs and ICSs will be exploring how to re-orientate some of these crucial intelligence teams and the insight they develop towards primary care providers rather than the transactional reporting which many are currently busy with.

Once we’ve helped colleagues understand the analysis we can then pass the discussion onto the next stage. The data will never be enough on its own as there will always be some information not quantified, but our clinical colleagues will be able to use their professional judgement to design interventions that will work to prevent illness and support wellness in different cohorts. Read more about how the interventions are influencing people’s lives.

Of course, each area is at a different stage of development in using PHM techniques, those systems on the NHS England PHM programme have learnt or are learning the techniques. Some areas have not yet begun the journey. Where is your organisation on that map and could you get involved in spreading the potential?


Adam started his career as a statistician in the Department of Health working on a range of areas including patient experience, workforce and the 18 week target. He has since moved into more general roles in NHS England and Improvement, though maintains an interest in the role of analytics in driving improvement in the health and care system. He currently works in the Population Health Management Support team in NHS England and Improvement.

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