Organisational attendees

• Office of the National Data Guardian
• Understanding Patient Data
• Academy of Medical Royal Colleges
• NHS Frimley Integrated Care Board
• Information Commissioner’s Office
• NHS England
• Department of Health and Social Care
• Academy of Medical Royal Colleges
• Royal College of General Practitioners
• Healthwatch
• Royal College of Surgeons
• NHS Confed
• NHS England
• Patients Association
• Association of Medical Research Charities
• National Voices
• Nottingham University Hospitals Trust

Apologies received

• UNISON

Open actions and decisions recorded

Meeting notes

Welcome and introductions

The Chair welcomed all members to the call and noted any apologies.
Introductions of new members took place as well as noting any conflicts/declarations of interests.

Minutes and actions from previous meeting

The Check and Challenge members approved the minutes and actions from the last meetings on 20th September.

The chair took the group through the open actions.

NHS Federated Data Platform Programme Update

The Federated Data Platform Programme Delivery Director provided an update of the Programme. Including an update on product development.

The programme are celebrating recent achievements which includes the completion of the transition phase of the programme. All local sites that had adopted products ahead of the FDP programme have now transitioned onto the FDP infrastructure and integrated with the Privacy Enhancing Technology. These local sites are now also able to adopt new products as well as continuing to use the now standardised products that they have, as well as being embedded into the FDP Centre of Excellence which provides full training offers and support to ensure those sites continue to achieve benefits.

The programme has also transitioned all of the National Products from the National Data Platform into the FDP, this included all the vaccination products of which the COVID-19 Autumn/Winter campaign is now running on the FDP.

Following the completion of the transition phase of the programme, this means that the programme is now fully focussed on the uptake of new products and new sites. The programme has exceeded its’ target of 71 Trusts signing up to the FDP, with currently 87 Trusts and 18 ICBs currently signed up and the programme are working with those organisations through to onboarding. The onboarding process includes working with local IG teams to make sure they are able to complete their DPIA process and working with the organisations and their local teams to prepare them for the local business change process, particularly as we go into the Winter period. Support is provided to ensure organisations are able to adopt products and realise benefits, of which we continue to monitor.

The programme is also starting its’ 2025 planning. The FDP Programme Delivery Director shared an overview of the programmes’ five-year vision and includes key pieces of work taking place such as how the programme can use the FDP Solution Exchange to support local innovation, and starting to scope the opportunities in Population Health Management. For Population Health Management, the programme is working with local ICBs to understand their needs in this area as well as the programme forming a steering group to collect ideas from a number of experts across the NHS which will help develop that Population Health Management roadmap. The programme has agreed to bring back a more detailed update on Population Health Management at the next FDP Check and Challenge Meeting.

The approach the programme takes to developing all of its’ products is to work with local organisations to ensure programme teams and policy teams understand their challenges and how each of the products can be developed to support them. This is then taken through a traditional product development life cycle which enables incubation and development to happen locally. Pilots are then arranged with a chosen number of sites and specialties before the product is then reviewed and standardised to make it scalable and accessible for organisations to adopt.

The programmes current products; Inpatients, Outpatients, RTT, and OPTICA, have continued to be made available to all organsiations to adopt. In terms of incubated products, which are products currently being scoped and explored in one site before then being reviewed and standardised to enable a pilot to take place, there are a number of products in this phase which includes; Shared PTL, Patient Led Validation, Assisted Discharge Summaries, Diagnostic Imagining Schedular, Cancer 360, Timely Care Hub, and System Control Centre. Once a more defined roadmap is created for each of these incubation products, the programme will bring these back to the FDP Check and Challenge Group.

A member of the group asked whether any concerns had been raised regarding the assisted discharge summaries product and the use of large language models. This was in relation to doctors training in which going through case notes and writing summaries is an important learning process, as well as whether there are any thoughts on trying to assess wider longer-term impact such as patient outcomes. The FDP Programme Delivery Director agreed and assured the group that there is a focus on ensuring that the product is safe and goes through the robust product development process which has included undertaking discrete trials with junior doctors, and working with organisations such as the MHRA to understand whether it will be classed as a medical device. The FDP Programme Delivery Director advised that this product won’t be one to quickly go to being scalable and the incubation is a very small and contained testing. However, the FDP Programme Delivery Director acknowledged the need to include the impact on the learning processes for junior doctors into the evaluation process.

A member of the group reported that the list of FDP incubator products looked to be moving into the EPR area, particularly when considering ‘patient facing’ elements, and queried whether this has been a natural movement or a deliberate strategy. The FDP Programme Delivery Director confirmed that this is not a deliberate strategy, and the programme are keen to ensure that EPRs’ functionalities, and as a clinical record, is retained. The programme have been working with systems such as EPIC and CERNER directly to understand the functionalities and capabilities in their road maps which can help identify where there are limitations within the EPR as well as ensuring duplicative efforts and scope creep are avoided, whilst exploring integration and write back opportunity. The FDP Programme Delivery Director gave an overview of the Patient Led Validation product to give an example on collaboration with patient facing services and the NHS app. The programme is working on this as the first use case to see how patient led validation could be done via the NHS App. The functionality to do this via the NHS app is still in development and at the point it is available the programme can start to enhance patient led validation through that process. The programme have been working with the Wayfinder Programme to ensure integration and alignment for local organisations.

A member of the group asked about the level of engagement taking place with patients to ensure patient led validation initiatives and products that directly link to the patient are driving the right behaviours and don’t create unintended consequences. The FDP Programme Delivery Director advised that this product is in early development and the FDP team will work with the NHS App Team where appropriate to develop an approach to public engagement to ensure this element is captured and considered. The Chair of the meeting suggested that this could be brought to a future FDP Check and Challenge meeting to review pipeline products and identify where there is specific needs to enhance public engagement activities as part of the product development.

A member of the group asked where the intellectual property of the products sits for the NHS. The FDP Programme Delivery Director advised that any product that is incubated or nationally commissioned by NHS England, that intellectual property ordinarily sits with the NHS and that is across all FDP contracts. As the FDP solution exchange space develops there will be products being developed by suppliers in which case if the product is ‘off the shelf’ then the supplier would retain their intellectual property. The NHSE Commercial Team are developing guidance to ensure we are supporting local organisations to understand this process.

A member of the group advised that they had a couple of examples where organisations want to onboard data onto the FDP for a future foreseeable use and asked for clarification on the criteria for data to be inputted onto the platform. The FDP Programme Delivery Director confirmed that with any data processing of patient identifiable information, there is a need to ensure there is a legal basis and need to process that data. Organisations are asked to describe their need to process data and the reason for wanting to process data which then must be assessed, and processes followed to ensure the programme adhered to its’ legal obligation to ensure it is protecting data. The FDP Head of IG advised that if a trust or organisation with an instance of FDP had a specific use for data that isn’t already in the FDP or is in the FDP but they would like to use the data for a different reason then this would require the request to go through robust IG assurance processes including development of appropriate documentation, such as a Data Protection Impact Assessments, and going through FDP and NHSE IG governance forums to ensure alignment with the FDP IG framework.

A member of the group asked whether an organisation could use the FDP as a ‘data backbone’ for their organisation as this would create an unlimited foreseeable use of data. The FDP Head of IG advised that local organisations’ data warehouse system needs to have a lawful basis and purpose for being there in which the FDP aligns to this as an IG principle. The amount of data that sits within the FDP for an organisation will build up with the amount of products an organisation uses but the principle of demonstrating why an organisation has data, how it’s being used, and the purpose is still required to then apply a lawful basis. This is an IG principle for any data collection.

A member of the group asked if there is an impact on previous data collection and opt-out arrangements at the point of a data processing agreement changing. The FDP Head of IG advised that there hasn’t been a change of purpose for the products currently used in the FDP. Organisations are using the FDP as opposed to a system that they’ve already got in place which means data is already processed in the NHS in the organisations. Each product is reviewed by the IG process where it is assessed to attribute a lawful basis. The products presented in the meeting today, are aligned to the current use cases and have not changed the purpose of data processing which means there is not a need for public consultation. If a product was developed where there was a significant change to the purpose of data processing, then IG advice would be the need for a public consultation to ensure the public understand how their data is being used. The FDP IG Framework also supports this approach.

A member of the group asked the FDP Programme whether they felt that the public facing communications currently available are up to date and provide that level of clarity on future proofing that change in data processing purpose to secondary data processing purpose. The FDP Programme Director advised that as there is no current change planned the focus at the moment is making sure that products that affect the delivery of care are the priority, but recognised that as the roadmap develops and additional data processing elements are identified that may require an update it will be important to ensure there is clear messaging and communications for this. The FDP Programme Director took an action for the FDP Communications Lead and Head of IG to work together to start developing this and invited the member of the group to join to support in providing input before bringing back to the FPD Check and Challenge Group at a future meeting.

A member of the group advised that there is an ‘Artificial Intelligence (AI) in Health and Care Advisory Group’ that has recently been set up and is attended by different groups across DHSC and NHSE. The group are discussing areas such as national direction for AI Tools and how they are used in the NHS, as well as similar topics on the potential for AI to support in processes such as discharge summaries. The member flagged this group in case other members are interested and to ensure the FDP Programme are sighted.

Action: FDP Programme Team to bring a more defined roadmap for incubation products, to the Check and Challenge Group, once developed.

Action: FDP Programme Team to bring an update on product development at a future Check and Challenge Meeting to discuss where there is specific needs to enhance public engagement activities as part of the product development.

Action: Communications Lead and Head of IG to work together on future IG communications and invite FDP C&C member of the group to join to support in providing input before bringing back to the FPD Check and Challenge Group at a future meeting.

FDP Benefits update

The FDP Head of Benefits provided an overview to the group on the Federated Data Platform (FDP) Evaluation Plan.

The evaluation plan is a Government Major Projects Portfolio requirement overseen by the Cabinet Office Evaluation Task Force, which is a cross government body set up to promote and support the use of evaluation and ensure that evaluations are conducted on high investment products.

The purpose of undertaking an evaluation is to determine whether the FDP programme is meeting its intended outcomes and long-term impacts as outlined in the programme logic model; understand whether FDP provides value for money; and to capture the lessons learned over its life cycle. The outputs of an evaluation will aim to demonstrate and understand the impact the programme is having and will in the future, discern if its objectives have been achieved, capture key learning and demonstrate value for money and accountability to its stakeholders.

The FDP evaluation process is due to move into a pre-market engagement phase, due to commence on 11th November 2024, and the FDP Check and Challenge Members were invited to provide comments and feedback in preparation of this. The pre-market engagement stage will be liaising with a number of organisations experienced in undertaking evaluations to receive initial feedback and comments with an aim to understanding if there is enough information for organisations to submit a proposal to be the FDP’s Evaluation Partner.

The FDP Head of Benefits described the structure of the FDP Evaluation Plan in three main elements; Process, impact, and value for money. The FDP Evaluation Partner will support the programme to set up the methodology of the evaluation as well as provide an external independent viewpoint.

The FDP Head of Benefits provided an overview of the evaluation design over the lifetime of the FDP programme. Currently this is due to be a mixed methods approach based on a theory of change, and will include elements such as monitoring over time, retrospective analysis, and rapid cycle evaluation from the external FDP Evaluation Partner.

The FDP Head of Benefits highlighted key focus areas of the evaluation which included the need to understand outcomes and impact through the health inequality lens, as well as a population perspective, and ensuring unintended or unexpected consequences are captured.

The FDP Head of Benefits presented a current draft of FDP evaluation questions. The questions covered a range of areas and aligned to the three evaluation elements of process, impact, and value for money. The Check and Challenge members were asked for any immediate feedback or queries.

A member of the group asked if the evaluation will include the public’s experience of the FDP. The FDP Head of Benefits confirmed this will be included and agreed that this element could be brought out more in the questions.

The Chair commented that in terms of impact on people, there will be a need to be a direct piece of engagement done by the evaluator with patients connected to a use case or number of use cases. The Chair also advised on the need to recognise that the impact on health inequalities could be negative in the application of FDP tools, citing an example of how increased theatre utilisation can create opportunity for short notice availability for those with means to travel and with flexible working arrangements. The FDP Head of Benefits thanks the Chair for their feedback and agreed to amend wording in the questions to reflect.

The FDP Head of Benefits advised that it would be helpful to continue to bring this piece of work back to the FDP Check and Challenge Group as it progresses. The Head of Benefits agreed to circulate the evaluation questions to the group for feedback by 1 November 2024.

The FDP Head of Benefits assured the group that although the FDP Evaluation Plan is a new activity, the programme has built in evaluation as a cross cutting theme throughout its’ workstreams. The FDP Head of Benefits provided an overview of current FDP programme evaluation activities taking place which included activities such as triangulation of output and outcome metrics, pre and post deployment comparisons, real-time monitoring of benefits and monetisation of benefits, statistical analysis, and evaluation activities as business as usual.

The FDP Head of Benefits presented the overarching logic model for the FDP Programme evaluation but agreed to circulate this to the Check and Challenge Group for review and any further feedback. The overarching logic model for the FDP Programme evaluation is split into five areas; inputs, activities, outputs, short term outcomes, and long term impacts and benefits.

The FDP Head of Benefits provided an overview on the next steps, which includes the commencing of the pre-market engagement on 11th November 2024 followed by a procurement process.

A member of the group commented that they welcome this process, and advised that the balance of intended and unintended consequences is really good, and they look forward to see how this progresses.
Action: FDP Programme Team to circulate FDP Evaluation approach and overarching logic model for feedback to be provided by 1st November 2024.

Action: FDP Evaluation to be brought back to a future Check and Challenge Meeting for an update.

FDP experience overview

The Director of Continuous Improvement across University Hospitals of Northamptonshire provided an overview of their experience in implementing the Federated Data platform.

The University Hospitals of Northamptonshire joined the IECCP (Improving Elective Care Coordination for Patients) pilot in January 2023 which started with the implementation of the inpatient trust CCS (Care Coordination Suite) Product. Since that time the University Hospitals of Northamptonshire have implemented inpatient CCS, RTT (Referral to Treatment) validation, Outpatient CCS, and are in the planning stages for implementing OPTICA. In addition, as an incubator site, the University Hospitals of Northamptonshire are supporting the incubation of three products; radiology productivity, shared PTL (Patient Tracking List), and prevention programmes for population health.

The Director of Continuous Improvement at University Hospitals of Northamptonshire provided an example of the implementation of FDP within theatres.

Key presentation points included:

• Prior to implementing the FDP, the Trust experienced challenges in theatres such as not having enough data, for example to help identify where to increase session utilisation, or the data being too difficult to access, for example rotas for difference medical staff held in different systems as well as theatre management system held separately.
• With the implementation of FDP, this has provided; easy visibility of key waiting list statistics, single patient list with all relevant details to support waiting list validation, management of clinical prioritisation and requests for booking patients, and visibility of theatre session management to review upcoming theatre sessions, check patient details, and identify additional booking actions to be taken.
• Key benefits from using the FDP has included:
  • Supporting the running of the 6-4-2 meetings in which emails and spreadsheets are no longer used, with all actions directly captured in the tool.
  • Estimation that the FDP has saved the theatre booking team approximately 1 day a week per theatre in managing the administration of the 6-4-2 meetings.
  • Theatre utilisation increased by 13.1% post-implementation, with 8% more patients operated on, with increased consistency in utilisation rates.
  • Reduced cancellations by 29% by having better visibility of key data.

Additional lessons learned included:

• Aligning the implementation of the FDP to a transformation programme makes sure that the transformation sticks, sustains, and that ways of working of teams are transformed.
• Engaging and working with the administrative teams is critical.
• Configuring flags to be meaningful for the teams and getting the right people involved is critical.
• Be clear on the governance and how the tool will be used (i.e. FDP tools being embedded in the operational management processes and not considered an ‘extra’).

The learning from theatres has supported the implementation of the RTT validation tool which was implemented quicker, and is demonstrating benefits such as supporting the running of Patient Tracking List Meetings, saving approximately 2 days a weeks of teams managing waiting lists, and teams accessing a single source of data.

The Director of Continuous Improvement at University Hospitals of Northamptonshire provided an overview of the implementation of the Outpatient CCS product. By piloting the tool the organisation was able to identify challenges in data quality and appropriate pause the implementation to focus on elements such as waiting list data and clinic template reviews. The FDP Team have been supporting the clinical template review. The FDP team have also been reviewing the Outpatient CCS products with a number of Trusts to identify opportunities for improvement, including the potential to include a clinical template review module.

The Director of Continuous Improvement at University Hospitals of Northamptonshire provided a quick overview of the incubator products currently being developed.

The Trust are working to develop a shared Patient Tracking List across University Hospitals of Northamptonshire to cover outpatient and inpatient waiting lists. The development of the products aims to include; a standardised route for Inter-Provider Transfer that is scalable across specialties, ensure clock stops and starts for patient transfers reflect national reporting, capture data to demonstrate benefits around waiting times, manage planning, approvals, and tracking of transfers. The aim is to provide a single view of the waiting list and support the administration and management of inter-provider transfers. Testing will begin shortly following Information Governance approvals.

The Trust are working on a smart scheduling tool to improve productivity of the diagnostic imaging workflow. This includes exploring opportunities such as artificial intelligence (AI) driven scheduling, automatic appointing scheduling, and assisted list scheduling. The product is being developed across both Hospital Sites and the team are very excited about the difference it will make to be able to book and manage appointments in a way that works better for them and for their patients.

The Federated Data Platform Programme Director thanked the Director of Continuous Improvement at University Hospitals of Northamptonshire and noted that the FDP Programme Team have enjoyed working with the Trust and value the support the Trust are providing in helping the programme identify areas of improvement. The Federated Data Platform Programme Director noted that this is the same for other Trusts who are currently in incubation phase and provide both a technology and improvement lens which is really important to ensure the focus is also on how quality improvement can support the frontline.

A member of the group asked if the Director of Continuous Improvement at University Hospitals of Northamptonshire had seen an impact on income. The Director of Continuous Improvement at University Hospitals of Northamptonshire advised that there has been 8% more patients in theatre and the trust are currently over performing on their ERF (Elective Recovery Fund).

A member of the group advised that they had received similar feedback from Trusts on how data quality issues can impact on the Outpatient CCS product and reflected the positive steps NHS England are taking to support Trusts to resolve this. The member asked when the review on data quality will be completed and the changes to the Outpatient CCS product will be known. The Federated Data Platform Programme Director advised that this work is ongoing at the moment, with collaboration with IG and policy colleagues as a wider NHS England initiative, but the team will look to provide a timeline to the group.
The Chair thanked the Director of Continuous Improvement at University Hospitals of Northamptonshire for their presentation and asked whether the FDP has been an enabler to helping ‘surface’ data quality issues to address. The Director of Continuous Improvement at University Hospitals of Northamptonshire reported that it has helped in the waiting list space as it is much clearer to see where there are data quality issues to fix. In the Clinical Capacity space as it is currently configured, it hasn’t, but the FDP Programme Team have supported in surfacing that information and will be part of consideration on further product development.

A member of the group asked whether the learning and identification of data quality issues is being shared with local organisational teams. The Director of Continuous Improvement at University Hospitals of Northamptonshire confirmed that this is being shared with local teams and NHS expertise on data quality is being sought through local teams and support teams.

A member of the group asked how the Inpatient CCS Tool captures Surgeons and Anaesthetists competency considering differences in pace of work. The Director of Continuous Improvement at University Hospitals of Northamptonshire advised that the tool uses a Consultant and Anaesthetist pairing average over a rolling 12-month period. The tool doesn’t include Nurse Groups as there has been little evidence to suggest substantial variance.

Action: FDP Programme Team to provide an update on the NHS England Data Quality review timeline.

Any other business (AOB) and close

A member of the group advised that there is an evolving media article regarding the use of data in Biobank.

The next meeting is due to take place on Friday 15 November.

The chair thanked all for their attendance and closed the meeting.